This was published 2 years ago
‘Posing naked after my mastectomy made me accept my body’
After a mastectomy, the question of whether to have a breast reconstruction, or not, is a personal decision that isn’t easy to make.
By Elli Jacobs
Jillian Exton posed nude for an art class following her mastectomy. “I found it amazing that their focus was on my bald head rather than my ‘unique’ breast.”
Breast cancer is the most common cancer affecting Australian women. In 2022, it’s projected that 20,741 people will be diagnosed with it (an average of 57 a day), including 173 men. Based on past figures, about 40 per cent of women diagnosed will have a mastectomy and of these about 60 per cent will undergo breast reconstruction. Those who don’t have a reconstruction choose to either use a prosthetic or live with the changes to their body.
“When you’re in the process of deciding which reconstructive procedure to have, you need to be guided primarily by your reconstructive surgeon,” says Jane Fletcher, a Melbourne-based health psychologist who has extensive experience of working with people with breast cancer. “Having a list of questions to ask them can be very helpful.”
According to Cancer Australia, such questions should include advice on the best option for you, any problems you may have in the future, the recovery time frame, what support you’ll need before and after, how it will affect your lifestyle and ongoing health, and whether they can share images of similar reconstructions.
“It’s important to also take the time to discuss the options with family and other people whose opinions are important to you,” says Fletcher. “Equally, talking to someone who has had a similar reconstructive experience can be vitally beneficial. Sometimes, seeing a psychologist or counsellor can also provide important clarity in the decision-making process.”
Here, three women share their breast-reconstruction decisions after undergoing a mastectomy.
“I’m whole with or without my breast and nipple”
Jillian Exton, 58, posed naked after her mastectomy, which made her realise that a reconstruction wasn’t what she wanted.
“I was diagnosed with breast cancer on Christmas Eve 2009, age 46, after feeling a tingling sensation in my left breast. Coming from a physical education background, health and fitness are a constant in my life, so the diagnosis was a big surprise.
In hindsight, after looking into cancer-risk factors, I realised that throughout my life I’d been exposed to endocrine-disrupting chemicals.
I had high levels of oestrogen due to endometriosis, including prolonged work stress that compromised my immune system. Therefore, an endocrine-dominant cancer was a matter of when, rather than if.
Initially, my surgery was a modified mastectomy, which meant only losing partial breast tissue. However, the night before the surgery, my surgeon informed me that I had cancer cells in the tissue of my nipple, and it would need to be removed.
Post-surgery, losing my nipple, which is typically a symbol of womanhood, made me feel like I no longer had a ‘breast’ but a ‘chest’. It really challenged my femininity and I questioned if I would ever feel whole, confident or comfortable with myself or my new body again.
Eight months later, when the chemotherapy and radiation were complete, I wondered if I should have a nipple tattoo or reconstruction. That changed when I came across an ad for models to pose nude for an art class.
It presented an opportunity to loudly and proudly come to terms with my new body, and I was curious to see how a ‘disfigured body part’ would be viewed. So, I challenged myself.
When the day came, I was very anxious, but I knew I had to do this to put my mind at ease about people’s perceptions of the new me. At the class, I dropped the robe, focused on my pose and took it from there.
At the end, the students invited me to see their sketches. I found it amazing that their focus was on my bald head rather than my ‘unique’ breast. They shared that they’d never had an opportunity to draw a bald woman and that was the most unique aspect of me. The breast and lack of nipple did not come up in any of our conversations. This made me decide not to have a tattoo or reconstruction.
Three years after my breast cancer adventure, my then husband and I parted ways for reasons unrelated to the cancer. Still I didn’t opt for a reconstruction. If my physical variations were going to be a concern for a future partner, then it wasn’t a relationship I’d like to foster. I’m whole with or without my breast and nipple, and I did what was right for me. I’ve now been with my new partner for eight years.”
