Plastic doll

Yes. I wished I was a Barbie doll. Those with boobs abundantly shaped. But boobs don't magically pop out of a box like that. That's what I realized yesterday, after meeting with my plastic surgeon.

I have two options at this point. Be willing to insert a foreign object made of silicone, saline or, one so called gummy bear implant into my chest cavity; or cut up perfectly healthy tissue, muscle and fat from somewhere around my body to make a breast mount (his term, not mine). The tummy tuck comes as a bonus. Some minimal skin graft with Allograft would be involved, too. But I simply don't want to have cadaver skin inside me, or any of these options for that matter. None of it. I wished I wanted.

Oh, I so badly wished I could lay down on the operating table and say: YES, make me a new breast a la Jolie, and wake me up when it's all done. But I just don’t seem to be able to do it. I try to tell myself: "Just take the package, Jennifer. It's what most people do. The insurance covers it 100%. Come on!" And anger overcomes me. I don't want to make these choices. I didn't want to make any of the choices I've had to make lately. I have to hold myself not to punch the car window as I am driving away from the surgeons' office. I try to swallow the question, but "why" is lurking above my head. I can't deny it. Why in all its versions. The "why me". The "why now". It is all there.

But it is me. It is now. And it's my decision. One that I'll have to live with for the rest of my life. Yes, I can do it later. Plastic surgeons do miracles these days, day or night, five or ten years down the road. But, if I am not comfortable with the options and risks involved in a plastic surgery done at the same time as a mastectomy, I am absolutely not comfortable with the complexity of doing it later, specially for someone that will undergo radiation treatment like me. So it's a now or never scenario. In 3 weeks at this time I will be on the operating table. And I must choose.

I was convinced I was OK with no reconstruction. I visualized myself being flat on the left side of my chest. A single line scar across it. And I told myself I could live with that. I even get to keep my right breast since BRACCA genetic testing was negative. So it's OK. But, what I didn't count on is that there are no guarantees of the scar being flat and smooth. The skin can be sunken in. It can bulge. It can have folds. Specially someone gifted with big breasts like me, particularly after radiation treatment. 

Which brings me back to the real issue here. This is not about my breast. This is about my life. The most important person involved in this whole procedure I'll probably never meet: the pathologist. The breast will be scooped out of my chest by the surgeon. The skin will be reshaped by the plastic surgeon. But it's the pathologist who will dissect the breast tissue and run tests. Tests that will define a lot. Tests that will decide what type of radiation, for how long and how much of it I will take. Tests that will define how many lymph nodes will be removed from my arm. Tests that will determine my life expectancy according to the latest study, age group, cancer stage and clinical trials. This is as serious as shit gets, folks! 

So back to the boob situation. I want to let my body heal. Fully and completely. With the least trauma and invasion as possible. And for me, that means opting out of breast mounts, cadaver skin, TRAM FLAPs and silicone pouches. No reconstruction is my choice. (No judgement on dear sisters who are walking the same hard path as mine. You go rock those beautiful boobs around for me. I applaud your courage. In fact, I envy it.)

So one more specialist is part of my medical team now. An oncologist plastic surgeon will be present during my surgery to do the closure and hopefully give me a chest as flat as possible. If a second surgery is required to achieve that, so be it. I trust him. Have you ever looked at a plastic surgeons hands? It's something to marvel. I was mesmerized by the sight of my surgeon's delicate fingertips on my chest. I trust him completely. But I just want to be as gentle as possible to my body. Full reconstruction feels like too high of a price for my body to pay. Only my body and I know how much we have been through so far. All my intuition tells me is to close my eyes and rock my body side to side, holding it like a carefully handmade rag doll, stitched together by beautiful hands, and sing to it: "Heal. It's over. No more." I will calm my body down, and give it courage to beat the odds so I can define my own life expectancy. One that is not dictated according to the latest study, age group, cancer stage and clinical trial as if I am a plastic doll out of a box, with a set expiration date.