Tomorrow I return to the OR for my latest stab (eek) at reconstruction. To recap: In August 2012, I had a double mastectomy, and tissue expanders were placed then. A couple months later, during chemo, I developed an infection and my tissue expander was removed and replaced with a new one. Then I did radiation, and my skin fried so bad that it broke apart at the seam. The expander was removed and replaced with a soft saline implant. Same thing happened again, and the implant was replaced again. Finally, in August 2013, the implant on the left side was removed. Each time, the most damaged skin was cut away. Since last August, there's been nothing there. I've been holding a little crocheted booblet of my own design next to my heart since then. Over the summer, I had a fat graft, taking a small bit fat from other, um, more endowed parts of my body and pumping into the vacated boob spot. The goal was to use the fat to nourish the tissue post radiation. Tomorrow, we will do that again, except with a lot more fat.
This will be my 7th surgery. Why the fuck am I doing this?
It's a real question. It's one I've asked myself many times. Why am I putting myself through this process? Why not pull out the other implant, and be done with it? I've considered it. A lot. After all, what's my motivation here? Why am I doing this? Is this an anti-feminist act? I am subjecting myself to pain and countless surgeries just to satisfy some societal requirement that my body be pleasingly "normal"?
Reconstruction wasn't something I spent much time thinking about in the days before my mastectomy. I visited my plastic surgeon the day after my diagnosis. He talked a lot about the process, promised to take good care of me, and I was kind of like, "Thank you very much, I don't really care."
I think immediate reconstruction is often presented as the most favorable option because our surgeons are worried about the shock of suddenly having nothing where there was something. I think, as a whole, they worry that we won't be able to handle it, and that immediate reconstruction offers comfort from the loss. Having had it and lost it, I don't really think that's true.
Last summer, after my implant was taken out, I placed my hand flat against the left side of my chest, and felt my heartbeat. I hadn't felt it there since I was a kid. In a way, it took me back to my kid body, which is really just my body. The same one I've had. As separate as I've always felt from it, it is where I will always live.
This surgery tomorrow will focus on injecting small amounts of fat into the strong strips of scar tissue, with the aim of breaking them down. This has shown to be an effective technique, and I hope that after I'm healed I will finally have back my full range of motion. After that, we'll see. If my skin heals enough that a little implant can just be slipped in there, maybe I'll do that. Maybe I'll have to do an expander again. Maybe I'll do this weird space aged suction bra thing. Or maybe I'll decide to leave it be, and take out my other implant.
When I felt my heartbeat against my flat palm all those months ago, I understood the loss more profoundly than I ever had before. Without the stand in, the implant, I was able to truly know that things would never be the same. And as hard as that is to learn, it's necessary. It's necessary to know that "reconstruction" is a misnomer. What you get isn't a functioning, feeling, warm breast. It's just an implant, numb and dumb. I won't get back everything I lost. I just know that I've got to get as close to feeling good as I possibly can.
Right now, I feel I'm on that path. I hope that when this is over, I will no longer feel deep loss when I brush my hand over my chest. That I won't reflexively cover the left side of my body every time I lean forward, and every time I feel self conscious. Whether I ultimately decide to finish reconstruction or not, my hope is that in the end I will not be haunted by this scar. Instead of aiming to reconstruct my breast, which is impossible, I aim to reconstruct myself. To make myself again out of parts old and new.
To make myself whole, whatever that means.