Finishing the Breast (or, Four Bras a Year)

Maybe it was vain to ask for a new breast after my left mastectomy. Some friends remarked they might have just lopped the cancer off and stayed flat. Maybe I should've considered that alternative before scheduling the plastics procedure.

I did not.

I did not read essays about losing breasts. I didn't google articles and compare outcomes. I didn't attend any support groups. I didn't even ask for anyone's opinion. I made the decision before I told my children, before I told my parents, before I told my friends. I'd had two breasts for forty-five years so it seemed logical to get a new one, put things back the way they had been.

I like symmetry.

I chose to have a silicone shell tissue expander placed right after the removal of my breast—stage one of my breast reconstruction—during the same anesthesia, the same operating room reservation. Two surgeons, one time slot. Efficient. Four months later, after serial saline injections into the external port of my balloon-like expander, when my pectoralis muscle and chest wall tissue were stretched into the desired size, I underwent stage two of my left breast reconstruction, and my expander was surgically replaced by a more permanent implant.

I'm always aware of the frame, now, of the walls and gabled roof outlining my new breast mound. Even when I'm naked, it feels like I'm wearing a bra cup, but only on that one side. Most of the time it's just a distraction, along with the steady ache of the muscle and soft tissue arching from sternum to armpit, my "tender crescent." Sometimes, there's a serrated deep stab—when I'm exercising or reaching up to a high shelf or pulling open a heavy door—but it's less predictable than it used to be. More random.

Whenever my husband, Chris, hugs me, we capture something foreign between us like one of those camping games from childhood when you passed a ball under your chins, but our ball has migrated down and around and smooshes between our two chests.

________

Seems silly to bother getting a nipple and areola. No one will see the embellishment, outside of my bedroom.

But I need to complete my reflection in the mirror.

The decoration is for me.

Nine months after my mastectomy and first stage of reconstruction, I watch my plastic surgeon cut a horizontal incision into my left chest, in the skin over my pectoralis muscle, which shields my implant. He gathers enough tissue to form a short columnar nipple to match the one on my right breast—my natural one. Natural, but recently healed from being excised and moved up my chest wall, along with the areola, when Dr. Noel reduced and lifted my right breast to match the artificial breast on the left. The mound he built to replace my real left breast, the one that harbored breast cancer.

I lie back thirty degrees on a surgical bed in Dr. Noel's office and watch him sculpt my new nipple eight inches away from my chin, as we chat about our children. In the ceiling above me is a large rectangle of glass with painted flowers, lavender and green, like a skylight scene. There is no pain. I can't feel a thing since the nerve endings of my left chest were torn away when my breast was removed. The numbness extends laterally, under my left armpit and around to my back, but now there's tingling and itching and burning in those areas, and I frequently lift the band of my bra to rub away the bug that isn't there.

If a spider were to crawl under my pajama top and bite my left chest, I wouldn't know it unless I saw the wound in the mirror. If I dumped scalding coffee down my front, I wouldn't know my skin was burned until I undressed. If the healing nipple became infected, I wouldn't feel any pain. When I slam the car trunk or close...