Flat AF

Last April when I felt like I was on a runaway train after getting diagnosed, I was given some options as far as after the mastectomy: reconstruction, no reconstruction, delayed reconstruction. I'll level with you - as someone who developed breasts a lot earlier than some of my classmates, my relationship with my boobs was always complicated. I got unwanted attention from basically 3rd or 4th grade on, almost always tried to wear looser clothing to try and hide them, then got badgered by my mom with "why don't you wear things that fit?" At times I even wondered what it would be like to not have them...or to have smaller ones. ANYWAY, fast forward a lot and within the last few, years I'd finally grown more comfortable with them. The idea of them going away was traumatizing in itself and thinking about waking up with nothing there was worse. My breast surgeon suggested no recon, like her or going direct to implants. The plastic surgeon suggested delayed recon because radiation could fuck things up. I went with delayed and had what's known as a skin sparing mastectomy. I think I've described elsewhere that it basically is like someone opened up the skin on my breasts and scooped everything out. I don't care for it. I think it was one day last July, I was getting dressed to go visit a friend and realized that when I looked in the mirror, I didn't mind what I saw. I liked the image of me with no breasts, and at that point started thinking that maybe being flat would be ok.

Then the research started. I found amazing photos of flat women online and saw that hey, this can be normal! And beautiful, sexy, cool, confident...all of it. Then I started looking into recon. Breast implants have a shelf life of about 10-15 years. Like, literally, they should be replaced about that often. I ruled that out on that basis, deciding if I wanted to look into reconstruction w/ my own tissue. There's one called DIEP reconstruction - a person's own tissue is used from the abdominal area and transferred up top to create new breasts. As a fat girl, I thought "holy shit, this is my time!!" Then I looked into it. It's many hours of mircosurgery, there's an incision that runs from hip to hip, hospital stay, chance of tissue death, so no thank you. (I had a lot of necrosis with the nipple grafting and it was very traumatic. Yeah I don't think I've written about that yet.) Other flap type recons were out because they involve moving muscle from either your abs or shoulder around to the front & then placing implants. At a follow up appointment with my surgeon, I'll call her Dr. O, I told her I decided to go flat. She asked why, I explained, she was cool with it. Said she'd write the script for things like mastectomy bras, etc.

Collage with glorious flatness fr. Flat Retreat page on FB

In the meantime, I joined a couple of FB groups for women who were flat after breast cancer and I found a group of some of the most fantastic women. I've learned so much about the breast cancer community and that quite a lot of women who ask for flat results - flat closure reconstruction - are ignored because doctors aren't respecting their choice. (Damn, that sounds familiar...) One such lady started Not Putting on a Shirt to help advocate for this and she began keeping a list updated with names of surgeons from around the country that gave good flat results. I contacted her for a name & got the list as well as a recommendation.

In June, I had a follow up with Dr. O. Which seemed weird because why do I have to keep seeing her? I see an oncologist several times a year who does the same kind of examination. Anyway, I'd been having a trying week and unfortunately I got emotional in the office. I say it was unfortunate because when I then talked about wanting to be flat, she didn't take me seriously. She launched into a crazy tirade about it that included reasons such as: it's really hard to get insurance to pay for revision, we could have just done this in the first place, you're so young, "once we do it, if you change your mind, that skin is gone," and "you'll be pear shaped." I told her I'd done research, stated my reasons, and mentioned the groups I'd found and she cut me off saying "I know about all the groups." And took my hand saying gently "don't let someone else's story be your own." Which is basically what she was doing? She brightened considerably about the surgery when I mentioned I thought a plastic surgeon had to do it & then said "oh if that's what you want..." then told me I should give it more time. I'd had a year!! I realized when I left that appointment and cried that I am not going back to her. If a friend told me about a doctor treating them that way, I would tell them to GTFO & find another doctor. The great part of this was me sharing with Flatties Unite (one of the groups) and joking about how she thought the group was a bad influence.

Melissa Jansen, (I Don't Need Two) with the meme magic. 

I did end up giving it more time because of how scheduling worked out. It also turns out that if someone has radiation, one should wait about a year before trying anything so the tissues have a chance to heal. After seeing Dr. Clark at Ironwood, I felt so much better about this decision! She referred me over to Dr. Berardi, a plastic surgeon, to answer some more questions and we're going forward with surgery this December. I am nervous because it's surgery, but excited because I'll get rid of this excess skin. She thinks it could possibly help with my lymphedema as well, since getting rid of the skin & scar tissue would make it easier for the lymph to move.

Seeing these two new doctors has given me a lot of feels. Specifically a lot of "this is so different from last time" and "oh god, I wish I'd found them first" feels which has been so hard. I can't let myself fall into that hole, though. Gotta keep moving forward.

A note - there's a lot from last year that I'm still kinda working through in my head and I intend to talk about it. But haven't gotten around to it yet. I've said it before that I intended to talk about things in a linear fashion, but that's clearly not happening and we'll all have to deal with it.