March 23, 2008
By ELLEN FREEMAN ROTH
A Body Resculpted
One woman finds that saying good-bye to her breasts is both
harder and easier than she ever imagined
“I’ll cut them off.”
For years, that’s what I said after my doctor explained my
risk of getting breast cancer. It’s not that I considered my
breasts to be expendable. It’s just that with my family
history — my mother died of ovarian cancer at 48; her sister
died of breast cancer at 39; and I’d tested positive for the
BRCA1 gene mutation, which increased my chances of
developing both diseases — my doctor had been abundantly
clear that if I was ever diagnosed with cancer, my safest
option would be to have a bilateral mastectomy. But losing
my breasts isn’t what frightened me. What scared me most was
dying young and leaving my kids, Josh and Maddie,
motherless. Then again, it’s easy to be cavalier when the
prospect of a double mastectomy is merely a possibility in
the distant future.
I’d already had my ovaries removed at 39; my doctor told me
it was my best choice, considering what had happened to my
mother. In the meantime, my M.D. monitored my breasts with
exams and mammograms. Still, technology doesn’t necessarily
trump DNA, and I worried about the faulty rung in my ladder.
However cautious I was, I knew I might someday get The Call.
The doctor phones
and asks, “Is this a good time?”
No. Call back in 40 years.
Decades of waiting have not prepared me for this diagnosis
of cancer in my right breast at age 45. When I see my
husband a few hours later, he and I clutch each other. “I’m
sorry,” I whisper into his wilted cotton shirt as though I’d
spun my own defective double helix.
“No, don’t apologize,” Steven says to me gently. “We’ll get
I hope he’s right.
Maybe sacrificing my breasts, emblems of womanhood, will buy
me back my life as mother, wife and friend. I tell Steven,
“I’m having my breasts amputated.”
I go to see my doctor in person, and she reconfirms that
given my risk of developing another primary breast cancer,
bilateral mastectomy makes the most sense. Actually, I’m
lucky. My cancer was discovered early, and my prognosis
appears to be good, although we won’t know for sure until we
get the final test results. I just want my diseased breasts
gone. We leave the doctor’s office and pass a sign I’ve seen
countless times: POSTMASTECTOMY SHOP. I wince and turn away.
In the car, Steven and I plan how to tell the kids, as
though artfully cloaking a death threat can make it less
menacing. “Hey,” I say, “at least there will be no more
mammograms or underwire bras. That’s a perk.” We both smile.
“Y’know, I bet we can do a top 10 list. Number three: What a
way to lop off a few pounds!”
“I’ve got number four,” Steven pipes up. “You’re losing only
two of your boobs.… You’ve still got me!”
The next week, we meet the plastic surgeon to talk about
reconstruction. I choose the simplest procedure with the
fewest potential side effects. During my mastectomies, he
will insert tissue expanders under my pectoral muscles,
which he will then inflate over the course of three months.
Afterward, in a second surgery, he’ll replace the expanders
with saline implants.
He asks to see my breasts. Awkwardly, I open my paper gown.
“Nice?” I think. “Not for long.”
Trying to be cheerful, I ask, “Will you make me nice
breasts?” although my voice sounds strained to my ears. The
doctor forces a half smile. “I’ll try.”
In nine days, my breasts will be gone. Reconstruction will
leave me with a passable cosmetic pair, but once the
nerve-rich breast tissue is removed, they may not have any
sensation whatsoever. That night, I lay in bed next to my
husband, aware of the covers against my body.
“I’ll never feel your hands on my breasts again,” I choke
out. “Touch me. I don’t want to forget — I want your touch
to be imprinted on my skin.”
Steven reaches over, but his touch holds no promise of
escalating excitement. It’s as if his hand, mechanically
cupping my breast, magnifies our sadness, priming us both
for the dead zone my chest will soon become.
Less than a week before surgery, pre-op testing reveals
abnormalities in my liver. Metastasis? “Our priorities would
change,” the doctor says. I’m terrified. The day before my
scheduled surgery, the doctor calls my cell phone while I’m
jogging with friends on what I’ve come to call my 10-mile
Run for Strength. Her news: My liver cysts are benign. I can
proceed with surgery. As passersby sip coffee, I spring into
the air, pumping my fist, and whoop, “Yes!
I only have breast cancer and can have them both cut off!
That afternoon, I take a trash bag to the bedroom and dump
all my bras, bathing suits and shirts that will no longer
fit. Before bed, I catch a glimpse of myself in the mirror,
then close the door, slip off my nightgown and stare. Should
I take a photo? Too mawkish. I lift each breast, dense with
sensual and maternal memories. You’ve nursed Josh and
Maddie. Your job is done. “Good-bye,” I say, sighing.
During surgery, pathology reports find that my lymph nodes
are cancer-free. When I learn the news, the relief
penetrates my postsurgical haze, through what feels like a
2-ton boulder pressing against my dissected chest.
It’s not until the next morning, my head still cloudy, that
I begin wondering how things actually look under there. I
weakly pull down the collar of my hospital gown. I want to
see…but I don’t. I tuck my chin and twist my head to the
left, then to the right. Bandages. I trace my fingers along
the adhesive to check for gaps. None. I close my eyes again.
