Going flat

There is a growing trend of people choosing to go flat when facing the question: To reconstruct or not? after a breast cancer diagnosis.

To reconstruct or not?

Of all the difficult decisions someone diagnosed with breast cancer faces, this is probably one of the most complicated.

We live in a society that holds very precise expectations of body shape, size and beauty.

We have our own beliefs and expectations for what we want to look like. We have our own pride, our own vanity, our own dignity.

So, as someone diagnosed with breast cancer weighs the question ‘To reconstruct or not?’ following a mastectomy, it is one of the most troublesome and personal choices they make at a time in their life when everything seems to be spinning away.

For me, I struggled with the question of reconstruction.

I was fortunate to work with a skilled general surgeon who did his best to not ‘maim’ me during initial surgeries. When we learned I needed a mastectomy of my right breast, I then met with a plastic surgeon who provided me a wealth of information about the many reconstruction options available today.

From silicone implants to DIEP flap methods, I was overwhelmed. Not to mention, I had to stand in front of the plastic surgeon naked from the waist up with my arms crossed high above my head, my jeans hiked low and try not to suck in my Botticelli belly as he took photos of my natural breasts.

When the surgeon told me to relax my belly, I laughed and thought to myself, ‘I’ve been holding this in for the past 20 years. If I let go now, lives will be lost.’

Then, I looked at my husband smiling at me from across the room and said aloud: ‘I’m not mature enough for breast cancer.’

The surgeon and my husband laughed, I relaxed my contracted belly and photos now exist in some secret medical bunker of me, my natural breasts and a very unnatural situation.

I think I understand why some people choose not to have their breast(s) reconstructed after a mastectomy.

First, for many people, reconstruction requires additional surgeries. More time in the hospital. More time dwelling on how cancer has changed them.

Second, there is no guarantee the reconstructed breasts, called ‘breast mounds’ blek!, will be ‘perfect.’ Certainly, everyone’s body has its own imperfections. Still, having a donut of silicone implanted in the chest isn’t exactly a flawless remedy. In my opinion anyway.

For me, I chose to have a double mastectomy with a DIEP flap reconstruction. This surgery is freakin’ amazing. Tissue from the abdomen is taken and transplanted into the chest. I chose this route for reconstruction after deciding I didn’t want anything ‘unnatural’ put into my body. Silicone implants were not for me. I chose not to 'go flat' for my own vain reasons. I question this decision a lot.

Today, I have new breasts. They aren’t perfect. In fact, they continue to trouble me medically and in appearance. My right treacherous breast (‘Cancer Joe’) is a pretty good facsimile of what it used to be. No nipple, no sensation, though.

My left breast (‘Boobzilla’) is a hot mess. It droops much lower than my right breast. Also, sans nipple and sensation. I’m not completely pleased with my reconstruction results. Still, I feel fortunate to have gotten through the 14-hour mastectomy and reconstruction with more or less what I expected.

As I’ve said the question of reconstruction is very personal. That’s why I admire women who choose to forego reconstruction. To go flat.

A group of women who made this choice were featured earlier this year in a report by CBS News. Ranging from 34 to 52 years old, the women talked about their decision to go flat.

For Rebecca Pine, the choice was difficult but one she has pride in today.

‘Beauty is something in the mind and in the heart,' she said. 'We’re just as feminine, we’re just as much women as we were beforehand.’

To illustrate that going flat can be more than a surgical decision, there is a growing awareness about it with ad campaigns, a fashion show and websites that offer stories, selfies and sisterhood.

Still, more often than not, people (about 60 percent) diagnosed with breast cancer choose reconstruction.

Dr. Deborah Axelrod, a surgeon and the director of clinical breast services at New York University’s Perlmutter Cancer Center, attributes this to improved surgeries and the notion that these surgeries will make the patient feel ‘whole’ again.

‘I think for us as surgeons, we feel that if we’re going to take a body part off, that we should then replace it with something that looks just as good.’

To read the story about more women choosing to go flat, visit www.cbsnews.com/news/a-matter-of-choice-mastectomies-without-reconstruction-2.

For people looking for more information about going flat or seeking others who have made this choice, FlatandFabulous.org offers support to women living without reconstruction.

‘Whether you are in the process of making the choice not to reconstruct, accepting the inability to reconstruct, or are living breast free, we want you to know, you are not alone,’ the website states.

Founded by Sara Bartosiewicz-Hamilton and Barbie Ritzco, who died in 2014, Flat & Fabulous was created to bring together the community of women living without breasts and to educate people about the validity of their surgical choice.

The group’s motto really says it all: ‘We laugh, we cry, we uplift one another — Flat & Fabulous is family.’