So, what should I look like?

I've been really anxious about all of the surgery I have in my future. We've gotten comfortable with the decision to do the bilateral mastectomy, rather than just the right breast. I'm only 35 now, and, because of the BRCA2 mutation, my chances of having breast cancer again in my lifetime are very high. Rather than spend the rest of my life in a cycle of worry-mammogram-biopsy-worry, Zack and I decided that it would be better for our quality of life to remove the left breast along with the right. As Dr. S says, "it's just an overgrown sweat gland". (Here's hoping the insurance company agrees with our assessment. All my doctors have offered to write letters and fight for me if it comes to that.)

Yesterday, Zack & I met with a plastic surgeon about the reconstruction options. Dr. L spent over an hour with us - it was really incredible. The biggest decision to make up front is whether to do a primary reconstruction (where the plastic surgeon would begin the reconstruction process during the same operation as the mastectomy), or a delayed reconstruction. Radiation does nasty things to skin, other tissues, and implants. Therefore, the chances of complications go up astronomically if I start reconstruction before the radiation. Bottom line: because I'll need a heavy series of radiation treatments after the mastectomy surgery, there isn't a lot Dr. L would be comfortable doing until that process finishes. Zack and I feel strongly about avoiding complications that would lead to extra surgery, so we've decided not to take the risk.

For me, this means that I'll wake up after the mastectomy with a completely flat chest. In some ways, I welcome this opportunity to see if I mind that body shape before making a decision to change it. (I just had a flashback to being the last girl in my gym class to wear a training bra). Zack, of course, has been absolutely supportive of whatever decision I ultimately make. His only concern has been my emotional well-being: he worries that the dramatic change will be hard for me to assimilate.

Our meeting with Dr. L took a lot of the pressure off, because we don't need to make a decision right away about what sort of reconstruction to do (implant and/or using part of a back muscle). Federal law requires insurers to pay for post-mastectomy reconstruction whenever we decide to do it - even years from now. The reconstruction process takes longer than I thought, though (4-6 months).

Overall, we are happy about our decision to wait because it matches our priorities. Step one: beat cancer. Step two: figure out a cup size.