A breast reconstruction after a mastectomy left one woman feeling like her body was a "horror show", but in time she learned to love her body's strength and beauty. Photo / Unsplash
Following a reconstruction on my right breast, my body was bruised and uneven. But I’ve come to find the beauty and strength in it.
Some women give their breasts names. I’d never been that invested in mine. Small but reasonably pert, they were just there… until one wasn’t. In June last year, I found a hard lump in my right breast. By July I had been diagnosed with stage one cancer and told I needed a mastectomy. I can honestly say the thought of losing this supposed symbol of my womanhood paled in comparison with all the other worries whirling about my head.
The specialist assured me I would live another 30 years (my cancer was later upgraded to stage two when they found it had spread to my lymph nodes, but survival rates are still 90% in stage two patients for five years after diagnosis). Despite this, I couldn’t help a cold dread clutching at my heart. I wasn’t ready to go yet - there was so much more I wanted to do. Most painful of all was the thought of leaving my children, aged 7, 10 and 13 at the time. I held off telling them anything until I had a clearer idea of the prognosis.
Over the summer, between juggling work and holidays, I waited for results and was presented with options. Knowing the cancer was growing bit by bit, I became quietly desperate to hurry things along. Did I want a reconstruction? I thought about how my clothes would hang after surgery. My answer was an unequivocal yes; I didn’t fancy being flat on one side or having to wear prosthetic inserts in my bra.
I opted for a breast made from my body tissue rather than implants, even though it was a longer, more complex operation leaving two scar sites rather than one. I wanted my new breast to still be “me”. The operation - a flap reconstruction using skin, fat and muscle from my upper thighs - was scheduled for the end of September.
I would be opened up like an envelope, the consultant told me, the cancerous tissue removed, then two half-moons taken from the top of my legs would make my new breast. This information did not faze me. My main concerns were how to tell my mum, my two brothers, and my friends about the cancer. And how to go about explaining to the children what was going to happen, and reassuring them that I would be okay, everything was going to be okay.
They took it remarkably well. My youngest daughter was fascinated, my prepubescent boy concerned but awkward, my teenage daughter stricken, but soon diverted by her quest for Taylor Swift tickets. My partner, something of a hypochondriac who makes a meal of the smallest setback, is nevertheless magnificent in a crisis. Short of packing my hospital bag and stashing some meals in the freezer, I had rather a head-in-the-sand attitude to the whole process, but he armed himself with knowledge and reassured me whenever I felt my nerves faltering.
I was told I would lose sensation in the reconstructed breast and it wouldn’t return, I would be permanently numb. It seemed trivial to mourn this. At least I’d be alive. My partner and I didn’t discuss this side of things much, and still skirt over it now. I was grateful I wasn’t young anymore, or looking for a new relationship, or to start a family. My breasts had already fed three babies with varying degrees of success.
Each time I was glad to get them back - not to reclaim them as sexual objects particularly, more because I found breastfeeding so messy, time-consuming and dull. My body now, rapidly approaching 50, was something I was not satisfied with, but accepting of. I was comfortable in my skin, regardless of my thickening midriff, the varicose vein running down my left thigh that arrived and never left after my third pregnancy, the weird spidery stretch marks on my ribs.
Despite my body’s numerous imperfections, I’d always been the type who wandered about the house naked after a shower, not caring to cover up and spare my children’s blushes. In my 20s I earned spare cash life modelling for local art classes. When pregnant, I wore figure-hugging tops, loving my watermelon bump and - finally - decent cleavage. But after the mastectomy and reconstruction, my body was a horror show. I didn’t want my children or partner to see quite how gruesome I looked.
Surgery was long and complicated (the two halves of my new breast failed to fuse after the first op, so I had to be wheeled back into theatre to be opened up again). I felt weak and exhausted. For a week afterwards, I was attached to a surgical drain - a tube drawing the blood from the site of the mastectomy to a clear plastic bottle I had to carry about with me.