“I wanted to be able to love my body again”
Megan Coburn, 41, is a Pilates instructor who decided that implants were her best option after a mastectomy.
“At first I found it difficult to accept my breasts as part of my body,” says Coburn.
“With three female members from my maternal side having breast cancer and testing positive for the BRCA1 gene, in my late-20s I decided to take the genetic test, not thinking I was going to carry it. To my surprise, the test came back positive. Until that time, I was sure I would be the exception, the one in my family who wouldn’t get breast cancer even though I carried the gene. I nourished myself with good food and exercise and by minimising stress.
My family was accepted to be a part of the Peter Mac Familial Cancer Centre program, where I had an MRI and mammogram every 12 months to monitor my breast health and for early detection. A routine check-up in July 2017 showed a small lump. When my doctor said: ‘Megan, it’s not nothing, it’s cancer,’ my whole life changed.
I was diagnosed with breast cancer at 36. I had just run a half-marathon and was halfway through publishing my book, Be Brave, Be Bold, Be You, about mental health and wellbeing, so it was a massive shock. I remember the whole world stopping in that moment and me thinking: ‘Am I going to die?’
After having the lump removed, I had some decisions to make. The options were to remove more breast tissue, leaving an indent in my breast, remove only one breast, or have a double mastectomy. What challenged my decision was that I was single.
I wanted a family, to be intimate with someone, for my breasts to look normal, and to love my body again. I opted for a double mastectomy
and breast-implant reconstruction.
The decision was one of the hardest I’ve ever had to make. It was a roller-coaster of emotions but being young and fit, and having family members around me who’d had breast cancer, I knew this was the right decision.
At first I found it difficult to accept my breasts as part of my body – I would say that they’re not mine, that they felt foreign. Now I love them and my body image has improved. I feel safe in my body, and I fill my own cup first before I give to others. My hope is to inspire and encourage other women to make an empowered choice about their body that will work for them.”
“I had fat taken from my stomach to fill the breasts”
Jo Murphy, 52, underwent a double mastectomy followed immediately by reconstruction using her own body fat.
“I just wanted to look like my old self, so to have them remade was the best option for me,” says Jo Murphy.
“With no history of breast cancer or even serious illness in my family, when my new GP asked me to undergo a mammogram before he would take me on, I was positive the results would come back negative. But I guess it was my unlucky day. At age 47, I discovered I had hormone-based breast cancer in my right breast. Fortunately, it was caught early, so it was very small.
I quickly underwent lumpectomy surgery, where they removed the tumour and five lymph nodes. Then only radiation and medication were required. Yearly tests kept revealing more small growths, this time in my left breast. I chose to have another surgery to remove those growths.
As it turned out, the Tamoxifen hormone therapy medication that was supposed to suppress my ovaries from producing oestrogen wasn’t working.
After further growths were spotted in anxiety-inducing tests, it was agreed that a double mastectomy – including removal of my nipples, as some of the tumours were close to them – would give me peace of mind. At least I’d know I’d done everything possible.
So, in 2021, about four years after diagnosis, my tiny AA-size breasts were removed. I immediately had a reconstruction using fat from my stomach to fill the breasts in the same nine-hour-long surgery.
I knew not having a reconstruction was an option, but I’m the type who stands in front of the mirror every morning and I didn’t want the reminder of cancer. I also don’t think I could have coped with having no breasts. I just wanted to look like my old self, so to have them remade was the best option for me.
Am I happy with the results? Yes, even though one is a B-cup and the other an A-cup – the breast skin that had radiation doesn’t have the same elasticity, so it can’t hold as much weight as the other side. Yet in the overall scheme, this is inconsequential. Just recently, I had my nipple tattoos done, and although I wasn’t in a rush to get them, I’m pleasantly surprised by how much I like them and how complete my reconstruction now is.
I don’t know what will happen in my future, nobody does. But I feel at peace knowing that I’ve taken every step that was available to me to give myself the best chance.”
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