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Would You Like Paper or Plastic?

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Here I am, sitting in the waiting room of the plastic surgeon’s office that Dr. Breast has referred me to. Why is it called “plastic?” For the plastic credit cards used to pay for it? Never in a million years did I think I’d be sitting in a plastic surgeon’s office. Isn’t that for Hollywood or vanity types—people with a lot of money? No, as I’ve just learned, it’s also for women with breast cancer who want reconstruction.

Reconstruction. It sounds like something that’s done to a building after an earthquake. Well, this cancer diagnosis sure feels like an earthquake. And bigger than the one in I lived through in 1989. I’ve spent the last four days reading about options in breast reconstruction so I am prepared. This isn’t just about my appearance. It’s also about feeling like a whole, healthy person again.

Look at this office! It’s like no other physician’s office I’ve ever seen. The walls are painted a deep gold; the carpeting is soft and wine-colored. Paintings and artful photographs of female bodies are all over the walls. A life-sized, white plaster relief of a female figure is hanging on the wall over the reception desk. And instead of those uncomfortable waiting room chairs where my feet never touch the floor, there are three long, wine-colored, backless padded couches, in a u-shape with giant over-stuffed floral pillows. This office is so girlie. I like it!


I notice that all the women sitting and walking around behind the reception desk are very pretty. Is that a requirement for working here? Actually, the whole place feels a little like a French bordello.

I reach for a magazine, but it’s really more interesting to check out who is sitting here. Discreetly I look around. With three women plastic surgeons in this practice, the place is packed. There are several women who appear to be in their fifties or sixties, society matrons, well dressed and well-coiffed, wearing large amounts of gold jewelry, who look as though they’re here for those nips and tucks. And there is one young woman with a man twice her age who looks very healthy and so perfectly pretty that I wonder if she is his trophy wife getting yet another makeover. But I spot a pale looking woman sitting quietly in the corner, wearing a hat. A shiver runs down my spine. I’m thinking that she is a breast cancer patient who is going through chemo.

In walks a tall woman with curly blonde hair, maybe about forty, in oversized overalls with her husband, and an older woman who looks a lot like her. I’m guessing it’s her mother. Her husband quickly grabs a magazine and sits down in the corner and begins to read intently. The Ladies Home Journal sure fascinates him. She and her mother are talking loudly. Suddenly, she is sitting next to me. Somewhat intrusively she asks, “Which doc are ya seein’?” When I tell her, she nods and says, “She’s great. You’re gonna love her. She’s worth waiting for.”

Then she launches in to her personal diatribe. “Have ya ever lost a lotta weight?” I shake my head. “Well lemme tell ya, it all goes south on ya when ya do. I’ve lost two-hundred fifty pounds in the last few years and I need a whole damn body job!” Two hundred and fifty pounds! That’s a whole person, I’m thinking. Well maybe two whole persons, my size. But before I can comment, she starts describing all the work she is having. “I’m gettin’ a breast job, a tummy tuck, liposuction of … fortunately I am spared the rest when I hear my name called. I wish her good luck and walk up to meet a petite Asian woman, with one of those chic diagonal haircuts. She is nicely made-up, and wearing large gold hoop earrings.

She leads me to an examining room and hands me a lush velour robe. I undress and put this on, and she comes back and brings me to the surgeon’s office. I look around. It’s comfortable and cluttered. There’s a picture of a good-looking man wearing bike shorts and standing next to his bicycle, on her desk. I’m sitting there wondering if this is her husband, when Dr. Plastic Surgeon walks in and introduces herself.

I’m taken aback by how young and pretty she is, with shoulder length, ash blonde hair, and clear skin over a fine bone structure. She is wearing very cool, polka-dotted rimmed glasses. Dr. Pretty Plastic Surgeon, I think, and I quickly scan her certificates on the wall to see how old she is. Okay, I calculate she’s been practicing about ten years. She must be older than she looks. At her request, I take off the lush robe and she scrutinizes my body. It feels very strange to have someone stare at my naked body like this, but it’s something that I learn I’m about to get very used to. Well, she says, “Would you like larger breasts?”

I want to slap her! I’ve just been diagnosed with breast cancer and she’s talking about bigger breasts?! But I realize that this is just part of her work. “No,” I say, “I really don’t care so much about size.” Not since I was about fourteen have I thought about my breast size. Being smaller breasted has a lot of advantages if you’re as physically active as I am. “I just want to wake up after surgery and see a breast there,” I blurt, somewhat surprised at my bluntness. Who wants to be breastless in a society that worships breasts?

She nods and tells me that I have two choices: an implant, or a TRAM reconstruction, which stands for transverse rectus abdominus muscle. These are the two most common types of breast reconstruction. An implant is a shorter surgery and faster recuperation. But it is not permanent, and somewhere down the line, I may be looking at a replacement. The TRAM is a longer surgery and longer recuperation. It involves moving tissue from the abdomen up to the breast area. It leaves a flatter tummy, but with a big, thick scar. Dr. Pretty Plastic tells me that I have good skin, good health, and enough abdominal fat to consider the TRAM.

We spend the next half an hour or so discussing these procedures, and looking through her photo albums of headless, legless women that she has worked on. I peer intently into these albums looking at the before and after torsos of women who’ve had an implant or a TRAM reconstruction and carefully consider their results and their scars. I don’t like the idea of an implant. I think I’m more interested in the TRAM because it is more permanent and more natural, but again, I need to think about it. Dr. Pretty gives me the names and numbers of former patients who have had these procedures, and I tell her I will call them and call her with my decision next week.

The very minute I get home I start calling these women. Each one is so nice and has something interesting to tell me. I realize that these are the first women I’ve talked with since my diagnosis ten days ago who have had breast cancer and it feels so good to connect with them. One woman welcomes me to “the sisterhood” and I start crying. I’ve been a part of several sisterhoods in my life, but I never thought I’d be part of this one.

This is an excerpt from a forthcoming book: “Twice Afflicted and Gifted”

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