Breast Reconstruction and You: Let’s Discuss Mastectomy and Reconstruction

My Fabulous Boobies writer and breast cancer advocate Nicole McLean kicks off our Breast Reconstruction and You Blog Series in anticipation of our Twitter Chat on October 21, Breast Reconstruction Awareness (BRA) Day. A version of this post appeared on her blog in October 2012. It was reposted with her permission.

Sex and Intimacy_Nicole McClean

Hello boys and girls. Today we’re going to discuss mastectomies and breast reconstruction. Don’t look at the screen that way… I’ll keep it easy. I promise.

I’ve attached a picture to this post of two women who are survivors. The sister in the first picture is posing with so much sass, and showing off her mastectomy scar. The second picture is showing the scars from a breast reconstruction surgery. I selected these two pictures because these two women represent me.

My Mastectomy Story

Four months after I started chemotherapy, I had a modified radical mastectomy.

Definition: a mastectomy is surgery that removes the whole or as much of the breast tissue as possible.

There are different types of mastectomies, but basically the purpose of a mastectomy is to remove the cancerous breast from the body in order to prevent the spread of the cancer to other parts of the body. It is (in my understanding) a life-saving measure.
I struggled for months to accept losing my breast. I could not grasp the concept that I had to lose a part of my body in order to save my life. However, because of different things about my cancer, as much as I wanted to save my breast it was not the best course of action.

In my case, I had multiple tumors in my breast tissue. At least one tumor was very, very close to my chest wall (which meant that it was close to my bones). And a biopsy revealed that the cancer had started to migrate away from the breast and had entered my lymph nodes (which meant that if it was not caught at that time, it would have entered my blood stream and could have ended up in other organs). So after debating with my medical team and pleading with God for some other option for months, I eventually accepted that losing my breast was the best course of action for me.

Each Survivor Has a Different Choice to Make After Their Diagnosis
Not every survivor has to face this decision. Some survivors do not have to have any breast surgery. Those cases are caught very early (perhaps from a mammogram or some other test that reveals cancer cells) and they are handled with chemotherapy or radiation (or both) without surgery.

Some survivors are eligible for a lumpectomy, which is a breast-sparing procedure that removes just the cancerous tumor and leaves the majority of the breast intact. I wasn’t that fortunate.

[insert advice here:  This is why being proactive about your breast health is important. The earlier the cancer is detected, the less invasive the treatment is and the higher the likelihood that the cancer can be removed completely.]

Now, Let’s Discuss Breast Reconstruction – I Chose a TRAM Flap Proceduremastectomy photo

The picture to the right shows a woman after she had a mastectomy. The second picture is a sister showing her reconstruction scars and her reconstructed breast. There are a lot of ways that a woman who chooses to have her breast replaced can do that. She can have implants. Or she can choose to have reconstruction that uses her own body tissue (like I did) to reconstruct a breast. There are a few different types of procedures that utilize your own tissue. The surgery I had was a TRAM flap.

Definition:  TRAM flap (transverse rectus abdominus muscle) is a surgical procedure that creates a new breast mound using tissue from your belly that is tunneled under your abdominal muscles and up to your chest.

The procedure is very detailed and requires a lot of surgery. But, it is a one-shot deal. Meaning, unlike breast implants, you do not have to have several procedures before your breast is done. I went into the hospital with one breast. I came out of surgery 12 hours later with two. It is not the same way for implants. However, with implants, the surgery is not as invasive and it works if you are not a candidate for a flap procedure.

Life after the TRAM

As you can see from the picture, there is a long scar that stretches from hip to hip along your bikini line and then there is a large scar around the breast. You will also notice that there is no nipple and no areola either. Lemme tell you… the first time I looked at my noobie (noobie = new boobie) I was not prepared for the Barbie-like look. (laughs) However, in all honesty, the option for what amounted to a tummy tuck at the same time I’d get a new breast was sort of the selling point for me.

You can laugh… yes I’m vain like that. And I’ve been pretty happy with my flatter tummy too. My theory was… if I’m going to lose my breast, get kicked into early menopause and lose my fertility… at least I can be gorgeous after its all said and done.

So, there ya go. Now you know the basics about losing a breast and gaining a new one. There are a lot more details that I could go into but… I’m trying to take you slowly so that you’re not overwhelmed and freaked out. (laughs) But this is it.

Why I chose the TRAM flap
I spent 10 months with one breast. I was miserable as hell about it. I felt like a lopsided freak. Even though I eventually came to accept it. I never liked wearing my prosthesis. I hated that even after I purchased the largest prosthetic breast I could find, it still was significantly smaller than my natural breast. I hated that I had to stuff my bra with the prosthesis to try to look even. And I hated that I had to have a breast reduction so that my natural breast was the same size as my noobie. I know… that’s a lot of hate right there. But its true. I fought and dragged my feet through all of this. But, now that I’m on the other side… I’m so much better about all of it. And… I can wear a bikini now. (laughs)  It is the little things in life that make me happy. I have about four bikinis now — before cancer I would be hard pressed to even put on a bathing suit. I will probably have many more before its all said and done.
I’m not suggesting that wearing a bikini makes all of this worthwhile. Because, well, that would be silly. But I am telling you that life does go on and you can reclaim some of your self-esteem and walk into your new normal with a happier outlook. for me, it was important to have two breasts. For some women it is not. Some women opt to remove both breasts. Some women opt to never replace their lost breast. It is a very personal choice and journey. There is no right way to do it. You have to do what works for you.

Tweet about breast reconstruction with Nicole and our panelists on October 21. 

2 thoughts on “Breast Reconstruction and You: Let’s Discuss Mastectomy and Reconstruction

  1. I am where you were at. I had a mastectomy in March. I just finished chemo (WOO HOO) and getting ready for radiation. I’m thinking about my reconstruction and just getting info and thoughts. Will they perk up the unaffected breast? Is the tram flap working out for? I’m leaning that way. Thank you for any thoughts you have. Congratulations Survivor 💟:)

  2. Pingback: Breast Reconstruction and You: Everybody’s Doing It, So Why Don’t We? | Living Beyond Breast Cancer's Blog

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