It’s tough being a woman. Images of women’s faces and bodies are used to sell everything from cars to holidays. The ‘personal care’ industry, with its make-up, firming lotions and slimming products, seems determined on making us dissatisfied with what nature gave us. With physical beauty – judged by ridiculously artificial standards of perfection – prized in the media above all other personal attributes, it is no wonder we often feel we are falling short of the ideal.
When a woman experiences a sudden transformation in appearance, such as breast surgery, these feelings are accentuated, and it can be a real struggle to regain confidence. After all, the choice of body-altering surgery has in most cases been forced upon her to save her own life. Dealing with the issue of self image is a key stage in the process of recovery.
Less a woman?
In her book, No Less a Woman – Femininity, Sexuality and Breast Cancer, Deborah Hobler Kahane has this to say about the hurdles that women face following breast surgery. “Confronted with the possibility of losing her life, the removal of her breast and resulting disfigurement, a breast cancer patient faces a devastating experience. Perhaps one of the most painful parts of the experience is the belief that a woman with breast cancer is ‘less a woman’ and will somehow be rejected by loved ones or future suitors. This stereotype evolved from our culture linking a woman’s identity to her attractiveness, her femininity to her breasts and body.”
Like so many women with breast cancer, when Deborah herself was diagnosed she was terrified about having a life-threatening illness, but thanks to her work with breast cancer patients she knew she would get through it. “I knew from my own experience that the majority of women carried on with their lives as normal. Living with their partners, raising their children, some dating and most still sexually active. Breast cancer had not ended their capacity for sexual intimacy, nor did they feel their femininity had diminished.”
Many AMOENA Life readers felt that their confidence took a knock immediately after surgery. Says Rosemary: “I’ve never felt particularly glamorous, but my hair and my breasts were always my best features and I made the most of them. Before my operation I thought I would be able to handle the loss of a breast. I was surprised how difficult it was. My husband has been absolutely fabulous but the difficult times are summer holidays, parties and dressing up. When I get undressed at night and take my bra off and the prosthesis comes too, my stomach turns.”
Nan agrees. “During each stage of the surgery, chemo and radiation I have tried to keep up with my ‘appearance’ but, somehow, after a mastectomy it is entirely different dealing with what to wear and a great deal of your self confidence goes. This, I know, compared to survival is really irrelevant, but a bit of self esteem goes a long way.”
So how can you help yourself to a better body image?
Take a look
Some women find the first look at their surgery scars extremely traumatic. “I was absolutely horrified when I first looked in the mirror, as it looked so abnormal,” says Theresa. “I still find it difficult to look – although when I have my prosthesis in I don’t always know which one is the ‘falsie’.”
Yet confronting their scars is one of the first steps women can take to re-establish their body image, says Deborah Hobler Kahane. “The first look is never easy, but for most women who have a mastectomy the worst scar scenarios they imagine do not materialise. Many women I have spoken to had not seen a mastectomy scar prior to surgery and were expecting to find ‘a big hole in their chest’. Fortunately, instead of a huge scar, most women are pleasantly surprised to see only a thin pencil line of stitches. Show the scar to those close to you – husband, family, friends etc. With the support of others you will quickly learn that you still look OK.”
This advice worked well for nearly all the readers we talked to. “Everyone was wonderful, especially my husband and 18-year-old daughter who said ‘You haven’t lost a breast, mom, you’ve lost a cancer’,” says Rosemary.
Sandra remembers thinking her scar looked very neat: “Just as though the surgeon had drawn a line across my chest. I was pleased that the cancer had gone and I remember saying to my daughter when she asked if I minded having my breast removed, ‘if you had a bad tooth which was causing you pain, you’d have it removed – this is very much the same’”.
Letting go
Accepting the loss of your breast and letting go of your old body image is also an important part of the move towards accepting your changed body and developing a healthy body image. “The loss is more difficult for some women than others, and depends on how you felt about your breasts prior to surgery and the role they play in your body image and sexual life,” says Deborah Hobler Kahane.
During this phase it can be helpful to meet other women who have been through a similar experience, and who can show you that you can feel good about yourself and the way you look again – it just takes time.
Deborah quotes Susie, whose ‘breast buddy’ was an inspiration to her. “She was an attractive forty-year-old woman who was very comfortable with her one breast and her sexuality. I didn’t look at her as a one-breasted lady. I looked at her as a pleasant, warm witty woman whose style was feminine.”
Reality check
Finally, you need to decide for yourself what femininity, or being a woman, really means to you – it’s a fundamental part of you, not something that can be surgically removed. If you continually tell yourself you’ll never feel good about your body again, you are preventing yourself from ever recovering a positive body image. Femininity does not reside solely in a woman’s breasts.
Carol says that the loss of a breast doesn’t bother her, or make her feel less feminine: “I was swimming within weeks, wearing a special swimsuit with a swim form. My breast form was carefully matched to my right breast – I look normal. No one looking at me would think I only had one breast.”
And femininity is an intrinsic part of being female; it is not something that can be diminished by a mastectomy. Deborah Hobler Kahane quotes Francois Giraud, the Swiss French journalist and politician who felt it was absurd to suggest that a woman could simply lose her femininity: “As though femininity is something you lose the way you lose a purse. The question of breast cancer and lost femininity is based on an outdated social attitude that equates a woman’s femininity almost exclusively with her breasts.” says Deborah.
As one of the women quoted in Deborah’s book sagely commented: “Many women are acting out of the culture’s commercial notion of what it means to be feminine. With nothing better to do than shave our legs, put on make-up and do our hair, women with breast cancer feel that they are not worthy and that nobody will ever pay attention to them.”
