The New Girls

After being diagnosed with breast cancer, Sally Koslow found a surprising upside to the illness.

The-New-Giorls-Esay.jpg

Two summers ago I became obessed with breasts. I scanned every scantily dressed woman I saw and scrutinized her pair. Were they perfectly shaped like champagne coupe glasses? Did their melonesque glory cause whiplash? Were they distractingly peppy? My preoccupation had nothing to do with a sexual orientation swap and everything to do with a mammogram. I had been diagnosed with triple negative breast cancer.

My breast surgeon recommended a unilateral mastectomy rather than the more typical lumpectomy. Because my cancerous breast had been pecked away by previous biopsies, having another chunk or two removed from my A-cup would leave me depressed in more ways than one. “After surgery we want women to love the way they look,” the doctor said. “You wouldn’t believe the results a plastic surgeon can create with reconstruction.”

Never had I considered getting cosmetic implants, which struck me as wearing your insecurity on your chest. But medical implants? That felt different. While my aerodynamic upper body had served me well over the years—I nursed a child and was built for jiggle-free running—it was distinctly off-trend. In a nation where the average bra size has ballooned to 34DD, I was living quite a few syllables short of va-va-va-voom. Once I learned my post-mastectomy options, I realized I didn’t have to.

One possibility was a long surgery that rotates muscles from the back to the chest. Another was an even longer operation that transposes belly fat, basically giving you a tummy tuck plus a new breast. Fine with my waistline, I signed on for a third approach, which takes about four to six months and was selected by most of the more than 100,000 American women who had reconstruction in 2014. After the breast surgeon finishes the mastectomy, a plastic surgeon inserts a hollow plastic disc under the muscle of the chest wall. (In my case, the noncancerous breast would also get a tiny implant so my set would look, if not like twins, at least like sisters.) Every few weeks, saline—about a shot glass’ worth each time—gets squirted into the disc via a port in order to expand the skin. The process is alternated with any necessary chemotherapy or radiation, and it’s repeated until the patient reaches a size she deems right. In further surgeries, the doctor exchanges the disc for an implant and may construct a faux nipple that can be tattooed to match any skin tone.

Even though I was facing down the fear and pain of losing a body part—or worse—there was suddenly a plus side. With respect to plunging necklines, reconstruction could grant me an upgrade from economy to first class. The thought of finally having cleavage had undeniable appeal. Who knew cancer had a perk? But first I’d have to get through my surgeries. The mastectomy took four hours and removed seven lymph nodes along with my right breast. You enter a hospital feeling nervous but healthy. You leave bruised, sore, swollen and bandaged. My convalescence was a word-slurring blur, thanks to my dear new companions: Valium and oxycodone, chased by antibiotics. Yet whenever I swam up from my stupor, I experienced a profound glow of gratitude. I’d learned my nodes were cancer-free! Also, I had a stellar support team. Throughout the pre-op appointments, my husband, mother-in-law and sister-in-law had been at my side, and there again was my intrepid spouse, cooking, fetching me blankets, even attending to a drain attached to my chest. I remember this stretch as one long nap punctuated by loved ones’ visits, calls, emails, cards and gifts like gourmet ice cream. This steady attention fed my courage like an IV drip.

Nevertheless, during follow-up exams I averted my eyes when nurses checked my wound. I wasn’t ready for the big reveal. It took four weeks to muster the pluck to examine my scar, only to find that I was far from freakish. The plastic surgeon had completed the mastectomy with a few squirts of silicone, to give me a gently rounded shape. I resembled a broken Greek statue, feminine on one side, tomboy on the other, embossed with a pink squiggle that stretched from mid-chest to armpit, not unlike breast cancer’s ribbon symbol.

I left the doctor’s office feeling empowered—a good thing, because dealing with the consequences of a mastectomy is hair-raising. I needed to research oncologists, track down pathology slides and, in thick city heat, shuttle them between hospitals in order to seek opinions on optimal treatment, if needed. Then there was the blizzard of bills. I had solid insurance, but no plan covers everything. I couldn’t help but notice that the “orthopedic device” that was placed inside me after the mastectomy to expand my tissue later looks like a toy you’d buy in Walmart—but costs a heart-stopping $10,795. Thankfully, my insurance did cover it.

Reconstruction began a month after surgery with saline injections administered via a long, scary syringe. The visits took only minutes, causing tingly pressure but—hand to God—no pain. While my left half remained dainty, my right side took off as the expander pushed the skin forward to create a breast. At this point I was told I could graduate from a camisole to a wire-free bra. I felt like an anthropologist as I strolled store aisles, assessing undergarments in sizes that could accommodate a whole hutch of Playboy Bunnies until I found one pleasingly unconstructed option.

I was remarkably chipper throughout the process until the evening a hostess at a party introduced me to a guest she assumed I’d have so much in common with. The woman had also gone through reconstruction but was less than thrilled with her results. “I had to see a physical therapist for a year to get back mobility in my arm,” she moaned. Hearing her complain, I considered how glad I was to have diligently performed my rehab exercises. They hurt but, unlike her, I’d become as pretzel-y as ever. “The reconstruction was botched, twice,” my new acquaintance added, to my dismay. “I’ve had to repeat it three times. Three!” With that, my emotional boom went temporarily bust.

The news of breast cancer, I discovered, initiates you into a populous sorority, and it’s hard to protect yourself from cancer-sisters on a mission to vent, not help. I applaud support groups, but I chose not to join one. I didn’t feel dreadful and feared that being in a group would have the reverse effect of prolonging my mental stay in Cancerville. When I received my diagnosis, I never asked, “Why me?” The American Cancer Society estimates that more than 230,000 new cases of invasive breast cancer will be diagnosed in women in the United States this year. Given the numbers, shouldn’t any woman ask, “Why not me?”

As I feared, following my party conversation, worry replaced optimism. I felt as if my courage had been stolen. Post-reconstruction, might I look deformed, with a bespoke breast that was higher than its partner, sagged low or had wandered over by my armpit? I’d chosen to stop after three injections, but now I wondered, was this number inadequate and would I kick myself for the rest of my flat-chested life? What if my body developed rocky roads of scar tissue? Infection? Lymphedema? Hematomas?

While bad karma fought for airtime in my head, four months post-mastectomy I underwent replacement surgery. That evening—no hospital stay required—before I collapsed into bed, I peeked at my bandaged body: I looked well proportioned for a woman with a small frame. I choked down monster tabs of a painkiller, since I ached far beyond the partially unzipped mastectomy scar and the incision under my remaining breast. Sleeping was nearly impossible. But I would have gotten little rest under any conditions, since hours after arriving home, my son on the opposite coast called to say his wife was in labor, a bit ahead of schedule. Twelve hours later I learned I had my first granddaughter! I sat in bed shedding tears of complex joy over the miracles I was experiencing: that the baby was born healthy, that she was here at all (since my son had also fought cancer) and that I’d survived cancer as well.

Two years later I can almost pretend that my diagnosis happened to someone else. My self-esteem has spiked from simply getting through the experience with a bit of grace as well as from the curvy result. My physical scars will never completely fade. But they remind me that I’m a woman with a designer body wrought by science. I’m a piece of work, in the laciest, sexiest bras—32D!—I’ve ever owned.

Sally Koslow’s most recent novel is The Widow Waltz.