nipple reconstruction

Breast cancer lesson 175: You don’t need a nipple to feel whole again after cancer surgery

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A few days ago, I called the hospital and took myself off the waiting list for nipple reconstruction surgery.

It wasn’t a rash decision (many a cup of tea has been needed in the build up), but as far as decisions go, it is among the best I have ever made.

I must confess that while I would have loved to have said to colleagues and clients: ‘Sorry, I won’t be able to make the meeting as I am having my nipple put on that day’, and, while part of me liked the idea of being put back together again, a huge part of me was shouting: ‘Why?’

After surgery and finishing active treatment, it felt like the natural next step (why wouldn’t I go for a cherry on top’?!). Sitting in front of the surgeon talking about cutting and snipping and stitching back in October, it seemed like a quick and painless procedure and an easy way to forget the past.

But, ask me what I am thinking about six months on and I can tell you, it’s not a pink, fleshy (albeit realistic) blob on the end of my fat-filled right boob. It’s the fact that I am happier, healthier and fitter than ever and a nipple really won’t add anything – except a ‘permanent outy’ that no amount of warm weather would conceal.

Now, I realise that I was more curious than in need of an extra asset. And, curiosity just isn’t a big enough reason to brave a hospital gown, needles, a knife, an operating table, a series of nipple tattoos and the memory of a year in the warm, but treatment-focused arms of the amazing NHS.

I guess you might call me lucky. Strange as it sounds, I don’t want to hide from my scars. Each one carries with it a story that makes me who I am. Each one reminds me not to worry when I get caught up in the complications that come with everyday life. Each one keeps me grounded. Each one is a reminder of all I had to lose and all I have gained as a result of this challenging – and yet weirdly fulfilling – period of my life. My scars are just as much a part of me as my right foot that turns in and my dodgy hip. I am not looking to replace them, but embrace them. I have no ambition to be a topless model so why would I cover up what is always covered up.

I read my story in the lines that cancer has given me and I smile. I smile because they remind me not of pain and surgery, but of just how far I have come – and of just how far I want to go. It is with these scars that I will be lining up on the starting line of the Bath Half in two weeks (and the Pink Ribbonwalk in July and the Royal Parks Half in October). It is with these scars that I will be flying to the Caribbean (yes, leaving Europe for the first time) with my new size 6 tankini (sun-exposure conscious as ever). And, it is with these scars that I hope to make a difference on this wonderful planet of ours. As I said, all the way back in lesson 21: ‘scars remind you where you’ve been and how hard you worked to get there. They don’t have to dictate where you’re going, but they can give you the strength and determination to make sure the path you do choose is a beautiful, interesting and inspiring one.’

Last year, I came face-to-face with my own mortality at the age of 32. I had the chance, at a young age, to reflect on what my gravestone could say and I decided the message needed to change – and fast. I can guarantee it won’t ever say: ‘Here lies Jackie, cracking right nipple.’ What I hope it will say (and not for a very long time) is: ‘Here lies a woman who smiled, laughed, lived and loved – and dedicated her life to helping others do the same (admittedly may need editing as I am not in the market for a tomb)! Sounds morbid, but I have plenty of years to get it right.

Breast cancer lesson 162: Why it’s hard not to laugh in a nipple consultation

The trouble with attending a hospital appointment on your own (don’t worry, I am not throwing caution to the wind after lesson number one, these are very routine appointments), is that you have no one to cover you if you need to pop to the loo. That’s why, I spent the best part of my 90-minute wait on Monday working out the best time to take the chance – only to realise it takes less than a minute to get back in the waiting room if you’re focused.

The reason for this latest waiting room visit was to meet the plastic surgeon and discuss reconstruction phase two. Phase two is, of course, the ‘return of the nipple’, if we see phase one as ‘destruction of the boob’. That was my understanding of the meeting anyway, so I was amused when the registrar took one look at me and asked me how the chemo was going! And I thought I actually had a bit of hair.

Now we are onto the cosmetic side of the job, I am finding it hard to treat the whole thing as surgery. I diligently took my top off on demand and smiled as we went through the usual: ‘we can tidy it up of you’d like to look even on both sides’. My stock reply tends to be: ‘I am very happy with my set (asymmetrical as they are) and I wouldn’t consider another general anaesthetic at this stage. Plus, the right one will grow and shrink as my weight fluctuates, so I will always be pretty lopsided.’ It is very kind that plastic surgeons don’t want me to be wonky, but I am just happy to be here – imperfections and all! Trust me, if they fix the boobs, their perfection would just look out of place.

I did consider stopping without a nipple given I am happy with my fleshy mound. But, I feel like the journey won’t be complete without finishing it off. It will be a permanent ‘outie’, so I think it will be padded bras all the way after surgery. It will also be tattooed so that it matches the left side.

Today was quite interesting in terms of reconstruction options. It seems there are two ways to reconstruct the nipple (or should I say we only discussed two). The first is a local flap, created using existing skin attached to the reconstructed breast. The only downside it seems is the fact that it would leave a little scarring to the sides of the nipple, but this would be covered up by the final tattooing stage of the process, Yes, I didn’t think it was enough to get radiotherapy tattoos. Now I want to tattoo my boob.

The second option is to remove skin from another area of the body to create the ‘protrusion’ (sounds a bit scientific for a boobie). The downside to this procedure is the fact that there would be two wound sites and the fact the grafted skin may not take to its new home.

For me, this didn’t feel like decision that would be hard to make. I have opted for the local flap and will take the extra scarring! I don’t fancy carving up any other body part for an extra bit of skin. It is already part belly. It certainly doesn’t need to be part anything else.

So, in six months time (you have to wait for the boob to settle after radiotherapy), I will, at last, complete my reconstruction. It’s a local anaesthetic. It’s a quick procedure. And I would bet money on it being one of the strangest experiences of my entire life. (I must admit, the consultation was pretty funny, with the highlight being the young doctor poking my boob with this finger to point out the position of the nipple. I kept thinking to myself, I haven’t been nippleless that long!)

It certainly is amazing to see what these plastic surgeons can do. I just never thought they’d be doing them to me!

NB: In other news, as part of Breast Cancer Care’s #hiddeneffects campaign for Breast Cancer Awareness month I put together a piece on smiling through cancer. Click here if you’d like to have a read.