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Nicola Pulling in her Toronto home on July 10, 2014. Pulling had breast reconstruction surgery after having one breast removed due to cancer. (Chris Young For The Globe and Mail)
Nicola Pulling in her Toronto home on July 10, 2014. Pulling had breast reconstruction surgery after having one breast removed due to cancer. (Chris Young For The Globe and Mail)

PERSONAL ESSAY

Reconstructive breast surgery makes woman feel ‘more beautiful than I’d felt in years’ Add to ...

Then I got a prosthetic. In public, I looked whole again. But I was conscious that when I wore any tank top, or V-neck, someone might see not only the prosthetic but also the flat space beneath it, where my cleavage, such as it was, used to be. My arm would reflexively hold my top in. My shoulders curved inward.

In private, I had more support and loving than I could wish for. My husband never made me feel less or different. This was the man who shaved my head the day my hair started falling out. He loved my body. He thought I was sexy. And he showed it. But over time, I found my boob, my chest area, off-limits. I built a barrier around my sexual self. I didn’t feel desirable. I stopped thinking about being beautiful. That wasn’t part of me anymore.

To the outside world I was fine. I pooh-poohed any notion of reconstruction, saying it’s pure vanity… that boobs are highly overrated. I think I was digging in my heels against being medicalized again. I just wanted to be left alone.

But gradually the incessant doctors’ appointments faded. My hair came back – on my head as curly as a poodle, my eyebrows like caterpillars. I got to the point where I actually cut my hair short again. And dyed it. And I realized... I was healing. Life was normalizing. I decided it was time to at least check out my reconstruction options. No one made me, I was just finally willing to look up and beyond this place.

I signed up for two different group sessions at two different hospitals. We sipped coffee and ate cookies while they explained to a group of hardy survivors – some newly de-breasted, others more than a decade out – how all this works.

You can have implants – saline or silicone. This takes months because first they surgically implant a tissue expander, which is a fancy balloon that they slowly, over six months, fill with saline through a syringe. Once the skin has stretched, you go back into surgery to have the implant inserted. They last up to 20 years – then might need to be replaced.

If you’re not a fan of implants, or have had radiation, which stiffens the skin and takes implants off the option list, you could opt for a TRAM flap, where they migrate muscle and fat from either your back or your stomach under the skin and up onto the chest wall. You sacrifice some strength where the muscle has been removed.

I’m not sure about the other women, but I was working hard to keep the astonished look off my face. Seriously, decades of breast reconstruction and this is what we have to show for it?

The second info session also offered the DIEP flap. I knew two women who had had the procedure and were thrilled with it. You pay up front – the surgeon takes skin, fat and blood vessels and reconnects them microscopically to the chest. It takes eight hours. Once the procedure is done, it is done. No tissue expanders, no sacrifice of back or stomach muscles, and it’s my own tissue. My very own frankenbreast.

After months of waiting, I finally got the consultation at the beginning of April. I doubted I had enough belly fat to build even an A cup. But, as the surgeon squeezed my belly between her two hands, she said it was just possible and that I could have the procedure within a couple of months. I was, she said, a textbook case. I was suddenly giddy. Up from my murky depths came an excitement and a truth that I was willing to embrace: Tank tops for the summer. I signed the consent. Just like that.

So that’s how I ended up in the drawing room. Still battling with why I needed to go through this but listening to a quiet instinct that said I deeply, deeply wanted to be whole on the outside. And yes that offends my feminist self. Deal.

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