I gave myself a new boob for Christmas: How picking the right surgeon to rebuild my breast made me feel whole

Have something to say? Lookout welcomes letters to the editor, within our policies, from readers. Guidelines here.

Having maneuvered a contentious divorce and cancer, I think of myself as pretty badass. Yet, the morning of my breast reconstruction surgery, I was terrified. 

I had been feeling scared ever since the 2013 breast cancer diagnosis, but this was the first time I really felt uncertain. Everything leading up to this point had been done to save my life. I was the mother of two middle school children and so I marched through the medical directives – chemotherapy, surgery and radiation – without much reflection. 

This elective surgery, to reconstruct my breast, felt different. A bit indulgent but in a good way. 

My surgeon arrived with his artist bag and pulled out his pens. He skillfully painted a design on my body. It looked pretty good. 

One in eight women gets breast cancer in America, and the rate is slightly higher in the Bay Area. Luckily, only around 2% of women die from the disease thanks to early detection and better treatment. That means we survivors often need or want plastic surgery. That is something you don’t hear people talk about as much. And the type of surgery I had is an option only in parts of the U.S. where surgeons are trained to do it.

For Christmas 2014, I decided I would give myself a new breast to replace the one I lost to cancer. I had wanted this reconstruction surgery all along, but Christmas that year was when it finally happened.

After my chemotherapy treatment ended, I had to find two doctors: one surgeon to remove the remaining cancer fragments and a plastic surgeon to make my body look and feel good again. Timing is an issue. The first surgery has to be done fairly quickly. The second surgery is done usually around six months later depending on whether or not there is radiation and how it affects your skin. The key is that in most cases, you need to find them in a combo package. The plastic surgeon is the trickier find.

Plastic surgery, I learned, is unlike other medical specialties. It is more like commissioning a painter or sculptor than finding a doctor. I thought they could all basically do the same thing. Yet plastic surgeons, I discovered, are varied in terms of what they are trained to do. Some can’t do this procedure and will advise women to get silicone implants. Also, some speak to you and others speak over you. I knew I needed one who would listen to me. 

I didn’t want to feel invisible anymore.

During a lecture at the Breast Cancer Connections in Palo Alto, a guest surgeon told us survivors that if you don’t like the first surgeon you see, find another one. That was good advice.

So my journey began. I liked the cancer surgeon at Redwood City Kaiser, but not the plastic surgeon. She told me that radiation would likely destroy my skin and cause the expander (the first phase of rebuilding) to collapse. She had an 80% fail rate in this regard, which didn’t sound promising. She also told me I did not have enough body fat for building a new breast. She recommended implants – at least I think that is what she was getting at. This set off first panic and then a fierce determination to find another surgeon. 

And I had confidence that I could grow enough fat to get good results. I love carbs.

A fellow mom-friend who is a plastic surgeon gave me much more positive statistics. She assured me that my good health meant that I would probably do fine with an expander and radiation. And while I am slim, she was sure there was enough fat on me somewhere or would be soon. I just had to find the right plastic surgeon.

My sister supported my quest. She and I traveled to the next-closest hospital, in Santa Clara and met the head of the department. He showed us a PowerPoint presentation. He was probably technically skilled, but he lacked warmth or an ability to connect, which was a component I needed in a doctor.

My stress was so high at that point that I took an Ativan in the middle of his lecture. My time was running out. I needed to have the cancer removed fast, yet I hadn’t found a plastic surgeon I liked.

We forged on to a hospital in San Francisco. At that hospital, I finally met the right combo of surgeons. A good woman surgeon for the removal and a plastic surgeon who could confidently put in an expander and had the skills to do the most advanced form of reconstruction down the road. And I liked him. We talked about philosophy and kids. He is a nice person.

Surgery and radiation went smoothly. Reconstruction was the next step, except that my family life left no space for it. My messy divorce got messier. I had to force a sale of the family home, and I (thankfully) got full custody of our children.

Whenever I thought I could do the surgery, something changed and I had to postpone it. My surgeon stayed in touch with me through the year, reassuring me that it was OK to wait. In fact, he wanted me and my skin to be as healthy as possible. He would be there when things settled down. Apparently, you can wait to do reconstruction for a year or two since the most important thing is that you are healthy. Insurance could be a factor in the timing. By law, they have to cover the costs of the procedure, but they do this only as a follow-up to the cancer surgery, so you probably don’t want to wait too long.

A week before Christmas in 2014, there was finally enough space to proceed. And as the Christmastime surgery loomed nearer, I got more excited. For me, it meant the destruction was finally over and I could rebuild. My friend moved in for one night with the kids until school was out and my former husband could take them for the two-week break. 

 For the next eight hours I was asleep, and I can only tell you in simple terms what I think they did. They opened up my stomach to retrieve some extra belly fat, muscle and a few strong veins and arteries. They sewed up my belly and then with a surgical microscope, a needle and thread and lots of skill, they sewed the belly stuff – fat veins and arteries – onto my chest and into a living breast. Eight hours is a long time; I heard that there were three surgeons. They had to take turns operating.

I woke up with a flat belly, a new breast and lots of tubes.

I had to stay in the hospital for five days to make sure the new blood supply to my breast was working. I missed Christmas with my kids. I had lots of visits from friends. I couldn’t drive. Looking back on that time, the reconstruction part of the journey is the only part I can really remember with any positive feelings. I think that is because I felt like I was in control. 

Many women think that breast implants are the only reconstruction option because no one tells them otherwise. If you live in this area or any large metropolitan area with skilled surgeons, the reconstruction procedure is available. It’s taken me 10 years to realize the importance of this choice. 

Two years ago, I was at Harbin Hot Springs in Lake County getting a massage. The masseuse commented on what a good job the surgeon had done. Then she told me about a young woman who lived at Harbin and was diagnosed with breast cancer around the same time as me. She was mistrustful of the medical establishment and chose to use alternative remedies. She refused the chemo/surgery treatment until it was too late. And when she died, she left behind two small children. The masseuse commented that maybe if the woman knew she had good options, she wouldn’t have died. I came out of that massage feeling grateful for my life.

Thanks to the reconstruction, I rarely think about my breast cancer treatment. My life has gone on in a good direction. In fact, I have reengaged in life in a more determined way because of the ordeal. My rebuilt breast feels soft, natural and matches the remaining breast fairly well. I would give it five stars. For any of you facing this common and awful situation, I hope you ask for what you want and get it. Eventually, it will all be in the past. And you will go on to be a strong woman with good boobs, or at least good enough for your life.

Lisa Herendeen, LCSW, M.Ed., is a private practice psychotherapist working with couples, families and individuals in Santa Cruz. Before she became a therapist, she was a writer for various political organizations in Washington, D.C.