Speaking of vanity, here's a sentence I never thought I'd utter: I met with my plastic surgeon last week. It was a consultation so that he could get an idea of what I look like now and go over my reconstruction options down the road. As he examined me, he said in all seriousness that he could "undo everything motherhood has done," and - at the very least - "they'll look better than they do now."
Also, I thought, my fake boobs won't be trying to kill me, so it's a win-win all around.
My surgeon explained that there are three primary choices women have when considering reconstruction: immediate implants, done at the time of the mastectomy; expanders placed either at the time of or post-mastectomy and later replaced with implants, an option that sometimes also requires a follow up skin graft surgery; or the non-surgical option of prosthetics worn in pockets sewn into bras.
Since 1998, insurance companies have been required by federal law to cover whichever option a woman and her medical team chooses. Congress reasoned in part that reconstruction restored a woman's "wholeness," both physically and mentally, following a mastectomy. Senator Dianne Feinstein argued that it is a reconstructive - rather than cosmetic - procedure, god bless her.
Have I told you I made the mistake of googling "mastectomy scars" early on in this cancer process? The images were raw and - for me, anyway - gut-wrenching. If you dare, David Jay's The SCAR Project takes a provocative look at survivors. Seeing those images, I am so grateful to Ms. Feinstein that I have reconstruction options.
Because I'll have radiation, which can cause the skin to scar and contract (like a sunburn on steroids), I'm not a good candidate for immediate implants. Instead, I'll have expanders placed at the time of my mastectomy. Then, to gradually stretch the skin, the expanders will be injected with saline every couple of weeks through ports where my nipples used to be. By this point, they assure me all sensation in the area is completely gone. I'm not sure whether to be relieved by that or not.
Eventually, the expanders will be replaced by actual implants. I may or may not also need an additional skin graft surgery, depending on how my skin heals after radiation. After six rounds of chemo, a bilateral mastectomy, thirty radiation treatments and at least one additional reconstruction surgery, I tell you what: I am going to rock one hell of a bikini when this is all said and done.