When it comes to the entire surgery process, I find myself falling into the realm of ‘queen of wishful thinking’. I had convinced myself that ‘flat’ was that way to go. I joined a great supportive Facebook group ‘Flat & Fabulous’ and found that I was creating a new vision of myself that involved a beautiful flat chest – but it also involved a beautiful flat abdomen with no extra body fat.

My reality is that I shall always being carrying extra body fat – if spending 16-month riding my bike around the world didn’t cause the perfect ‘flat’ body that I had envisioned then why do I think that cancer surgery would fix this. I’m in great physical shape now, and yet I still have 40% body fat. It isn’t something that will be changed by eating right and exercise – cause, in reality I do that already. As I age, I’m destined to gain a few more pounds, not loose them, and when you add in the early onset menopause (drug induced) that is part of the long-term treatment for breast cancer, my battle to keep my weight from increasing is all up hill.

Another reality is that women who look as young as I do, and don’t have breast, but do have buddha bellies get as “when are you due?”. Our society associated that shape with pregnancy.

So when the surgeon burst my bubble, I’ve had to do some serious reflection. What do I really want to look like after surgery? Long-term what do I want my body to be, in order to have a positive body image? What is a reasonable lifestyle for me to maintain?

This last question is probably the most important. If my body image is tied to a lifestyle then I most definitely need to ensure that I’m not setting up unrealistic expectations of myself. I should not expect that magically, after double-mastectomy surgery that my body fat will just suddenly reduce itself. That I’ll magically be reformed into this skinny girl with no breasts and awesomely toned body – that is just me being completely unrealistic.

Realistic expectations of mastectomy with my body type include having a concave space under my arms where currently I have fatty breast tissue. Not ‘flat’ space there, rather concave space! Reconstruction would be required to put some fat there, otherwise, I’ll have a gap between my armpit and my stomach fat where the ribs can be felt. My thoughts and focus had been on the front view, but I had not considered the three-dimensional view of my body.

So now I’m looking at reconstruction options. There is a great video here that explains the various options. I’m strongly considering the procedures that involve re-allocation of my own body tissues. In addition, I’m looking at immediate reconstruction. This is a real option because I’ve done neo-adjuvant chemo, so the surgery will not delay chemotherapy. The only unknown variable is radiation. The surgeries that involve using my own tissue mean longer surgery (8-12 hours), longer hospital stay (4-5 days), plus longer recovery time (6-8 weeks). But from the reading I’ve done so far, I’m an ideal candidate. I have enough extra body fat, but not too much such that I shouldn’t have an increased risk of complications. It will be interesting to see what the surgeon has to say.

So, now I’m in wait mode for a few weeks – while I recover from my last AC chemo and subject myself to the first couple of rounds of T-chemo (the first two or three rounds are supposed to be the hardest on this new chemo, as your body needs to adjust to it). One step at a time!