Controversial question of the day: is breast reconstruction after mastectomy an anti-feminist practice?
I find coming to any sensible conclusion on this issue particularly taxing. As with most issues of moral ambiguity, the answer always slides into the terrain of ‘situationally-dependent.’
Audre Lorde takes issue with reconstruction and prostheses post-mastectomy in her Cancer Journals, arguing that while prosthetic limbs serve a functional purpose, “false breasts are designed for appearance only, as if the only real function of women’s breasts were to appear in a certain shape and size and symmetry to onlookers, or to yield to external pressure.”
There’s no arguing that the purpose of breast reconstruction is appearance–and it is indeed worrying that appearance, rather than survival, may be a woman’s first concern. But the ‘external pressure’ of which Lorde speaks does not necessarily have to be about achieving a sexualized aesthetic. One doesn’t opt to undergo breast reconstruction, I hope, merely because one is influenced by a demand from society for ‘normalcy’–as if having two breasts were a socially constructed, arbitrary attribute of ‘femininity,’ like nylon stockings or nail polish–but because of a demand from one’s own body, for balance. To return to default.
I don’t feel my choice for an LD flap reconstruction was a yield to pressure of any sort, especially to the pressure of men. Here’s why:
I don’t believe I would have opted for reconstructive surgery had I not been able to have it at the same time as my mastectomy. I cannot imagine myself willingly enduring the pain of a surgical procedure purely for aesthetic purposes. Which leads me to believe I’m not entirely appearance-oriented.
For me, the appeal of immediate reconstruction was just as much about having a ‘breast’ as conserving my chest skin, which otherwise would have been largely scarred to achieve flatness–rather than the circular incision around the areola, which allows space for an implant or skin flap. The skin is meant to stretch into that shape, and though I couldn’t abide the thought of having an inorganic implant, using my own body seemed a compromise. True, it’s not exactly ‘natural’ to have muscle and fat from your back tunneled around front. But then, it’s not ‘natural’ to cut your breast off, either.
I promised not to show photos, ever, so you’ll have to take my word for it: to see my reconstructed ‘breast’ is to be 100% sure I’ve not done it to be attractive. Most certainly not to be attractive to men–I never cared terribly about breasts in the first place; I was happy for having small breasts which allowed me to be sporty, and would never risk gaining unsavory attention.
Finally, it is not just about a societal pressure to have two breasts; I consider it a convenience. Maybe if I were braver, I’d have gone without reconstruction–really, I think it’s more accurate to say “if I were less lazy.” Lorde calls for women who have had mastectomies to become visible to one another–and I do believe that, considering the number of women who have mastectomies, clothing that acknowledges one-breastedness (“mastectomy fashion”) should be commonplace. However, it isn’t the case. And admittedly, as a mastectomy patient at twenty-four, I’d be a niche market. (Where do you get a mastectomy business suit or wedding dress?) I don’t have the interest in designing clothing to draw attention to myself, and I couldn’t stand the thought of buying special mastectomy bras and having to think constantly about what’s feasible to wear. I don’t want to wear a “normal” bra just because men find it sexy or because society says I must, but because I can walk into any department store and find one, and have a choice in the matter. I can devote less time to considering my appearance with reconstruction, ironically, than without it.
Lorde categorises the adverse psychological effects of reconstruction/prosthesis like this–
The emphasis upon physical presence at this crucial point in a woman’s reclaiming of her self and her body-image has two negative effects:
- It encourages women to dwell in the past rather than a future. This prevents a woman from asserting herself in the present, and from coming to terms with her own body. Since these remain alien to her, buried under prosthetic devices, she must mourn for the loss of her breast in secret, as if it were the result of some crime of which she were guilty.
- It encourages a woman to focus her energies upon the mastectomy as a cosmetic occurrence, to the exclusion of other factors in a constellation that could include her own death. It removes her from what that constellation means in terms of her living, and from developing priorities of usage for whatever time she has before her. It encourages her to ignore the necessity for nutritional vigilance and psychic armament that can help prevent recurrence.
I agree insofar as guilt here is key. Indeed, one is made to feel ashamed of what are ironically deemed idiosyncracies in bodily appearance, despite the fact that thousands of women with cancer experience the same physical changes–not only with mastectomy, but with hair loss in chemotherapy. You’re made to hide under wigs and scarves. But that’s a whole other post.
How insulting to say to a woman with breast cancer: “No one will know the difference.” As if that should be your aim.
And I wonder, could a woman who’s had breast cancer ever steep so far in self-delusion as to find she didn’t “know the difference” in herself?
From my own experience, and from my faith in women, I think Lorde may be crediting women who’ve had reconstruction with a little too much ability to maintain such a suspension of disbelief. At least, it’s too much for me. Both physically and psychologically, my reconstruction–the nippleless, asymmetric mound–hides nothing. I don’t mistake my priority as survival, and I don’t mistake what’s on my chest for my breast.
Which is okay, I guess, considering my breast tried to kill me.