Going flat

March 27, 2015 12:46 AM

"You’ll be standing in front of a classroom, and you’ll want to look pretty." Mary-Anne Mohanraj writes about a conversation with her breast surgeon, who was shocked when Mohanraj suggested she might not want breast reconstruction after surgery.

Meanwhile, many women do choose not to have reconstructions - even though studies from the American Society of Plastic Surgeons have found that more than 70% of women aren’t fully informed about their reconstructive options before mastectomy.

posted by Athanassiel (21 comments total)

I have a good friend who underwent radical mastectomy on one side a year ago. She's 86 and otherwise in fantastic health. She made it clear to the surgeons that reconstruction was not something she wanted--her priority was to be done with them as expeditiously as possible.

When I took her to be fitted for a prosthesis, we both marveled at the lifelike texture, weight and appearance. But the minute she walked in her front door, she reached in, yanked it out and tossed it across the room. "I didn't realize how much I didn't miss that saggy old breast until I got a replacement," she said with a smile. "Kinda wish they'd taken both. I feel a lot more aerodynamic without."
posted by kinnakeet at 4:51 AM on March 27, 2015 [24 favorites]

So how much of the pressure from doctors is reinforcing social norms and how much is adding another billable service?
posted by GenjiandProust at 5:15 AM on March 27, 2015 [8 favorites]

I'd go flat in a heartbeat. Seriously these things on my body are heavy.
posted by AlexiaSky at 5:35 AM on March 27, 2015 [11 favorites]

Ditto. Wish I could take them off, like a vest or a harness.
posted by GrammarMoses at 5:51 AM on March 27, 2015 [2 favorites]

I don't suppose you can get a double mastectomy for fun?
posted by jb at 6:12 AM on March 27, 2015 [1 favorite]

I'm with your friend, kinnakeet. Having no breasts would be so freeing.
posted by jb at 6:15 AM on March 27, 2015 [2 favorites]

Another thing to consider - I've been an A-cup most of my life. Small breasts still fall within the venn diagram of "normal". This doctor saying that only big was "normal" was also being really short-sighted.
posted by EmpressCallipygos at 6:37 AM on March 27, 2015 [12 favorites]

"I don't suppose you can get a double mastectomy for fun?"

There is such a thing as breast reduction surgery. I'm a guy but my only "problem" with mastectomy is that the nipple usually gets removed. Ouch. Anything that removes pleasant sensation kinda sucks. Ofcourse cancer sucks a lot more but still. Ouch.
posted by I-baLL at 7:05 AM on March 27, 2015

In summer, especially, I would gladly take them off and put them on a shelf. Once you're done having babies (or choosing not to have babies) they are several pounds of purely useless bodyweight that require expensive underwear to support.

I had never thought about how women getting mastectomies could turn that into a freeing choice, but...I'd probably do it. I'd prefer falsies to implants, for sure. Those things make me nervous.
posted by emjaybee at 7:06 AM on March 27, 2015

I may have told this story before. On 1979, my mom had to have a mastectomy. Afaik, reconstruction was not an option at all in those days, so she simply wore a prosthesis. In the early 1980s, reconstructions started to be performed, but only in the biggest cities, and only by referral. My mom couldn't get her insurance company to pay for the surgery. They said it was an "elective, cosmetic" surgery, and she would have to pay for her own vanity. Finally, in 1995, she was able to get her breast reconstructed. She was 60. I am still so angry for her mistreatment.
posted by toodleydoodley at 7:22 AM on March 27, 2015 [4 favorites]

There are many reasons to avoid reconstruction (and sometimes reconstruction just isn't possible). For a lot of great information visit:

--Flat & Fabulous and their Facebook group
--Why Choose Mastectomy without Reconstruction
--Breast Free
--Reconstruction and Nonreconstruction Choices
--Going Flat: Choosing No Reconstruction
--The Choice No One Talks About
...and more
posted by ReginaHart at 8:23 AM on March 27, 2015 [1 favorite]

I find the pull quote hilarious. Pretty is the last thing I want to be in front of a classroom. Respected, intelligent, informative; those are much more desirable. (And due to stupidity, for many in the audience, "pretty" might interfere with these more important qualities).

I am a bit confused that a doctor of any sort would think (a) beauty is the major goal (b) breasts are required for beauty (c) implants are the best way to achieve this post-mastectomy.
posted by nat at 8:28 AM on March 27, 2015 [6 favorites]

I am a bit confused that a doctor of any sort would think (a) beauty is the major goal (b) breasts are required for beauty (c) implants are the best way to achieve this post-mastectomy.

I'm not.
posted by EmpressCallipygos at 8:51 AM on March 27, 2015 [7 favorites]

Wait, don't breast implants require periodic maintenance surgeries? Additional surgery every 15 years or so is the last thing I would want to sign up for if I had just finished dealing with chemo and a mastectomy.
posted by insoluble uncertainty at 11:32 AM on March 27, 2015

I know there are people who feel differently, but every woman who has had to have their breasts or uterus removed that I know well enough to discuss it with, has considered it a net positive.
posted by tchemgrrl at 1:02 PM on March 27, 2015

Thanks, ReginaHart - I was a bit too clever with my links and they ran together a bit. Your list is much more sensible. I found some of those sites but missed a lot of the others you posted that look really good!
posted by Athanassiel at 1:55 PM on March 27, 2015

There is such a thing as breast reduction surgery.

Yes, and Mohanraj writes about that too in the linked article. She also had a breast reduction and her surgeon didn't allow her to go below a C cup. Could she have insisted? Maybe - she writes about that too. Having read her article, I know I wish I had.
posted by Athanassiel at 2:01 PM on March 27, 2015

Wait, don't breast implants require periodic maintenance surgeries? Additional surgery every 15 years or so is the last thing I would want to sign up for if I had just finished dealing with chemo and a mastectomy.

Back in 1992 or so when my mother had a mastectomy, she was told the implant would last forever. Turns out, they do have a 15 year or so life and she had to have it replaced and was, once again, assured that it would last the rest of her life. She was not amused, but apparently found the argument that it was worth replacing with another implant convincing.
posted by hoyland at 5:24 PM on March 27, 2015

Wait, don't breast implants require periodic maintenance surgeries?

Another thing to consider: I had a family member who underwent a radical mastectomy in the early 90s. Ten years later, despite the radical mastectomy, she had a recurrence of breast cancer, so they had to do surgery again which involved taking out the original implants. This time around she opted not to have them put back in.
posted by litera scripta manet at 9:35 PM on March 27, 2015

You're super welcome Athanassiel. Actually I felt like a dork because I unwittingly reposted some of your links. Regardless, thanks for submitting this post. It's really important for this information to become common knowledge.
posted by ReginaHart at 9:24 AM on March 28, 2015 [1 favorite]

From the comments on Mohanraj's original blog post: Shirts off, Underwear on: Play Out, Breast Cancer and Gender Expectations by Melanie Testa.
posted by brainwane at 6:39 AM on March 31, 2015