Today I sat in the bath and peeled off my nipple and proceeded to rub off the remains of the glue on my right breast and then clean the back of the nipple, ready to put it back on again after my bath. I’ve been doing this every few days for the last two years. Peeling off my nipple, which has been cast from my remaining one and colour matched, has become a normal activity for me, like cleaning my teeth or washing my hair, it’s just part of my routine.
I came downstairs with the nipple glue and instinctively put it away in the fridge. And then I remembered, I can throw it away now. I won’t have to live with it anymore, this glue that I dislike so much. It forms gobbits of surgical glue after cleaning the nipple, like sticky lumps of snot that turn up in the bathroom. It attracts fluff around the edge of the silicone nipple, like a dirty plaster. Reminds me it’s not really a nipple. (And yes, the ‘Peppermint Nipples’ tin is where I keep my collection of silicone nipples, I have spares – really – and the tin was a gift from a friend with my sort of sense of humour).
But today will be the last time I glue my nipple back on. Because this week I am having my surgical nipple made, the end of an extremely long process of breast reconstruction.
Extract from Being Sarah:
I don’t even like the word – reconstruction. Sounds like a heavy, messy, concrete and bricks term. It’s about as far removed from the image of a female breast that I can imagine. And anyway, why on earth would I want to put myself through all that surgery?
An extremely personal decision. One that I agonised about. I’d initially said no to recon, but changed my mind further down the line. My emotional pendulum swings and crashes, up and down. I want it. I don’t want it…. How on earth do I decide?
In 2008, a year after mastectomy and oophorectomy I started to think about it.
Extract from Being Sarah:
At this point I have done some research about breast reconstruction. I understand that it is a process. It’s not just one surgery, a single fix to put things back how they were. And I know too that it will not be a breast with sensation, at least the same sensation as a real breast. Or a nipple that is responsive and changes shape and colour. No. That is lost forever, cut off and taken to a lab. The reconstruction is only a sort of ‘version’ of a breast.
And also it is not possible to copy my existing breast. Alison (my breast cancer surgeon) had told me, very nicely by the way, that no surgeon would be able to match my existing breast, the droop. So several months after the big surgery to create the new breast has settled, I would need a reduction and lift on my left breast to achieve symmetry. And then it might need some surgical revision, depending on how it settles. And then there would be minor surgery for a nipple, if I want it. And then the tattoos, done over several sessions. And, of course, the scars from every surgery.
And, through all of this, every surgical procedure carries the risk of complications.
Do I really want to go through all that?
No, I didn’t really want to go through all that, but I have, well nearly. It’s taken two years to get to here from my first surgery, a DIEP flap reconstruction followed by revision and more surgery six months later, and before that process started another year of research and thinking and talking to surgeons and other patients. Phew. What a long road, I’m so glad the recon process is nearly over, I’ve got so impatient along the way, and emotional.
Last summer I made the mistake of going to a ‘routine’ hospital appointment on my own. It was so upsetting that I wrote a a blog piece about it. It was just so… so clinical, that I ended up crying on my own in the café, feeling like a fool. A fool for it to matter so much, that I was so fed up with being a patient and yet I still wanted this next ‘procedure’. And here I am, ten months later, about to have the surgery.
The Accidental Amazon recently asked on her blog, Is breast reconstruction worth it? Well, I don’t think there’s a definitive answer to that. I do know that many women choose not to, I myself considered that option, and the Breast Free website is an excellent resource for women thinking about whether to go ahead with reconstruction or not.
I also know that at my hospital, they call this plastic surgery, not cosmetic surgery. They still class reconstruction as treatment for breast cancer. I do know that for me it’s been psychologically necessary and an important part of my ongoing recovery. But it’s a big subject, it’s complex and I also hesitate to focus too much on it because I don’t want us to simply see breast cancer as a cosmetic disease. It’s cancer. And it’s cancer that kills you.
When I received the letter from the hospital with the date for this surgery my initial reaction was to cancel it, or postpone it. It never feels like the right time to have surgery… especially not this sort of surgery, the sort that doesn’t attempt to save your life or try to keep you cancer free. But I have a surgeon I trust and if I go ahead now then my reconstruction will be so nearly finished, which is where I’ve wanted to be for so long. Fellow blogger Stacy wrote recently about her latest conversation with her surgeon about nipple reconstruction, and how difficult it can be. She says she has thoughts like, “I can’t say how it should look. I never thought about it before.”
She also reminded me how special the relationship between plastic surgeon and patient is. How true. And just as well, I can see now that liking your surgeon is so important because you’ll need to have such intimate discussions about your breasts… and nipples. And whilst thinking about this blog piece, I wondered if I could share this information, somehow nipples seem even more personal than breasts.
So, here goes. I’m choosing to have a nipple bud created from skin on my breast mound. Although it’s possible to reconstruct an areola using donor skin from elsewhere, I’ve decided to have the simplest procedure. The areola will be tattooed at a later date, in the meantime I have fabulous temporary tattoos from Rub-On Nipples – really these resourceful women think of everything – plus their website has some stories from women about their experiences of reconstruction.
But this is a long haul. I sometimes reflect that it took a single surgery and an hour or so in theatre to remove my right breast. I’ve now spent over two years getting back the appearance of two.
So this week I know that my lovely surgeon, Ken Graham, will appear at the end of my hospital bed and smile at me. He’ll shake my hand, and ask me how I am. We’ll chat. He’ll ask me about my book (well, he’s not your average surgeon, he even came to the book launch and bought four copies). Then he’ll very graciously ask if I can remove my gown, and we’ll discuss the exact position of the nipple on my breast mound, then he’ll produce a pen and draw on me. Then theatre, and scalpels, and all that other stuff I dislike so much.
Sigh. I just want it to be done. I just want to feel finished. I’m so weary. But at least, no more nipple glue.