Why I waited 10 years to have breast reconstruction

Maybe I’m a late bloomer. After being diagnosed with triple-negative inflammatory breast cancer (IBC) in August 2007, I had a double mastectomy at MD Anderson. But I didn’t have breast reconstruction surgery until this March, almost 10 years later.

Why did I wait so long? For many reasons. 

Living ‘breast-free’ was an easy choice — initially

For one thing, after a brutal year of treatment, I was told that breast reconstruction could be dangerous. I was happy just to be alive, so living “breast-free” was very comfortable. I was also deeply tired and achy from the chemotherapy and radiation, and I didn’t want to lose even one more minute of my life to cancer.

As more time passed, though, I learned that I’d entered the “safety zone” for IBC survivors, which meant the risk of recurrence was lower. It also meant the recommended reconstructive surgery, called “DIEP” (deep inferior epigastric perforator flap procedure), would not endanger my long-term health.

Suddenly, I had a choice. 

New options bring quandary

Now, I felt greatly conflicted. Was it vain of me to go through this massive operation to have breasts again, when they were not really mine or natural? Wasn’t being alive and healthy enough? Somehow, I felt that by even considering this, I was betraying all the “flat and fabulous” survivors I admired so much.

I’d also heard stories about failed reconstructions: bodies rejecting flaps, expanders tearing skin and wounds not healing. And I knew that the skin damage I’d incurred from my own radiation treatments made similar complications more likely for me. 

Lymphedema: what finally forced the issue

Finally, something happened that pushed me to a decision: lymphedema. I developed this side effect very early on, and the swelling in my right arm was now moving into my right leg, my neck and my trunk. I felt uncomfortable in my own skin and hated how I looked. 

Then I read about a surgery called a lymph node transfer, in which surgeons transfer healthy lymph nodes to areas that are blocked or damaged. I also learned that most insurance companies would not cover this procedure unless it was bundled with another one that had a better success rate. A DIEP met that criteria, so I decided to look into it.

My breast reconstruction surgery at MD Anderson

At MD Anderson, I contacted plastic surgeon Mark Schaverien, M.D. First, he recommended a fat transfer and a scar release to see how I healed.

I loved his suggestion, because I’d had a large, uncomfortable dimple on my chest for years, where one of my mastectomy scars had adhered to my breast bone. And this showed his willingness to take small, careful steps to test the waters. I also had some microsurgery done on my upper arm, called a lymphovenous bypass procedure, whereby blocked lymphatics are bypassed into the nearby veins, to relieve the lymphedema.

Those procedures worked out so well, I was tempted to skip the reconstruction altogether. My husband was fine with his breast-free wife. And I was fine with being breast-free. So why continue pursuing this, after all this time?

Partly, it was because I knew DIEP surgery showed great promise of relieving my lymphedema. But the other part was purely sentimental. One evening, I was reading a book to my grandchild, and she leaned back against me. But instead of resting her head on a nice, soft breast, she hit the hard ridge of my breast bone. At that moment, I wanted breasts again. I wanted what used to be.

Feeling like myself again

I finally had my breast reconstruction surgery on March 7, 2017. And I can’t tell you how pleased I am with the results. I was never defined by my breasts, but my body had them before cancer and I’m happy to have them again now. My new breasts feel very natural. My truncal lymphedema is gone, too.

I’m glad that I waited so long to have the DIEP. It allowed science to catch up with my needs, so the nodal procedure would not be viewed as experimental. 

Now, when I take my grandchildren in my arms, I feel like myself again. And that feels good.

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