Christina Applegate's Breasts: Hopefully, in Good Hands

I read that Christina Applegate elected to have both of her breasts removed as the treatment for her breast cancer, as well as to prevent ever getting breast cancer in her other breast. To that I say, BRAVO!!!!

I also understand that Christina is going to have her breasts reconstructed, and to that I also say, BRAVO!!!

I had both of my breasts removed at age 36, following a diagnosis of breast cancer in one of my breasts, and in the six (glorously healthy!) years that have followed, I have never ever, not for one nanosecond, looked back with even a modicum of regret. I will never again have to endure a mammogram, and I have all but ensured that I will never ever get a diagnosis of breast cancer again (primary breast cancer, that is, which originates in the breast; recurrent breast cancer will always be somewhat of a worry to me, but that is another topic for another day).

Like Christina, I also had my breasts reconstructed. And like Christina, who in a recent interview joked, "I'm going to have cute boobs 'til I'm 90, so there's that," I looked forward to my reconstruction with glee, bragging to my friends, "I'm gonna get me some brand new, stripper quality boobs!" After two babies, and a total of two years of breastfeeding them, my once youthful, perky breasts were heading south, literally. So, to me, the prospect of new boobs was all upside. God may have closed a door, but he had opened a plastic surgery O.R. And insurance was paying!

Yay for breast cancer!

But seriously.

Not all breast cancer patients have mastectomies, and of those that do, not all have their breast(s) reconstructed. I know one woman who said that the idea of planning for a life after treatment (i.e., reconstruction) seemed like bad "juju". In other words, she felt that she was jinxing herself by addressing vanity issues when her life was at stake. So, four years later, she is a lovely woman with a breast on one side, and nothing but skin and rib bones on the other. Not a size A breast; NO breast. Nothing.

I think that is sad. And I have to lay part of the blame for the result on her doctors. I was lucky: my doctors led me by the hand and said, "here is what you should consider doing if you are going to undergo mastectomy." I never had to ASK about plastic surgery. My breast surgeon, Dr. S. simply said, "After you see me, you are going to see Dr. A to discuss your reconstruction options." Dr. S paved the way, made it easy, made it seem like part of the treatment.

And in fact, some doctors maintain that women who HAVE reconstruction have a higher survival rate than those who don't. Of course, it is not altogether clear whether or not this supposed higher survival rate simply reflects a healthier population - one which is healthy enough to endure seven or eight hours of surgery, which is what a mastectomy with reconstruction can take (compared with one or two in a mastectomy without reconstruction). Indeed, perhaps a higher survival rate is due to a sort of "wish fulfillment" - a desire to live beyond the cancer. Or perhaps it is due to a positive outlook - that there WILL be reason to have breasts after all is said and done.

Or perhaps having the reconstructed breasts helps the survivor to NOT focus on her illness long after her treatments are over.

But I won't lie to you: for me, this last statement not only does not ring true, it is excruciatingly inaccruate.

Every time I look in the mirror, every time I put on a bra, every time I try on a bathing suit, every time I put on a v-neck, a halter top or a strapless dress...I remember that I had cancer, and a tiny voice in my head quietly mourns the dissonance between how I thought my breasts might turn out, and how they actually did turn out.

Like Christina, I was (and am) a petite woman. And by petite, I mean slim. My chest has almost zero fat on it. If I had had a double mastectomy WITHOUT reconstruction, my chest would have looked like a washboard - no padding at all on the ribs. My only reconstruction option was implants because I had no extraneous fat with which my plastic surgeon could have created new breasts. But after a mastectomy, there is nothing left of your breast except for muscle and skin. The implant is placed below the muscle. If you have no fat below your skin and on top of the muscle, things can feel very tight. Sort of like having a tennis ball under your skin.

My initial reconstruction was with saline implants. Through no one's fault, those were disastrous - hard as rocks so that I couldn't even lay on my stomach. I had them replaced with silicone implants three summers ago, and my plastic surgeon placed layers of sterile human tissue between the implants and my skin. This was supposed to provide the padding that my own body could not provide. Still, over time, the tissue either bunched up or absorbed into my body.

