The DIEP decision
The breast surgeon looked me calmly in the eye and reported that I had not one but three small lumps in my left breast. She suggested that in making the decision to have it removed, it would be reasonable to opt for having a bilateral mastectomy. I decided then and there to proceed. Driving away from the appointment on that gray-sky January day, hurrying back to work, I remember saying to myself, this is me going into shock.
As the shock spread to other body parts, including my brain, over the next few weeks, I recognized that I was shut down, in no condition to start researching the options for breast reconstruction prior to the looming mastectomy. Still I tried. I went to a support group. I surfed the net, sifting through wildly various personal anecdotes and professional websites. In shock, nothing sinks in. I met with a plastic surgeon on the day of an ice storm, skidding into the frozen parking lot after the office opened late. I was sure I didn’t want silicone breast implants. I came firmly to my low-tech decision: I would not embark on being a plastic surgery patient with reconstruction until I recovered from the cancer surgery.
During the next two flat-chested years, I recovered from cancer and regained my physical fitness. I faced the existential dilemma head on. The feminist, humanist, Buddhist part of me truly believed that I was worth more than my body parts, that I didn’t need breasts. I adopted the Downton Abbey look. I tried prosthetics - hot, sliding around and uncomfortable against the wounds - and eventually skipped them entirely. I wore colorful scarves to minimize other people’s discomfort. I secretly enjoyed swimming miles at the pool without the extra ballast and I got back to relaxing in the hot tub. The freedom from having breasts was evocative of an innocent, pre-pubescent time of life, both girlish and boyish. I looked for other women like me and never saw a single one. Men politely made a lot of eye contact. I convinced myself that everyone looked but no one really cared whether I had breasts or not. But I soon came to learn that I did, I cared.
One sunny day I took the ferry to Fire Island with my friend and we happened upon a big party tent where there were preparations for an event. The handsome gay guy at the front table ignored my friend as we passed by gawking, but smiled and offered me a free pass to the back of the tent, where he said I could pick out a costume for the upcoming parade. Puzzling as I was on the windy ride back - what was that about? - a plausible explanation blew into my thoughts: he didn’t know whether I was a male on my way to becoming a female, or a female on my way to becoming a male. It was really the only time I felt someone’s sympathy towards me in public, someone able to recognize and acknowledge the profound difficulty of it all. Being breast-less was shifting, misty moment on the tumultuous sea of sexual identity.
The difficulty increased rather than faded. I answered a follow-up questionnaire at the breast surgeon’s office, with a simple remark “I am sad without breasts.” It triggered a call from the Social Worker - newly added to the Breast Health team - and when I met with her I burst into tears. Something powerful and profound about femininity and my identity with my own self was in turmoil. I started to research reconstruction options. What had been unthinkable two years earlier, the DIEP flap procedure suddenly looked obviously smart. My own tissue moved from belly to breast, help with my body, nothing artificial. I called seven different plastic surgery practices before I found Dr. Jonathan Bank and Dr. Peter Korn. Mollie Sugarman, the Clinical Director of their Patient Empowerment Program, helped me talk it through. I scheduled the procedure on the same day I interviewed them.
The reconstruction surgery is now six months in my rear-view mirror. The deep psychological relief and satisfaction I feel is worth every ounce trepidation, pain and exertion of recovery I experienced. Feminism, Buddhism, and rebellion intact, I now also have beautifully conforming and lovely breasts, and a surprisingly flat stomach. I hear myself saying, this is me, healed.