When I opted to proceed with reconstruction after my bilateral mastectomy, I was unprepared for the number of steps to complete the lengthy process. Once my new breasts were completely healed, the plastic surgeon gave me the option of nipple reconstruction. I was pleased with the shape of the breasts and the similarity to my former self while clothed; however, I had to admit something was missing. I could only compare it to looking at a face that had no eyes. There were no defining features; only a scarred blank slate remained.
Was vanity totally at play? Some women proudly and bravely face the world without reconstruction altogether and others forego nipple reconstruction to avoid the protrusion under clothing. Yet I was still trying to recreate to the last detail what was lost forever. What purpose would reconstructed nipples serve? Surely they would not be useful as nature intended, nor would they likely have any sensation. I had already endured three surgical procedures; was a fourth necessary?
I had heard the stories of surgery successes and failures. Some processes used grafted skin from the inner thigh or other delicate areas, some procedures required the patient to wear small suction-like cups over the nipples to keep the skin from flattening out, and various methods utilized local tissue from the nipple location of the reconstructed breast to create flaps that when arranged and sutured would create a nipple. Most procedures also require tattooing to recreate the areolas. Ultimately, the plastic surgeon makes the decision of which method he or she is most confident will work best for each patient. The surgeon will take into consideration the condition of the skin, whether or not radiation has damaged the local tissue, and the patient’s history of healing and scarring.
Even though I questioned the necessity, I felt compelled to move forward with reconstruction. The procedure was a quick 90 minutes and since my reconstructed breasts had little sensation, I was able to have local rather than general anesthesia. The doctor used local flaps of tissue to create the final product, although there are varying procedures for this process. I came out of recovery quickly after what was easily the simplest procedure endured thus far. Upon the unveiling I was surprised at how pleased I was with the procedure. Suddenly, the lumps that had been recreated on my chest had been transformed into breasts. The picture was complete; the face now had expression.