What I am left with now looks something like, well, very prominent pecs. They don't look anything like natural breasts. Putting a positive spin on it, you could say that they're more like Barbie's breasts: Double Mastectomy With Reconstruction-Barbie breasts. My reconstructed breasts certainly don't feel like natural breasts. Instead, they're more like extra-firm water beds. They don't sag, but they also don't bounce. And bouncing breasts are kind of nice, in a Pam Anderson on Baywatch kind of way.

Nonetheless, I want to be VERY clear here: I will never ever ever regret having chosen reconstruction.

I look perfectly normal (even quite fetching, I am told) in clothing. It just has to be the right clothing - clothing which does not show my scars or the striations in my pec muscles which show through my skin. Plus, I had the unique benefit of being able to experiment with different breast sizes before I finally chose to live as a 32A, which was quite a change from 34C, my pre-cancer size. It turned out that smaller breasts just looked better on me.

Sometimes I think it might have been better if I had had more realistic expectations. Then, I realize that perhaps my lofty, stripper-quality-boob expectations were what got me through the day in the days, weeks and months following my diagnosis. I may not have come out of my surgery with stripper-quality boobs, but I also didn't come out feeling butchered.

I didn't come out with NOTHING where there used to be SOMETHING.

Six years later, my imperfect reconstructed breasts may never be "all that", and once in a while, I toy with the idea of going back into the O.R. just ONE more time...thinking maybe this will be the time it works, maybe this will be the time I wake up after surgery with the stripper-quality boobs. But so far, I have no immediate plans to do so.

Stay tuned?

Comments

[MarleneRossman]

Sorry to blow your calm, but breast cancer can recur in the chest wall.
I know two women who had prophylactic mastectomies and still got recurrence of their breast cancers.
GET YOUR CHECKUPS, girlfriend.

[Lauren Cahn - Huffpost Blogger]

I just saw this...and I need to clarify something so that people don't get the wrong impression.

A prophylactic mastectomy prevents a PRIMARY breast cancer. It cannot prevent a recurrence. If you don't ever GET a primary, you can't have a recurrence though.

If you have no breast tissue, then a recurrence to the breast will happen at the scar line and will likely be seen or felt, as opposed to experienced deep within an intact breast.

So those are the facts. My own checkups are not at issue here at all.

[etreader]

The issue of your friend being afraid to seek reconstruction (assuming she is unhappy that she hasn't had it done) is one thing. Finding it "sad" that " four years later, she is a lovely woman with a breast on one side, and nothing but skin and rib bones on the other. Not a size A breast; NO breast. Nothing. " merely reflects your own bias. I had a single mastectomy with no reconstruction, my only regret is not pushing my doctor to perform a double (this was my 2nd round of BCA) - mainly because now I feel forced to wear a prosthesis in public so as not to offend others (both with the missing breast and the remaining one that requires a bra). I have no desire to undergo the extensive elective surgical process and the potential problems with trying to match the existing breast. Not to mention implant replacement down the road. Since insurance is required to pay for post-mastectomy reconstruction, most surgeons are required to present the option. I appreciated that my surgeon offered all the options and graciously accepted my decision that I do not want reconstruction. And, should my opinion change in the future, I can have the reconstruction done at that point. I certainly understand if I were in my 30's my decision most likely would have been to go with reconstruction, but I don't think that even then I woiuld have found it required for everyone else to do the same.

[Lauren Cahn - Huffpost Blogger]

Surgeons would never be required to offer reconstruction since insurance companies are not in the business of offering medical services.

As for a single mastectomy with no recon, my obvious question is: why did you bother to save the one breast? If you weren't attached to having breasts, wouldn't you have gotten rid of both?

Seriously. I feel that my decision to have both breasts removed belies an underlying LACK of vanity about the whole thing, even as my reconstruction screamed: vanity.

[Bart Motes - Huffpost Blogger]

What a marvelous story! Thank you for sharing it. I am sure that there will be countless women who will draw strength from it. I forwarded it to a friend who is an aspiring plastic surgeon. I am certain he will be inspired by it.

[BaxterJ]

I'm really proud of Christina Applegate for being so public about this decision, especially when she works in a business where women are judged so harshly about their bodies, and their age. She's even able to joke about it! I loved what she said about having the best boobs in the nursing home.
http://www.entertonement.com/collections/2247/Christina-Applegate