Recently, someone asked me if I am happy with the outcome of my recent TRAM Flap breast reconstruction surgery and if I would do it again. Well, Kathy, actually, I'm glad I did it. It's been more than three months since I had my prophylactic bilateral mastectomy and TRAM Flap reconstruction and I must say, as difficult as the recovery was the first month, I would do it the same way again. (Of course, what else am I going to say at this point?)

Still, this surgery was a good solution for myself and my situation. After having tested BRCA positive, I knew I would be removing my breasts due to my high chances of getting breast cancer--my sister has had breast cancer twice and our grandmother and aunt both died from this monster. Choosing the type of reconstruction was a bigger decision for me. My sister was given far less options than I.

Even now, there are times when I really notice the movements/activities I can't do yet (lifting, etc. that take strong stomach muscles). I've been told it takes about a year to really get back to normal. For instance, while camping last week, we took some hikes that had some hills to climb. Half way up the hill, I was holding my stomach. It's not that holding my stomach did anything to really help, it just seemed like it helped as I felt the muscles dramatically tightening as I stepped up the hills. Whatever...I was just glad to get out of the house and away to one of our favorite campgrounds.

Still, this surgery was a good choice for me. As bad as this sounds, it's a good "lazy" way out of having to find prosthetics, dealing with ongoing implant maintenance, and more. Being a mom of two young kids, I don't have time for repeat surgeries, etc. It was done and I can move on. And what the hell...I got a much-needed tummy tuck out of the deal.

But there are times when I look in the mirror at myself and wonder how I could have mutilated my body this way. It's been a relatively short time that I've had these new breast shapes, and yet, I have trouble remembering what my old, saggy "mom boobs" looked like before I received this perkier pair. I also "get" the crude slang term for breasts: "headlights." The circle scars left on my breasts, absent nipples or areola, really do look like headlights on a car. I suppose that's my way of laughing at myself. If I didn't find something funny in my situation, I'd likely go nuts and slit my wrists or something. I figure, it is what it is.

And fuck it! I made my choice and now I get to live with it. Yes, I get to live, and more importantly, I don't have to worry as much as I had been about getting cancer. Even my kids have gotten used to the whole new tit thing and think nothing of seeing mommy walk around nude with my scars and new breasts hanging out.

I do have a friend who had the TRAM reconstruction and while she says she's glad she had this type of breast reconstruction, she also says she can't look at her naked body in the mirror because of all the scars the surgery produces; it's too upsetting. Regardless, she's glad for the tummy tuck and how she looks while clothed.

In other words, as much as I hate repeating the surgeons' favorite line, everyone is different and will react differently to their outcome. (It doesn't hurt to have an excellent plastic surgeon.)

In Kathy's case--having a flat chest after her bilateral mastectomy and trying to find comfortable breast prosthetics--I am sympathetic to your situation after having watched my sister's discomfort when her second breast was removed. After her expander became infected and had to be removed, she was left with one absent breast. I noticed she hunched over more and repeatedly pulled her shirt away from the sensitive skin of her absent chest because of her discomfort and the way she felt having a missing breast.

Even though I had TRAM reconstruction and my sister has implants, there's something else we have in common you may consider. It always feels like we are wearing a bra. It's the way the skin pulls at the base of the breasts and across the chest (especially for her) that makes it feel this way. Having been a woman who would remove my bra upon returning home, sometimes I find myself instinctively reaching back to unlatch my bra when I walk through my door only to be reminded, there is no bra to unlatch. This tends to be frustrating because it feels like I can never relax the skin of my breasts. I'm told this gets better with time.

So, should you--Kathy or anyone in the breast reconstruction boat--have this type of surgery? It can be a good solution if you don't mind the recovery time, the scars and the long-term effects of moving muscles around in your body (you won't be doing as many, or any, sit ups in the near future...oh, darn!).

Kathy, and other breast reconstruction patients, I wish you the best of luck in choosing your favored reconstruction. Just remember, when you are so confused about your options and can't make up your mind, you can always try what I did..."everyone vote," I told my family at one of the pre-op appointments. Even the doctor raised her hand for the TRAM Flap surgery. It didn't matter. I think I already knew what I would do, I just needed some positive reinforcement so I knew I wasn't crazy for choosing such a barbaric surgery.