How to cope when you need a mastectomy

A change of heart
But that soon changed. On the Friday before my surgery, I went to my Pilates class and told a friend there about my diagnosis. She asked me if I’d thought about reconstructive surgery. When she said that someone she knew had had it done right on the operating table after a mastectomy, I was thrilled. I guess I was more upset about losing my breast than I realized.

When I got home, I immediately called my surgeon and asked him. “Yes,” he said, “we could do that.” It meant he would need to find a plastic surgeon available at the same time and book the operating room for a longer period. Soon I had a consultation appointment at Toronto East General Hospital with Dr. Laura Tate, the chief of surgery and a plastic and reconstructive surgeon, who is also assistant professor at the University of Toronto’s department of surgery.

A supportive husband
I know some people wonder why I would go through more surgery just to reconstruct a breast. You can’t always analyze why you make certain decisions but I think you have to go with your gut. I just knew it was important for me to save my breast and continue to look the way I always do.

Lawrence made it clear that it was my decision. We were both rather accepting of the possibility that I might “go pirate” – flat on one side, breast on the other. He said he would go along with whatever I decided, and he came with me to my appointments so he could understand all the options.

Decisions to make
When I went to see Tate, she said I had two decisions to make. I could have reconstruction immediately after the mastectomy or at some point in the future. Also, I could have either a new breast formed using tissue taken from somewhere else in my body, such as the abdomen or buttocks, or I could have a two-stage procedure, in which a tissue expander would be inserted during the initial surgery that would stretch the skin over the area where my right breast had been. Then after several weeks of expansion, a permanent saline or cohesive gel prosthesis would replace the expander.

My surgery was approaching fast; I had only two days to decide. I knew I wanted immediate reconstruction but wasn’t sure which kind. I tried writing out all the pros and cons, which were as follows.
• Using my own tissue: This meant two surgery sites, a longer recovery period and abdominal numbness and tightness.
• The tissue expander: With this option there is a chance of rejection or leakage, or needing a replacement later on.

In the end, I decided on the first option, with tissue taken from my abdomen. I just felt my body would accept my own tissue better.

I felt like myself again
I was so happy to wake up after the six-hour surgery and still have a breast. And I think having the reconstruction made facing chemotherapy easier. You lose your hair, you feel weak and nauseous, but at least you have your breast.

I was happy with the way the breast healed, too. It matched the other side and except for some hard tissue inside, felt soft to the touch. My clothes fit the same as before; I can still wear a low-cut top. Once I got through chemo, I felt like myself again.

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