A deadly set of knockers

As published in Al.com

In March this year, investors sued breast implant manufacturer Allergan for allegedly concealing the link between textured implants and anaplastic large cell lymphoma.

After a hearing in which women urged the FDA to ban textured implants as other countries have done, the FDA initially cited lack of proper evidence to justify a ban. As of this July, the FDA announced the U.S. is recalling implants made by Allergan related to a rare form of cancer.

This controversy had yet to make the headlines two years ago when I sat on the hard table at the plastic surgeon’s office, the flimsy gown covered in dots open in the front, as instructed, a red Sharps box of used syringes hanging on the wall across from me. I hadn’t bothered tying the short ties.

The doctor sat half-turned to me while he asked questions and typed my answers in my patient profile: Female. 51 years old. Stage 1 breast cancer. Left breast. Estrogen and progesterone positive. A highly curable diagnosis if I followed the standard protocol he said.

I stared at his yellow bowtie and round glasses. This was a research hospital after all, and certainly, I was in good hands.

He had ignored my husband Hugo, a take charge real estate broker, after an initial handshake, but now Hugo filled in my answers as I sat, still in shock about my diagnosis three weeks earlier, though the doctor glanced at me. Finally, he swiveled his chair to Hugo and asked impatiently, “Are you a nurse or a doctor?” I lay back on the table and closed my eyes, tired of men who washed their hands briskly before they asked me to open my gown and dropped their gaze to my breasts to assess and feel the questionable tissue with their cold hands.

After 30 years of marriage, Hugo joked I was so modest I took my shower in a turtleneck. A journalist and mother of a teenage daughter and college-age son, I’d always chosen women doctors instead of men. Now here I was half-naked before men whose names I quickly forgot as I searched for answers about different treatments.

I sat up and listened to the doctor explain how he would insert tubes for drainage and implant expanders before a second operation to insert the silicone implants. A radical mastectomy can cost up to $55,000 without breast reconstruction, which can then cost up to $30,000 more. I felt lucky my insurance covered both procedures.

He explained the difference between textured implants and smooth ones saying the textured ones had a more natural feel. He briefly mentioned women sometimes develop a hardening around the implants, and rarely, even cancer.

“It’s not if you will need to replace them, but when,” he said. When apparently meant within ten years. He asked to see my thighs. I stood up, feeling like an animal on an auction block, and dropped my pants. His hand slid between my legs jiggling my inner thighs to see if I had enough fat to use instead of implants. I didn’t. He tried unsuccessfully to pinch my stomach fat.

“Another option is to cut the muscle here,” he said, running his hand below my right shoulder, “and pull the muscle around front.” He’d slip the implant underneath the transferred skin he explained. His tone made it seem as simple as a facial, yet the procedure sounded to me like a modern-day version of medieval torture.

Then the assistant handed me a notebook full of before and after photos of every size and shape breast. I’d agreed to let the nurse take pictures of my breasts for a potential before shot to be featured in a book such as this. Now I regretted it, worried about the picture of my naked body filed away in their endless archives.

I stared at the normal sagging boobs replaced with a higher version of themselves. Many were upright and firm, nipples centered correctly with red scars curving across the mostly white chests as if a knife had sliced through a soft piece of Wonder bread. I’d seen few real tatas during my life though I felt surrounded by the wallpaper of cleavage in magazines and advertising. Not many women I knew unveiled their bodies in locker rooms or spas the way I’d heard men paraded around exposed.

“You can always go bigger. Most women do,” the assistant assured me.

“I’m just researching my options,” I said.

Neither seemed to have heard I was gathering information while I waited for the genetic testing results to determine if I had the BRCA gene. I was still raw from the whole unexpected ordeal. Yet it appeared to be a foregone conclusion in their minds I was moving ahead. I pulled my gown tighter.

“And if I do this, I’m just fine the size I am,” I said. I was consumed with thoughts about dying, about whether my kids would have a mother.

The doctors seemed more concerned about how big they could make my cleavage. And for whom? Certainly not me, more athletic than curvy in build. My fear had outweighed my vanity the moment I heard the word cancer.

“It’s nothing to be ashamed of,” the doctor said flipping to the next page. Did this middle-aged white man really think my path to health and empowerment after a potential death sentence was sporting a rack worthy of a Playboy bunny to clash with my middle age smile lines?

I had friends, dissatisfied with their small breasts or dismayed after pregnancy and nursing to see what gravity and motherhood had wreaked, who’d had implants. Another buddy had recently shown me the results of her mastectomy, upset her doctor had neglected to tell her she’d lose feeling in her nipples. Within the past five years, she suffered through two more operations and refused a third to deal with complications. Another had told me how her implants from reconstruction were larger than she’d asked for and made her cold all of the time.

The assistant closed the book to their handiwork. “I’ll think about it,” I said.

I didn’t want to lose a natural part of my body. I didn’t want silicone balloons that had to be replaced, could harden and become encapsulated into scar tissue, or give me lymphoma, a blood malignancy. I didn’t want to have a lumpectomy and face a mammogram or MRI every six months for the next five years, imaging which carried its own risks from the radiation and the dye.

A month later, I opted to fly California for a second opinion and a few weeks later flew there again to have the small tumor frozen. My breast blew up like a basketball and the necrotic tissue hardened like a lump of coal. According to the doctor who performed the cryoablation, the “frozen” tissue was supposed to absorb back into my body by the end of a year.

After six months, at my Alabama oncologist’s urging, I had a lumpectomy. The day before surgery, the nurse felt for the lump of coal. Nothing. The dead tissue had disappeared. I had the lumpectomy as planned, and thankfully, the biopsy was clear. Almost a year from my diagnosis, I had managed to keep both my breasts.

But with my own pair, without breasts, with fake ones, for the rest of my life, no one could fix the fact disaster might strike again. Women undergo mastectomies to lessen their chances of a recurrence of the disease not because their diagnosis is a wonderful shopping opportunity to buy a deadly set of knockers.

Lanier Isom, a Birmingham area writer, shares her story as October kicks off Breast Cancer Awareness Month.


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