There Are Options: Double Mastectomy to Flat Aesthetic Closure with Tattoos

I look at the tattoo each morning and feel proud of my decision, knowing what it took to get me here today.

• Procedures: skin-sparing double mastectomy to aesthetic flat closure
• Reconstruction immediately postmastectomy: no
• Year of procedures: 2022
• Age: 40 years old
• Race or ethnicity: white

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The diagnosis timeline

I found a lump in January 2022. I was already an established patient at Northwestern’s breast cancer center because my mom is a two-time breast cancer survivor.

I had imaging done in 2017 when I was 35 (thankfully). When I had the mammogram and ultrasound in 2022, those images had changed. Having the baseline imaging helped save my life, in a way.

It was a surreal experience because I actually didn’t think it would be anything. My family doesn’t carry the BRCA gene, and I had been proactive for years prior.

I didn’t tell my parents anything until I knew for sure. I went to the appointments alone because I thought it was all going to be routine.

Getting that call was shocking. I couldn’t believe the words that were being told to me over the telephone. I was diagnosed with breast cancer on February 14, 2022.

My three best friends were the only people who knew about these appointments, so I called them afterward. I waited until the next day to call my parents because I knew my mom, especially, would take the news harshly.

I needed some time to collect myself before making that phone call.

My surgery and reconstruction options

It was recommended to have a mastectomy on my cancerous left side. I also had benign tumors in my right breast, so I made the decision to have a bilateral mastectomy. I wanted to be proactive and give myself the best chance at survivorship.

I met with my plastic surgeon (I love him) a few weeks after my diagnosis. He stayed late at his office on our first meeting to see me, which meant a lot.

I wasn’t sure about reconstruction at the time. The idea of foreign material in my body wasn’t appealing.

My surgeon didn’t pressure me at all. He gave me the options and told me to take my time. He said if I was at all on the fence, I should get the tissue expanders at the time of surgery. I could always have them removed if I didn’t want to move forward with implants.

That’s what I did, and I ended up staying flat.

Truly, I felt heard and supported the first day I met my plastic surgeon and his team. Although I didn’t make a decision until a few weeks later, he guided me in knowing the facts and didn’t pressure me to look a certain way.

Surgery went well

I felt prepared going into surgery. I had time to wrap my head around the diagnosis, took time away from work, and spent time with family and friends.

The surgery took place on April 20, 2022. It went well with both doctors — the breast surgeon and the plastic surgeon. I spent 1 night in the hospital and remember waking up in the hospital room with my mom next to me.

I devoured the vegetable broth and crackers I woke up to. I literally thought it was the best ever. Then I drifted back to sleep.

My blood pressure dropped in the middle of the night, and the nursing staff took great care of me.

The resident from my plastic surgeon’s office came in the next morning to remove the dressing. We ended up having a mutual friend, so we spent most of the time talking casually and not about my surgery. It felt great.

Still, I couldn’t look at my scars yet — I guess it all still felt surreal.

I am grateful to live in a city with access to wonderful medical care. The surgeons, their teams, my oncologist, and the nurses all made me feel supported and like I was just as important as the next person.

We all have varying experiences, yet mine was one of transparency, great care, and a collaborative effort to help me move forward.

The recovery process

Heading home, I felt I was in good hands. I have the best support network full of family and friends.

I also met two women at my fitness studio who had gone through the same surgery as me. They loaded me up with drain supplies, gave me clothing to wear, and helped me shower the first few days. The drains were overwhelming to start with, so I was grateful to have help.

I’m an active person, and I got lucky with the weather in late April 2022. A few days after surgery, I was able to begin walking outside. I also had visits from friends, dinner outside, and many messages of love and support. My family even arranged a party in early May to celebrate my journey thus far.

At this point, we didn’t know chemotherapy would be the next step. All of these events were bright spots prior to this information.

The mental health impact of breast cancer

At the time of surgery, I didn’t think chemotherapy was on the table.

The doctors discovered postsurgery that the cancer was a bit more aggressive than originally thought. This was hard news to hear. It also pushed my tissue expander removal surgery back 3 months to September.

Learning I had to have chemotherapy was a huge blow to my mental health. I watched my mom go through it in 2016 with her second diagnosis. It was, at times, heart-wrenching.

My saving grace was that I also have my mom’s oncologist. She’s the best and has become part of my family. She walked me through the entire process and advised me to continue living life as best as I could.

Breaking it down one treatment at a time seemed to make it more manageable, and I underwent chemo beginning June 4, 2022.

When life changes with one phone call

It is true that life can change with just one phone call, and it did. Perspective became a keyword in my vocabulary after my diagnosis.

I had spent many years struggling with my mental health, so at the beginning of my cancer journey, I was nervous that my depression would haunt me. The idea of moving forward in life prior to my diagnosis was already an uphill battle.

Yet after getting that phone call, I felt the urge to fight for my life. It sounds cheesy, but I can say with 100% honesty that breast cancer saved my life.

Stressful situations that had once shattered my mental health became less important.

While I put in the work mentally, I credit my amazing team of mental health professionals who stood alongside me during this journey. Even though I was scared, their support and care were vital in managing both my rational and emotional mind. I could be both nervous and prepared — it didn’t have to be one or the other.

Knowing this allowed for more balanced thoughts as I began to fight my cancer.

Why sharing matters to me

If my story and imaging can help just one person, then I know it’s important. Knowing you’re not alone and that there are options is key.

One thing I haven’t shared yet is my tattoo journey. Once I decided to remain flat, I turned to designing my chest tattoo. I had several tattoos at this point, so it just seemed appropriate to have this option following my surgeries.

In learning more about myself, my core values seemed like an important reminder to have on my chest, along with my favorite flower, the peony. I listed my core values and had my parents, best friends, and their children write them out in their own handwriting.

These tattoos will forever hold a special place in my heart.

I had an art therapist who helped bring my thoughts of the design to life. Then, I found a tattoo artist locally here in Chicago who specializes in mastectomy tattoos. We waited the appropriate amount of time for healing and then she went to work.

It’s hard for me to put into words just how special she is to me. We spent many hours together — some laughing, some crying, opening up, and being vulnerable with my chest and my emotions. She took great care to make sure I felt safe and supported each time.

Her artwork blew me away. From paper to finished product, I couldn’t have asked for anything more. I look at the tattoo each morning and feel proud of my decision, knowing what it took to get me here today.

What I want others to know

You are your best advocate. Ask questions to feel informed. There are options.

Lean on your support system. I also joined a breast cancer support group through Gilda’s Club after active treatment. It’s been a lifesaver in helping to navigate life after cancer.

It is an honor to share my story. It’s something out of my comfort zone, yet important. Thank you for providing this space to possibly help someone on their own journey.