Post-Mastectomy: The Lay of the Land

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Barbie show

Some years ago, during my late twenties and early thirties, I penned and performed a one-woman show about Barbie. I had (and still have) a love-hate relationship with the ubiquitous doll, who, as the play reveals, was the source of many happy hours of childhood play, but whose questionable influence on young girls’ ideas about women’s bodies and gender roles troubles me. One scene in the show tells the story of a lavender nightgown I was given by a friend who’d outgrown it, a gown 10-year-old me was enamored of because its silky nylon bodice with sheer chiffon sleeves reminded me of a similar Barbie doll gown I found particularly glamorous. There was only one fault with the lavender nightdress: it hung straight down from my shoulders, whereas my Barbie’s gown “nipped in at the waist, flowed out over rounded hips,” accentuating her every curve. I began to insist my gown needed a belt, and after much pleading, my mother—reluctantly—purchased me a yard and a quarter of matching lavender ribbon. I bloused the top of the gown over the ribbon belt, reasonably satisfied.

My original vision for staging this scene in performance was to wear a gown similar to the one described; then, as I told the story, I would raise my arms into the air and stand on tiptoe as a stagehand came out and laced me, grommet by grommet and tug by tug, into an old-fashioned corset. Though it proved impractical to realize, that’s still my preferred staging of the scene: the tale of the little girl glorying in the big girl nightgown, beauty equal in her mind to Barbie’s womanly curves, juxtaposed with a literal representation of the cost of attaining that desire. As she (innocently) embraces society’s ideal of feminine beauty, she becomes increasing restricted by the corset.

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Equipment tray for my first fill

That image has been on my mind recently, now that I am almost three weeks out from a bilateral mastectomy and in the beginning stages of reconstruction. During surgery, after my natural breast tissue was removed, two devices called “tissue expanders” were placed between my chest wall and my pectoralis muscles. Essentially “baggies with ports attached” (my surgeon’s description), the expanders function as placeholders for future implants and, more importantly, slowly stretch the skin and muscle to accommodate them. What that means in practice is a series of appointments during which the doctor uses a magnetic device to locate the metal port and imprint the skin with an “X”-marks-the-spot. Then 100 milliliters of saline are injected into the expander through the port. These are called “fills,” and I will receive a weekly “fill” until my expanders reach their maximum capacity of 550 milliliters each, their size having been determined by the size of my natural breasts.

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I’ve heard other breast cancer survivors refer to the expanders as the “iron bra”; some have compared the process of getting fills to having dental braces that are tightened at regular intervals. Both are fair descriptions, though between the expanders and the various pressures exerted by tight muscle fibers and swelling from the trauma of surgery, I feel more like someone has implanted an entire whalebone corset—rather like the one I’d imagined in my Barbie play—inside my body. Sometimes I feel like I’m wearing a strapless, corseted evening gown whose stays keep riding up, jamming into my armpits. My impulse is to want to grab hold and shimmy the offenders back into place, but it’s my own flesh and framework that has risen up to cause me pain.

~~~

So I’ve been thinking a lot about that little girl in her nightgown, the costs and trade-offs of my desire to have breasts, my choice to undergo reconstruction. Without it, I could shorten the whole process: I would heal faster, experience less discomfort. I cannot get my permanent implants until radiation treatments are done and I’ve fully recovered from them, so I’ll be living with my internal corset for six months or longer, if I can stand it.

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My edgy androgynous look…?

More and more women are electing to remain flat-chested post-mastectomy, in part because the process is long and uncomfortable. There’s a definite declaration of freedom in that choice, and I admire women who make it. With my currently flat chest and super-short buzz-cut, I’m projecting what I like to think of as an edgy androgynous look. As a woman who enjoys playing with fashion and modeling, it’s intriguing to see this other version of me look back from the mirror. But I don’t think I’m prepared to embrace her long-term.

Seeing my altered body for the first time post-surgery was hard, though less traumatic than I anticipated. I’d heard of women who refused to look at themselves, or let lovers see them, for weeks or even months. Instructed by the surgeon to shower and remove my bandages 48 hours after my release from the hospital, I didn’t have much choice but to take the plunge.

Having both breasts removed, I think, made the changed topography of my body seem less, rather than more, shocking, since there was no immediate point of comparison between what was before and what was after. Seeing a flattened and grayed-out mountaintop removal mining site is devastating in part because of its contrast to the beautiful, rolling green hills surrounding it. But my chest had become an entirely foreign landscape, as if I’d fallen asleep in the Appalachian foothills and woken up to the western prairie. I was a little bumpy and not entirely flat, given the expanders and some general swelling; two reasonably symmetrical incisions sealed with a length of surgical tape bisected the memory of each breast mound. That was the phrase the reconstructive surgeon had used when he came by my pre-op station the morning of surgery, and it was the one gesture that had made me cry: watching him outline my natural breasts in black marker so he could remember their placement after they were gone. It was also my last sight of them.

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I feel a strange blend of grief and fascination when I look at or touch my changed body. At first everything just hurt; I had limited use of my arms and needed help going to or from lying prone. As I’ve healed, the overall soreness has faded so that now there’s a distinct difference between the skin over the expanders, which is essentially numb, and everything else, still tender. I’d been warned I would lose most of the sensation in the skin of my breasts. Steve asked if the sensation was akin to how your face feels after a shot of Novocain at the dentist, and some areas are a bit like that. But a more accurate comparison would be to place a book on your thigh, and then tap on the book—you can feel the vibration of the tapping in your leg, but no direct sensation from your fingers touching it. When I got my first fill, I felt nothing when the needle of the saline syringe pierced my skin.

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JP drain at work

Perhaps I’m able, for the most part, to retain a certain level of detached curiosity because I’m aware the construction of my new breasts is a long process, and it’s still early days. It’s a little bit like writing: my first drafts are messy, uneven, and rarely look much like the final product, but their deficiencies are tolerable because I know I’m not yet finished. Knowing it’s a process helps me feel less disturbed by my bionic boobs’ current non-breast-like appearance. They’re still a bit Frankensteinian at present, with some discoloration from bruising, the odd swelling, and those infernal JP drains, whose tubes are sewn into my skin and descend down my sides to two plastic bulbs. I tuck the bulbs into pockets during the day and squeeze the collected fluid out of them each evening with my husband’s help. Sexy, right?

~~~

 In my Barbie play, I follow the story of the lavender nightgown with the story of Cindy Jackson, who underwent more than twenty plastic surgeries in an effort to become a living Barbie doll. Together, the two stories were intended as a kind of cautionary tale. Just how high a price are we willing to pay to have our bodies conform to the hourglass ideal? The memory gives me pause. My eventual implants, whether fashioned from silicone or my own tissue, will be far more comfortable than the tissue expanders, though my new breasts will probably never regain much sensation. I hope that someday, instead of calling up the feeling of a corset, they will indeed begin to feel like bionic boobs, that they will become a part of me, imperfect but powerful reminders of my strength as a survivor.

Until then, I’ll just have to resist the urge to grab hold of the skin in each of my armpits and yank.

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