What No One Ever Tells You About Mastectomies & Intimacy

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mastectomy, breast cancer
"The good news is, you'll have a brand new pair of breasts!" Well, not exactly.

Sounds great in theory, and I'm sure hubby meant well, but was it she who was worried about the size, look and immediate replacement of her boobs ... or was it he? A husband's concern over the appearance of the new breasts, a boyfriend's curiosity about the scars, a cue signaling anything other than complete acceptance — these are the things that can undermine a woman's confidence. I'm not saying that she's not entitled to be concerned for her looks, but the last thing she needs after losing her breasts is to be caught up in someone else's idea of what's aesthetically best for her.

Then there are the logistics. Let's start by saying that "store-bought" implants do not have the same cosmetic effect on a mastectomy site as they do on a woman who is augmenting her own natural breasts. A breast augmentation is a procedure that slips an implant (ranging in size) beneath the fatty tissue of the breast to basically plump up what's above it, making a natural breast appear larger. The external appearance, the skin, the shape and size, the nipple — all of it, once fitted with an implant, has a larger, fuller look.

A mastectomy removes the entire breast, leaves no fatty tissue, no nipple and no extra skin to slip an implant beneath. The woman must first undergo a skin-stretching process in order to accommodate the implant; that's done by placing a tissue expander beneath the tightened skin, which is later replaced in yet another surgery by a silicone or saline implant. The road to reconstruction is a long one.

What does a finished reconstruction look like? It looks like a small, round, featureless, flesh-colored mound in place of where the breast once was. It is quite soft and nice and is of great comfort to a woman. If she wants, she can opt for a nipple (by tattoo or skin graft) at a later date. But many women tire of all the surgeries and simply accept the breast mound as is.

So, whether you're Angelina Jolie, me or any woman out there who's had to say ta-ta to a breast or two, it doesn't matter how much money you have or don't have, if you're one of the most beautiful women on Earth or just a plain Jane living a plain-Jane life; losing a part of you that's so closely tied to being a woman is a challenge that is both daunting and surmountable.

It's daunting because of the vulnerability it introduces into your life  it’s hard to feel so fragile, so emotionally raw, so alone. What's surmountable is the misconception that you've become something less than who you are. That you can get over. I did. In fact, give it enough time and you'll get over all of it, I promise. You're not ugly, undesirable, ruined, unlucky or worthless, as I thought myself to be for so, so long. It takes time to acclimate to the battle scars that will become part of your back-story.

And when all else fails, there's always humor. Want to freak out friends and family? Nothing works better than whipping out a nipple-free breast mound at your next barbecue. Time — and laughter  heals all wounds.

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