My Plastic Surgeon Made My Post-Cancer Breasts Two Sizes Too Small

“This has never happened to me before,” he says.

by Lindsay Jean Thomson
Jan 4 2018, 3:00pm

Lindsay Jean Thomson

This is the 16th entry in a multi-part series. Read the rest here.

Going into reconstructive surgery is a lot like going into the mastectomy. I’m less nervous, though it feels more permanent than last time.

Right after I got diagnosed, I talked to a psychic in France. Rosine. Don’t judge. She told me lots of things I wanted to hear—that the cancer would go away and never come back. That my hair would be long again. That I would meet someone before my reconstruction. That last part hasn’t happened yet, which is fine, but I’d hate for her to be wrong about the cancer coming back. That would be a bummer. She also told me to check in about my surgery date, but when I emailed her I never heard back. I’m sure she has more important things. The world is a hot mess.

After I check in at admitting, my friend Paula and I head upstairs and they weigh me, check my blood pressure and temperature, and have me take a pregnancy test. Good news: I’m not pregnant.

The medical assistant signs into his Netflix account to give us something to pass the time while we wait to go back. But we’re not there long—a few minutes later, a very cranky nurse takes us to the waiting area. She complains about everything. Everything is wrong: It’s the wrong bed, something is wrong with the computer, someone is supposed to be there who isn’t. I don’t remember. I try not to take it as a sign. It’s early.

She leaves for a minute so I can disrobe, put on the funny socks, and get in the wrong bed. It seems like they’re running behind. Surgery is supposed to start in 15 minutes and I haven’t seen the anesthesiologist or my plastic surgeon. But then they’re both there and it’s much quicker than last time—no one asks me the same safety questions over and over again.

“Do you have any questions?” my plastic surgeons asks. “Umm, yeah. Do you test the tissue from my other breast?” My healthy breast. I almost don’t want to know. “We do.” “And what happens if you find anything?” "Anything" is cancer. “Then we have to do a mastectomy on that side too.” Okay.

This time they don’t give me anything to put me out before going into the surgery room so I’m totally conscious as they wheel me back and it’s surreal.

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When we get there, I move myself onto the surgery “bed”—it’s just a long, narrow metal table, barely wide enough to fit me, with a large, oddly placed hole below my calves. I lie down awkwardly and my surgeon asks me to sit back up so that he can mark me.

He asks me to lower my gown and I don’t think I’ve ever felt so naked as I do in this bright, sterile room. It’s cold. My real breast is quite large; he has to pick it up to mark beneath it. “Now I’m going to manipulate the breast,” he says. Manipulate. What a strange word choice. He tells me my nipple is closer to the midline of my body than it should be. What? How is that a thing?

When he’s done, my chest looks like a mandala. A chestplate for battle. I lie back down and the anesthesia is administered. I’m out within seconds.

When I wake up in the recovery room, there’s a nurse sitting with me. I look down at my chest and I know that it’s bandaged up tightly, but it looks so small. Something isn’t right.

The nurse gives me more fentanyl for the pain and I fall back asleep. When I wake up, she asks me to rate my pain. More fentanyl. More sleep. When I wake up again, I get moved into the secondary recovery room. Paula comes. They won’t let me leave until I’m more or less awake and I can go to the bathroom.

Paula leaves to get the car. The orderly who takes me out pushes the wheelchair aggressively. I can feel every bump on the ground reverberate back up into my chest and it hurts.

Back home, I’m more alert than I was after the last surgery. We watch Outlander and I eat some toast. I’m only supposed to take my pain pills every four hours but I need them every three.

The next day, I get the courage to look at myself in the mirror. I’m all bandaged up so it’s hard to say for sure, but they look too small. Paula tries to tell me that I can’t tell yet but she’s wrong. At the hospital, they gave me a card with the implant details. It says 450cc.

When we did the mastectomy in January, my breast surgeon removed the entirety of my right breast (and a bunch of lymph nodes) and my plastic surgeon inserted a tissue expander. The tissue expander is sort of like a temporary implant that they can fill post-surgery, stretching my muscle incrementally. At the time of the mastectomy, I was at 300cc. After I healed, I got three fills (150cc, 100cc, and 100cc), putting me at 650cc total. So this implant is 200cc less. But it was only supposed to be a little smaller. What happened? Why are my breasts so much smaller than we talked about?

The left breast was supposed to be reduced to match the size of the right breast. But because he put too small of an implant on the right side, he ended up reducing my left breast more than expected. Everyone keeps telling me that it looks fine. It isn’t fine. I hate being placated, but it’s hard to get mad at people when they’re taking care of you. After a couple of days, when everyone leaves and I’m alone for the first time, I cry harder than I did when I got diagnosed.

I leave my plastic surgeon a voicemail. When he calls me back that night, he sounds genuinely concerned. He says my tissue expander was 500cc, which is why he chose a 450cc implant. I try to explain to him that that’s not the right number, but I don’t think it comes out clearly. I’m still on pain pills. “This has never happened to me before,” he says.

It didn’t happen to you. It happened to me.

“It’s not permanent. You know that right? You know that we can fix this, right?”

When I go in for my first post-op appointment a few days later, he’s apologetic but in that “I’m sorry you feel that way” way, not the “I’m sorry I made a mistake” way. He won’t say that his numbers were off—“if” they were, he owes me a big apology, he says.

He tells me it’s okay, and that we can easily fix three to six months. You say that like it’s not a big deal. This has consequences in my life. I’m supposed to be done and now I’m not. This is more time. More time off work. More surgery. More stress.

“I didn’t mean to…” he struggles to find the right word. “I don’t mean to minimize it—I understand that this has an impact on your life. I just want you know that we can and will get you what you want.”

I want to know what went wrong. He says he’ll look into it, but I’m not sure I believe him.

Friends come to bring me food, to check on me. It’s hard repeating this story every time I see someone new. “I’m not a small person,” I say. “They look nice, but they’re not in proportion to my body.” The response, inevitably, is more placating.

When you tell someone who isn’t thin that they are, what you’re really doing is fat-shaming them. Chew on that. My body is great. I don’t need you to tell me it’s something it’s not. I FaceTime with my sister and she says, “Oh god. They’re way too small. What did he do to you?” Thank you. You can always count on your sister to tell you when you look like shit. I appreciate that.

*Update 1/4/17: A former version of this story was titled "My Doctor Botched My Post-Cancer Breast Reconstruction." This updated version also includes more information about Thomson's surgeon's original intentions for her surgery, which were reconstruction and minor reduction.

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