It’s okay, sweetie boo, I’m just making you more comfortable – promise! I said.
He tried rolling off the bed.
I grabbed his ankles to hold his bum off his soiled nappy before whipping it away into the orange bag.
Once cleaned he sat upright, turned onto his stomach and dangled his legs over the sides. I like your ambition, but it’s not going to happen, I said, sitting him back up on his change quilt.
You cannot leave the dirty nappy in the bin, and you have to take it with you, I’d been told.
Yes, darling, I wanted to say. What else would I do with it? Eat it?
I knotted the stinky bag and dumped it into the pram’s basket, planning to throw it into the first bin I saw outside on the street. I secured Celso back in his stroller and cleaned my hands.
Once inside, I faced my plastic surgeon, the man who was going to perform my breast reconstruction after a double mastectomy. Dr Theile was a dignified figure, too young for his light grey hair. He was reassuringly direct when I asked him about nipple-saving options. Well, if you’re doing this to significantly reduce your risk of recurring breast cancer then why would you leave any breast tissue?
Good point.
I don’t want to leave my nipples. I just wanted to ask about the difference, statistically, between nipple saving and removal. To know the chances of my surviving breast cancer, I said.
He put a rough figure together. It likely goes from 97 per cent to 90 per cent.
Can I look at some photos of reconstruction?
Sure.
He lit up his flat screen and an assortment of women’s breasts appeared, their owners aged 29 to late 60s. The youngest woman had opted to forgo her nipple reconstruction and just use stick-on nipples, which worried Dr Theile as he hadn’t finished his job for her.
An older woman’s breast was reconstructed on one side using a TRAM flap procedure. A TRAM flap creates a new breast from abdominal fat, skin and muscle. The woman’s other breast had to be lifted to match the newly bouncing bosom.
Celso reached across to grab a notepad. I pulled his hand back and jiggled him about on my knees. You can give him this, Dr Theile said, passing an unbreakable ampersand ornament.
Celso grabbed it and tried to fit it into his mouth. It wasn’t a choke hazard so I let him and continued viewing the photos.
Another older woman had had a double mastectomy and immediate reconstruction. I saw her breasts in the inflation stage, where the flesh of the breasts was removed during a mastectomy and saline implants were inserted under the muscle on the chest wall – her chest held two child’s balloons. It looked unnatural. Then I saw the result once the silicone implants were in after expanding the skin to the desired breast size. They looked pretty good. There were scars of course, long lines across the middle of the new breast, where a nipple used to be. The surgery and tattooing came later.
It would take four distinct steps to go from a double mastectomy to the finished result. My breast surgeon would remove the breast tissue, then the plastic surgeon would put in saline tissue expanders. When the scars healed enough I’d return to Dr Theile’s rooms once a week for approximately ten weeks and he’d inject saline solution, through my skin, into the expanders, thereby stretching my skin and making my breast mounds bigger.
Once they inflated to the right size I’d go in and have the expanders removed and replaced with silicone implants. The surgical technique of a nipple tack, where they would cut and fold some skin from where the nipple had once been, would come after this, then areola tattooing once the ‘nipples’ healed.
Should I go with the size I am now? The thought went around as I looked at the other women’s breasts.
At 34, in the early stages of pregnancy, I finally had a proper bra fitting at Myer and discovered that I wasn’t a 12B after all, but a 10C. After Celso was born and I expressed for six months my breasts deflated. They were even smaller than they were pre-pregnancy. This was fine, but with the chance of a ‘choose your own adventure’ a robust 10C did sound nice.
Dr Theile remained calm with my squirming son and allowed him to sit on his desk as I asked questions. I’d given Celso an Old McDonald puppet book to play with, in which each finger had an animal to animate while singing. He was chomping down on the cardboard pages of the palm book and some of the paper had come away in his mouth. He choked on it straight away, so I flicked it out of his mouth and held a handkerchief up to his face, assuming he’d vomit. He didn’t.
He okay? asked Dr Theile.
Celso resumed playing with the black and white cow on the puppet’s thumb.
Yes, I replied.
Behind Dr Theile were framed pictures of his family. His good-looking wife once anchored the news in Brisbane and had her own professional standing in the community. In the photo she had her arms around their three children but still maintained the well-dressed-and-presentable-at-any-occasion appearance of a newsreader. The consultation room was large but seemed larger because the windows went from wall to wall and revealed a cityscape of office buildings.
Dr Theile’s main concern with Celso sitting on his table was that he might fall off. Not that he might barf all over his private documents and silk tie. Big tick.
The first time I went to Dr Theile’s rooms, B was in tow. Celso was cared for by a relative so we could focus in an adult way and spend time later talking through the decision in a café. It was four days after my diagnosis of breast cancer. In that first week B and I
