Monday, July 25, 2011

Reconstruction Project

Let there be plastic surgery, boobies, ta-tas, and tummy tucks.

And lots of envy.

Some people envy me because of that glam cancer thing. After all, I was transformed -- through the miracle of plastic surgery --  into a bionic woman of sorts, a superior version of my pre-cancer self.

Here's how the reconstruction project played out:

In The Beginning There Was Lumpectomy

The biopsy reveals I have breast cancer in my right breast, so my doctor lets me "choose" between a mastectomy or lumpectomy. He beams because I "choose" lumpectomy, or a "breast-conserving" procedure. I've never been vain, but dammit, I want to keep my breasts.

As a result of the lumpectomy, there's distortion, but I can live with it.

The lab results come back, and it shows that there are dirty margins. I need a re-excision ASAP.

Lumpectomy #2. Now the surgeon is going to gouge out more breast tissue to make sure the margins are clean. I'm all for it; I want the cancer gone from that site. And he takes a nice chunk this time (and my breasts originally were not that large to begin with!), rendering my right breast completely deformed. No bras fit right anymore, and I leave bra shops in tears. I feel horrible about my body.

Lumpectomy #3. Fast forward five years or so. An MRI reveals there is a growth in that same breast. The surgeon takes another really huge helping of breast tissue out. Lucky for me, the "growth" is scar tissue; unlucky for me, I feel so mutilated, I wish I could rewind to Lumpectomy #2.

At this point I insist on a double mastectomy due to my breast cancer history, my dense breasts, the possibility of more scares, and because I am sick and tired of watching more and more chunks of my breast being taken from me.

My surgeon believes otherwise; you see, he is a breast conservationist.

So I fire him.

And then I fire a bunch of doctors who agree with him.

Then my wonderful oncologist and primary care physician agree with me. I find doctors who agree with me.

I get a double mastectomy (a DIEP flap specifically, which involves the surgeons moving fat and minimal muscle from the belly up to the breasts, plus rerouting the torso's circulation a bit, so there's blood flow to the breasts). The surgery takes 10 hours, and it takes me 10 weeks to recover, and a year to feel more like myself.

Now I have scars -- I mean scars -- and created nipples that look nothing like the ones I was born to have. My new breasts look good, especially the left one. The surgeons did the best they could with my right breast, but with all the lumpectomies and radiation, well....

Oh, and my tummy "tuck" is really a tummy bulge that hurts all the time and causes me a lot of back pain.

Don't get me wrong. I am grateful to all the wonderful doctors who tended to me. Even the first surgeon was especially kind to me during my biopsy. I am grateful for the bra specialty shop that sold me bras that fit, as well as a great prosthesis for my right breast.

I guess when I hear the words "plastic surgery," "boobies," "ta-tas," and "tummy tucks," I tend to get a tad angry.

Just a tad.

This posting is an excerpt from my upcoming book, Calling the Shots: Coaching Your Way Through the Medical System. To obtain these excerpts regularly, please subscribe to this blog by clicking the orange subscribe button. I am a professional writer and have published numerous academic and magazine articles, as well as an essay on my breast cancer experience in the anthology Voices of Breast Cancer by LaChance Publishing. I can be contacted at and


  1. You make a terrific point, Beth. It's very difficult newly diagnosed women to grasp the innocent sounding "lumpectomy."

    To me a lump - is something the size of a melon ball. Clean margins around that and a smaller breast? Then yes, you conserve the breast but you've totally lost symmetry.

    Good points -

  2. Oh, know how I feel about this whole subject. Sigh. Can't believe that idiot surgeon did 3 lumpectomies. And they call that "breast conserving." Yeah, right. Hugs.

    Can't wait for your book.

  3. Beth, Great post about the reality of it all. It's hard for me to imagine going through the lumpectomy thing three times! And then the bilateral and reconstruction. And then the healing and the scars and the pain. And then... It does go on and on doesn't it? Nothing about this is simple or easy and it certainly isn't anything for people to envy.

  4. Thanks, Jody, for your response. Yes, "lumpectomy" sounds pretty harmless. Sometimes it goes well, but other times it is more deforming than anything. Yet I can't say I should've gotten the mastectomy in the first place because the innovative DIEP flap really wasn't around then, so I would've had a more invasive tram flap.

    BTW, thanks for RT this blog posting, and the #BCSM dialogue last night was terrific!

  5. Kathi, thanks for your support. Yes, it went from breast conservation to breast deformity. And that wreaked havoc with my psyche.

    I'm in the final revisions (hopefully) for the book. Basically, it's a primer how to take the reins in one's own medical care, even if that means firing doctors.

  6. Nancy,

    Yes, after three times, lumpectomies do get rather tiresome. I had made the decision for the double mastectomy after the third lumpectomy and scare. I had had enough. When it comes to this sort of thing enough is enough.

    And you are right; it never ends....physical reminders and psychologically.

  7. Beth, When the surgeon said they didn't get clear margins & wanted to take another "ice cream scoop," I said there wasn't enough to tolerate another scoop so take the whole thing. Actually I wanted them to remove both breasts, but 7 years ago was told no because the other breast was a perfectly viable organ! Four years later, when I tested positive for BRCA2, I had the other one removed & beat breast cancer to the punch.

    Scars, deformity, symmetry problems, not to mention fear, anxiety and finances. Only those of us who've been through this really understand, and yes, it never ends. Never!

    Looking forward to your book. Let me know. I'd love to read it, blog about it and add to my site to sell it.


  8. Beth, Also, am finally adding a list of great BC blogs & am including yours. Would you add my blog to your list as well?


  9. Brenda,

    First of all, congratulations on your voice being heard in that USA Today article! That's truly terrific.

    I am adding you to my blog list. Thank you for including my blog on your list!

    That's so sweet of you regarding my book. I'm trying to finish it this week. We'll see!

    Your experience was a lot like mine, except I didn't have a BRCA mutation. When I was fighting for my double mastectomy, doctors would say how my left breast was "normal" and I countered with, "How do you know that?" Sure enough, after the double mastectomy, a biopsy showed my left breast was loaded with precancerous cells.

    Eerie, huh?

  10. I am having a "lumpectomy" on August 5, which is actually a partial mastectomy. The surgeon will take considerable tissue around the mass but not the whole breast. I am all about research and have thought about the whole mastectomy thing. However, I really like my doctor. His research has focused on increasing MRIs and decreasing re-insition rates. He himself talked about insurance companies paying over and over again for re-insition. For some doctors breast cancer is a money making business.

    Thank you for your blog.


  11. You are welcome, Ana. Good luck with your surgery.

    My surgeon was actually an excellent one, and he believed in breast conservation. For my first lumpectomy and second one I agreed with him -- I was a breast conservationist too. But by the third, I was tired of doing this whole lumpectomy thing.

    It's really a personal decision -- lumpectomy, mastectomy, and all we can do is make the best decision we can at the time.

    Thank you for taking the time to read my posting and comment.

  12. Beth, excellent post! I never went through breast reconstruction, but I did have a lumpectomy with dirty margins and they said they would have to remove the whole breast if they took out more margins. I opted for radiation and then got cancer back in that breast. So I "chose" a double mastectomy like you. I am fascinated to read what the reconstruction experience was like for you, and proud that you fired a doctor! I may have to do that, too!

    Congrats on your new book coming out. It will be a dandy.