I retreated to my mum’s flat for a few days, claiming it would be easier without stairs to climb. Far more efficiently than my well-meaning partner could, mum helped me to wash, and change my dressings and drain bottle. I felt like a child again, sleeping in my childhood bed - though fitfully, propped up with pillows, unable to turn on my side. I succumbed to being bought tea, cooked for, my hair washed and my back gently sponged. I appreciated mum’s calm female presence, our sense of solidarity. Using my mobile phone, she took daily pictures of my surgery sites to track the healing process and sent them to the breast team if there were any concerns.
I examined these pictures with morbid fascination. My thighs looked, and felt, like a drawstring bag pulled tight, puckered and swollen. The wound lines ran, sticky with surgical tape, all the way under my buttocks, curling into my crotch. My new breast was weirdly solid and unyielding compared to its sister, and a mottled yellow, with a very noticeable dip between the two half-moons of donor tissue. There was what looked like a giant blue bruise on the upper half of my breast, actually the cast of a blue dye injected to help locate my lymph nodes. I was covered in smaller bruises and scratches. I thought about my comatose body being hauled over on the operating slab to slice into my thighs, then rolled back to cut my breast open.
Despite this, as I looked, I marvelled at the skill of the surgeon. The shape and size were a good match, and she had spared my nipple (many reconstructions leave women without a nipple, or one is tattooed on later). When my nipple started bleeding and cracking, I nursed it delicately, terrified it was going to fall off. It survived.
Recuperating was slow and frustrating. For six weeks after the operation, I had to swaddle the surgery sites in compression leggings and tight sports bras to keep everything in place. I couldn’t reach into cupboards for teacups and was advised not to carry anything heavy. I was counting the days when I’d move to the next stage. I ordered stretchy padded bamboo bras in pretty colours. I bought a shopping trolley. I dutifully ran through my exercises four times a day to regain flexibility in my thighs, arms and shoulders. I took short, ponderous walks in the park with my best friend and her new puppy.
Other friends sent flowers, bought round lemon cake, vegetable soup and dhal, a box of “healing biscuits”. Junior school mums took my youngest daughter away for play dates and sleepovers, for which I was enormously grateful. I was fragile - I winced when my children came in for a hug, saying, “Mind my boob! Left side only!” My partner admonished them: “Don’t upset mummy, leave her alone.” Then I felt guilty for wanting to put a force field up around my body.
Next came radiotherapy and hormone treatment, and more changes. Just as I had felt my strength and flexibility returning, daily letrozole tablets and monthly hormone injections have turbo-charged my menopause, leaving me with stiff joints, a short temper and hot flushes. My neck feels cricked and I can’t bend down easily to pick things up from the floor.
I don’t want to feel old and decrepit - and for the most part, I don’t. To ease my aching limbs, I bought board shorts and a waterproof top so that I could swim, hiding my scarred thighs with their “dog ears” that will eventually be neatened up with liposuction, and my right armpit, which radiotherapy has left looking like someone left a hot iron on it. But when it came to it, I couldn’t be bothered and just wore my regular swimsuit. If anyone stared, I didn’t notice, and I didn’t care.
I have started leaving my bedroom door open again when I am moisturising and dressing. I want my children to see I am healing, even if I am still a bit bumpy and uneven. I am considering taking up life modelling again, though I worry I’m too stiff to hold a pose. I look in the mirror now and see a beauty in my healthy left breast that I never appreciated before, and a right breast that is still settling in. It’s shrunk a bit since surgery and hangs lower than the other. It needs filler in that valley. It’s still hard and knotty in places. But it’s undeniably a part of me.
There is no “back to normal”, not yet; probably never, because to use the Covid-coined term, I have a “new normal” now. My body has changed. In some ways it is fitter and firmer than before, thanks to my more dedicated exercise regime. I look strong. I am strong, though I realise now - in a way I didn’t this time last year - how very fragile and precious life is.
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