Voices awaken me
later that morning. Four strangers are mobilized around my
bed. “We’re the plastic surgery team, here to check your
incisions,” a doctor says. Two of them unsnap my gown,
exposing a stratum of bandages and tape. One man yanks the
tape off, and they all lean in. Noses close to my chest,
they palpate and speak among themselves. I try to eavesdrop,
craning my neck to peek. My fleshy breasts have been
replaced with two 4˝-inch horizontal lines of stitches, the
black thread tracking across my newly puckered planes. The
swollen skin looks a half size too big. An involuntary “oh”
escapes from my throat. “So that’s what it looks like,” I
rasp nonchalantly. We all act blasé. Just a few body parts
hacked off. Chop, chop.
One of the doctors hastily turns on his heel and declares,
“Everything looks fine.”
A brief but profound sense of loss penetrates my chest.
Ten days later, at home, I receive the complete pathology
report. My cancer was ductal carcinoma in situ, which means
it was confined to my milk ducts. I won’t need any radiation
or chemotherapy. We rejoice, marveling at my Houdini-like
escape, at how I’ve managed to emerge from all of this
unscathed, sort of.
Weeks pass, and I regain strength and go back to running. I
return to my plastic surgeon periodically; each time, he
injects saline into the tissue expanders, and I experience
topographical growth: After he empties a syringe into my
chest, my breasts bloom in a fast-forward trip through
puberty. I’m an artwork in progress, resculpted every two
weeks, which I find alternately entertaining and freakish.
My breasts are constantly sore, as if they’re screwed on my
body too tightly. And I don’t know what to call them.
Perhaps Thing, inspired by the old “Addams Family”
television show. Or Thing One and Thing Two. Whatever they
are, this pair of Things is certainly not sexual.
I avoid my nakedness in the mirror, feeling a self-revulsion
that takes me by surprise. I never thought I packed my
identity in my bra. For one thing, I’d always considered my
ample C-cup breasts cumbersome; they had a tendency to draw
unwanted attention, my nipples saluting through my shirt
with the slightest breeze. And they chafed when I ran.
But my breasts had also been lovely. And they were real.
Six weeks after my surgery, my family and I take a trip to
New York City. My doctor assures me that the metal ports
inserted in my chest for the saline injections won’t set off
airport scanners, but I’m nervous in the security line. I
pass. Phew. The guard pulls us aside. Steven leans toward me
and points to a code on our tickets earmarking us for
special security screening. A guard runs a wand along
Steven’s body. His belt buckle sets the detector buzzing.
Josh’s turn. Belt buckle.
Bzzz. I start to sweat. A rivet on Maddie’s
Bzzz. I’m queasy. The guard motions to me. “Put
your arms out.”
I lift my trembling arms. He runs the wand down the right
side of my chest.
Bzzz. My stomach lurches. He tries again,
puzzled. I steel myself for the inevitable.
Bzzz. Then the other side.
Bzzz. My heart pounds. “I recently had
mastectomies for breast cancer, and now there are metal
ports in my chest for my breast reconstruction,” I explain
to the man, my voice quivering.
The guard glares. “I’ve never heard of that.”
Travelers file past as my disfigurement broadcasts its
menace to society. My eyes well up. “There’s metal in my
chest.” Steven, Josh and Maddie watch. I don’t want my
ordeal to upset them.
I’m passed to a female guard. Surely
she’ll understand, I think. “I had
mastectomies,” I say. “I’m in the process of getting breast
reconstruction, and I have metal ports in my chest.”
She appraises me and leads me into an anteroom. I’m
incredulous: How can she not believe me? Another female
guard joins us. Humiliated and sobbing by now, I try to
“I’m sorry, dear, but we have to do our job,” she replies.
“You could have explosives strapped to your chest.”
I have to lift up my shirt for these strangers? It would be
degrading enough to expose my real breasts, but displaying
their absence — my ugliness — seems even worse to me. The
guards stand around, quietly watching, waiting for me to
act. I’m center stage in a freak show, but I see no
alternative other than to comply with their demand if we
want to make the flight. My chest heaves.
Now! I close my eyes, grasp the hem of my shirt
and lift it up high to reveal my bare chest. Then I lower my
shirt and, covered once again, put my face in my hands and
“We’re sorry, dear,” one guard says kindly. “It’s all
No, it’s not. I blow my nose, wipe my eyes, smooth my
sweater and open the door. Steven, Josh and Maddie gather
round, rubbing my back. “Are you OK?” they ask, soothing me.
Keep it together. “I’m fine. Really.” Sniffles escape as we
walk to the gate. When we board the plane, I turn to Steven
and deadpan, “After all that, I sure hope nobody has any
“I’m ugly with these
I tell Steven in bed, a few weeks later. “I’m afraid I’ll
“You couldn’t repulse me. You’re beautiful. All of you.”
I know my husband loves me, but I’m skeptical that he
believes all of me — all of
this — is beautiful. I’m afraid to have sex.
