We – the system

I’m turning the pages of the portfolio of the plastic surgeon. She’s understandably proud of her work. “I’m sure I can get a very good result with you,” she reassures me, while I’m looking at small breasts, medium breasts, large breasts. They’re all fake, it’s easy to see. It’s undeniable good work, but the situation is surreal. “It will feel exactly like a real breast,” she continues. I’ve done my homework – she’s referring to how the breast will feel to someone outside of my body. From the inside it will be numb. I’m here because my physician has recommended to remove and replace my left breast with a silicone implant. The first part is for medical reasons, since there are very early stages of cancer in that breast, the second for psychological ones. It can be difficult to figure out the difference when you’re in a state of shock and need to make a fast decision. The nurse had already booked a visit to the plastic surgeon. “It’s entirely up to you, but we think it’s a good idea to reconstruct. At least hear them out.” I’m hesitant from the start, but I want to keep all possibilities open. Will I be a freak if I don’t do it? The words from the physician echoes in my head. “Being your age, you have many years left”. Left of what? Being looked at? The creeping feeling of being an object, designed only to be seen becomes overwhelming.

Looking at the pure statistics there is much higher risk of complications for a reconstruction compared to going flat, according to cancer study at the University of Texas. This was also confirmed by my own physician. Furthermore, all the focus of the surgery is on the visual representation and on the perspective of the outside world, making some women disappointed about numbness in the breast after surgery. I’m not doubting the fact that many women are highly uncomfortable with having only one breast, let alone having both removed. But the interesting question here is NOT how we can fix these women; it’s why is this making women so uncomfortable? Right now we internalise the issue in the women. They are offered make up classes, “how to style your wig” and are put through medically unnecessary surgery that increases risk of complications. They themselves are responsible for feeling good in this situation. But when you look at reality, it doesn’t seem to work. The article in this month’s magazine for health in Denmark tells the story of the psychological effects of losing your long curls in cancer treatment. And the results of reconstruction is not always that good, requiring several reoperations dragging out for months or years, leaving the patient unsecure or even worse in pain.

I eventually decided on “flat reconstruction”, but there wasn’t any pictures to look at for this choice. It is not considered a choice for aesthetic reasons. Once I made up my mind, there was no questioning it at all. But the discourse was all the time that my new look should be hidden away. Something to be embarrassed about. The talk of getting a prosthesis back home on the day of surgery became ridiculous; I turned it down numerous times, but everytime a new nurse came on shift, I had to start all over. In the end I got one home after all.

What I really want to stress is that I have only met kindness and big hearts during my illness. All doctors and nurses have been very respectful and wanted the best for me when treating first the prestages and then later the cancer. But there have been a lot of general assumptions. And it has been very hard for me to get through with my viewpoint. It most certainly comes from their experience, a lot of people can change their mind at a later stage and want reconstruction after all, but it takes a lot of effort to keep saying “No – I’m happy with the way I am” over and over again. And it makes you questioning yourself – since they don’t trust me, maybe I’m wrong after all? Is it in fact impossible to be happy without reconstruction?

As long as the system, which is all of us, keep acting on the “normal reaction” we keep reproducing it, even enhancing it. But if we want to make sure the women feel better, we need to shift the perspective. We need to change the underlying fact that the primary worth of a woman is her looks. That she is an object to be looked upon. We need to value the wellbeing and mental health of women, starting with their self-esteem, saying your are good enough no matter what you look like. You don’t have to change yourself to be accepted. I respect and encourage every person’s freedom of choice. But if you choose to reconstruct because otherwise you are afraid to go to the beach or to be seen without two breasts at all, it doesn’t seem like much of a choice. 

What is beauty; who is it for? If the alternative choice of going flat is not represented, how can anyone perceive it to be beautiful at all? If the health care system keep telling you about the psychological effects on average women to not reconstruct, you start believing it will have an impact on you. We are the ones judging what is beautiful and what is not. To be seen and be proud without reconstruction is to me to fight absurd beauty standards.