Note: This is part 1 of a 3-part series related to our recent XRAY review on Roni Caryn Rabin's New York Times piece "‘Going Flat’ After Breast Cancer."
by Robin Karlin
Roni Caryn Rabin’s New York Times piece, “‘Going Flat’ After Breast Cancer,” brings much-needed awareness to the option of skipping reconstruction after mastectomies for breast cancer treatment or prophylaxis. I do not oppose reconstruction, but I suspect that I might not have chosen to reconstruct if some of the current proponents of going flat had been writing when I made my decision.
As a FORCE volunteer, I have had a few women express interest in skipping reconstruction. I send them the resources that I have found to be the most helpful and supportive of this option. Flat and Fabulous is an organization “committed to advocating and providing support for those who are living post-mastectomy without reconstruction.”Melanie Testa is a breast cancer survivor and blogger who writes “For me, beauty ideals and expectations related to the female body are a form of tyranny. I resent that in the face of a lethal disease the conversation turns to hair and wigs, reconstruction and ‘Look Good, Feel Good’ programs.” These new voices resonate with me.
After I found out about my BRCA1 mutation in 2011, I studied risk statistics and prophylactic surgeries. I attended local FORCE meetings and my first FORCE conference. I consulted a psychologist at a local cancer center who successfully helped me make a reasoned decision about prophylactic mastectomies that I would not regret. I never seriously considered going flat despite having some exposure to the idea and cautionary advice from the psychologist about the risks of reconstruction. She urged me to ask questions about complications and failures when selecting a surgeon. In our local group I met a woman who had no doubts about her decision not to reconstruct. Her comfort with her body and her self-confidence made her beautiful. I saw other flat-chested women at the FORCE conference “Show and Tell,” where women volunteer to show off their post-surgery bodies (both with and without reconstruction) in a comfortable, informal setting.
Despite all this I just couldn’t see myself living without breasts. I didn’t really “hear” my psychologist’s cautions. But I did worry, deep down, that reconstruction was not consistent with my usual feminist world view. I searched Google a few times looking for women who chose not to reconstruct for feminist reasons, but I didn’t find much. I knew that I would lose sensation in my breasts. I somehow thought that if they looked “normal” they would help me feel sexy. I proceeded down the normative path despite some embarrassment about what I saw as an abandonment of feminist principles.
I had a serious complication after my reconstruction, and my outcome after four surgeries is far from beautiful. I have learned to accept my body as it is and I make myself feel beautiful by nurturing my health, by exercising, and by dressing in ways that express my creativity. I still miss my former sensate breasts and have found my “foobs” to be pretty useless during sex. What was I thinking, I wonder now? I don’t know whether feminist disquisitions on female stereotypes, sexualization of breasts, and objectification of women’s bodies would have persuaded me to go flat. I do wish those writings had been available and I want to share them now in case they may resonate with other women who are struggling with this decision.
Robin Karlin is a Peer Support Group Leader for the Pittsburgh FORCE group, a volunteer for FORCE’s Peer Navigation Program, and a member of the Steering Committee and the Research Priorities Working Group of the ABOUT Network. She participates in the University of Pittsburgh Cancer Institute’s Breast Cancer Research Advocacy Network (BCRAN). Professionally she is a software engineer at Carnegie Mellon University in the Computing Services Department. Contact at email@example.com.