What if he recoils when he sees me? Before I can imagine the
full range of his reactions, Steven lavishes love on me,
vanquishing my anxiety. The penguins on the flannel
nightshirt I’ve refused to remove practically join me in
weeping tears of relief.
Over time, Steven gently insists that we navigate my new
landscape, unwilling to pretend that my shoulders attach
directly to my abdomen. He won’t treat the terrain over my
heart as a no-man’s-land. “Can you feel this?” he asks.
“No. Try here.” I move his hand between my breasts. “I feel
that. And higher.” My new breasts aren’t sensual, but when
we survey them together, they’re not oddball accessories,
On my next trip to the plastic surgeon, he inflates my
expanders and asks what size breasts I want.
“I was a C-cup. I want to be smaller.”
The nurse arches her brows. “Are you sure? Most women want
their new breasts to be bigger.”
“Not me. I want to be an A or a small B.”
“I don’t know how big that is,” the doctor says. “We measure
by cc’s.” He calculates. “We’ll do 220s.” If his math is
wrong, I’ll either be shopping in juniors or Frederick’s of
Suddenly, wherever I go, I size up women’s fronts. I check
out the cashier ringing up my Altoids. Too big. I peep from
behind a sardine tin at a fellow shopper. Too small. I surf
the Internet, print photos and label them TOO BIG, TOO
DROOPY and JUST RIGHT, as though a fairy-tale doctor can
finesse flawlessness from my remnants. I count the days
until surgery for what I’ve come to call my Hollywood boobs,
pondering how implants could make a woman feel sexier. Mine
make me feel fraudulent.
“It will take time to adjust,” says my brother’s childhood
friend, who happens to be a plastic surgeon. “The bonding
between a woman and her new breasts takes time.”
“Is this how they’re supposed to look?” I ask, unveiling my
works in progress — ironic, since for a spell 25 years ago,
I’d have given my eyeteeth to show him what was under my
“Yes. You’ll look fine after surgery. But remember, this is
reconstruction, not replacement. You won’t look perfect.”
“I wasn’t perfect before.”
“Your body and breasts were normal for you. But now, you’ll
have to get accustomed to a new normal.”
The morning of my surgery, my plastic surgeon greets me and,
when I press him for details, is vague about the exact size
of my implants — oh, 220s, 225s, whatever.
Whatever?! Afterward, when it’s all over, I
awake, eager to know how they look and wary of pain. But the
implants are comfortable, nothing like the thicker and
larger expanders. My upper body feels liberated!
The next day, I get my first glimpse. Size seems OK. A bit
bigger than I’d hoped, more a solid B than a B minus. Scars
still divide each breast, but overall, they’ll do. A week
later, I return to have the surgical drains removed. When I
arrive home, I grab my most body-conscious shirts from the
closet, then survey myself in front of the mirror. A
racerback running top, a clingy tee. Nicely compact. I could
go braless. My new breasts are proportioned better for my
frame than my real breasts had been.
Shopping for my first bra feels as odd as, well, shopping
for my first bra. I grab one and steal into the dressing
room. Before I slip it on, I catch my reflection and, for a
second, am taken aback. Long, dark scars. No nipples. The
new me. Just move on.
Soon, I’m going running again. The winter feels unseasonably
cold, but when a chill passes through my chest one
afternoon, it strikes me that it’s not simply the weather:
My implants seem to conduct the cold — at least, that’s the
way it feels to my body — whereas my former breast tissue,
full of fat, insulated me.
I return to the gym and discover how weak I’ve become in the
past four months; it’s a struggle to bench-press 5-pound
dumbbells. When I do, I notice that my chest feels funny, so
I look down. My pectoral muscles no longer sit snugly on my
rib cage and contract under my breasts. Now, wrapped over my
implants, my pectorals are part of my breasts, flattening my
falsies each time I heft the weights. The new normal. As I
lift, one of my scars slides into view, exposed by my skimpy
workout top. A primitive line mapping my journey. I hastily
cover myself and thereafter avoid wearing that top. Later, a
friend who has had breast cancer confides that she finds her
own mastectomy scar sexy.
Sexy? Perhaps my own scars don’t merely mark me
as aberrant. Maybe they’re also symbols of experience and
As time passes, the emotional charge connected to my new
breasts dissipates; before my mastectomies, I’d wanted to
have them completely restored. More and more, that seems
less important. Now, a few years later, I still have no
nipples — I haven’t wanted to invest the time or energy in
the process, and it seems silly to do it merely to avoid
scaring people in the gym locker room. My breasts are simply
my breasts, like before, except they are perkier and don’t
have any nipples, so I can go around braless. Yet I still
don’t feel very sexy, despite the fact that my husband
clearly thinks I am. I know my sexiness doesn’t start or end
with my breast tissue, but I can’t get past the saline. What
I do feel is happy, attractive, strong and healthy.
Of course, there are times I miss my old breasts, especially
when I see my teenaged daughter developing as I once did.
The other day, she was wearing a camisole I considered too
revealing. “Why don’t you dress more modestly?” I chided
her. Then I added, “You like your breasts, don’t you?”
“Yup,” she said, pulling her shoulders back. “Besides,” she
added matter-of-factly, “who knows how long I’ll have them?”