Almost everyone we spoke to believes that society places too much emphasis on the importance of breasts. “There is no escape in the media,” said reader Pauline. “Every day you open a newspaper and see stars in stunning low cut dresses, and advertisements for plastic surgery.” Diane agrees: “The pressure to have a perfect body, hair and skin is enormous. Fashion dictates how we all look instead of allowing self-expression.”
Beauty in itself is not only a highly subjective concept, it is also a double-edged sword. Usually equated with youth, physical beauty is ephemeral and by no means an automatic ticket to love, success and happiness. If a woman invests all her self-worth in her physical attractiveness, she is undermining her personality and building a very unreliable foundation for her existence. After all, we are most often remembered and valued for our actions – not our looks.
Your own personal reality check, then, will aim to discover what you feel about your femininity and how you value yourself – and are valued by others, enabling you to reach into a deeper level of confidence in yourself as a woman.
Swimming against the tide
Many of the women whose stories we have drawn on for this article made their own journey back to self-esteem by going against the dictates of the media and popular concepts of what it means to be a woman, rather than accepting the so-called ideal.
In defiance of media hype and sexual stereotypes, many readers were adamant that surgery was not going to change the way they felt about themselves. Sandra says: “I can still look good. Nobody would ever know that I have had a mastectomy and I won’t let breast cancer stop me from doing anything I want to do. My friends and family still feel the same about me, so why should I feel any different about myself? I have had an illness which I wish I hadn’t had, but these things happen to all sorts of people and I am pleased to have got through it. I am a strong person and can be comfortable the way I am. Advertising promotes perfection, but in reality few people are perfect – we should look at the whole person.”
Julie says, “I have to look down and check sometimes as I can’t tell if I’m wearing a breast form or not.” Julie’s surgery has not changed the way she feels about her body: “When I wear a prosthesis I look as I always did. When I don’t wear it I am proud to show people how normal it can all become to only have one breast.”
And Debbie is determined to brave the beach as she always did. “I feel that I am still an attractive, desirable woman. I am gradually regaining my confidence.”
It is up to you to decide who you are, and to a great extent this will influence how other people perceive you
Make the most of yourself
However hard we try to reject the media’s concept of perfection, personal presentation is important for both men and women and for people of all ages. And learning how to make the best of your looks is an excellent way to boost your self-image.
We asked personal development and image consultant, Judy Fearn, for her advice. Judy found a lump in her breast in April 2000 and had a lumpectomy, removal of her lymph nodes, chemotherapy and radiation, and is currently taking tamoxifen. Aged 50, she is married and has two children in their twenties.
“What is happening on the outside when you have been operated on affects how you feel inside,” she says. “I remember after my surgery the first time I needed to dress up for a meeting. I put on one of my little suits and was discouraged.”
“If you’re feeling less confident, my advice is to ask yourself what you can do about it in practical terms. If you have had a mastectomy, think about trying to get the right angles into your body shape again. Start with the foundations. If you haven’t opted for a reconstruction it is vital to get a good breast form and find the right bra. This really is worth pursuing. Keep trying them on until you find one that works for you. You’ll be amazed at the difference it can make to your silhouette and the way you feel about yourself.
“You may also need to consider taking some of your clothes to a dressmaker who can adapt them to flatter your new shape. And if you prefer to wear casual clothes then try not to hide beneath voluminous shapes and several layers. In fact if you are small you could try a cotton t-shirt much smaller than you would normally wear – this can be much more comfortable than wearing a bra, particularly at first. Alternatively sports bras or even maternity bras can work well. Experimenting with weights of material can also help define your outline.”
“Color is another amazing confidence booster and it really affects the way people perceive you,” says Judy. “I usually wear a lot of black, but I didn’t wear it at all when I was ill. I wore soft pinks and blues which flattered my skin but also made people react differently towards me.”
Hair plays an important part in people’s appearance. “It is vital to remember that, although you may lose your hair if you have chemotherapy, it will always grow back. It is worthwhile exploring wigs, and I would suggest synthetic hair because real hair is heavy and can be hot and uncomfortable. Think of your face shape, too – if you have straight facial lines you should go for a more angular hairstyle, whereas rounded faces need a softer shape. Consider having your hair shorter during treatment. Short hair can look thicker, and if you do lose some it will be less noticeable. If a wig makes your head itchy and uncomfortable there are lots of things you can do with scarves and turbans.”
Light at the end of the tunnel
In the early days after a mastectomy, it’s difficult for many women to believe that there is light at the end of the tunnel.
“Unless you have been through the trauma of breast cancer, it is very difficult to explain to people how you feel about yourself. Personally I found losing my hair far more traumatic than the operation itself. Whereas I would often go out without make-up on, I now find myself making an effort even to go to the supermarket! It is important to me that I look as well as I can, all the time. While my family and very close friends have seen me without my wig, I do find it difficult, as least for the first time, letting others see me with no hair. Their reaction is what worries me more than how I look – after all, this is me now, at least for the next few months.”
Many women said there were significant milestones in their journey back to a positive self-image. “After surgery I felt very unsexy, losing some hair, eyelashes and eyebrows,” says Pauline. “But I decided to treat myself to a new bra and when it arrived I couldn’t wait to try it on. Wow! It looked perfect. It immediately made me feel 100 per cent sexy again and my husband loved it.
“I have recently met so many ladies who are either undergoing surgery or having chemo, and who can’t see a light at the end of the tunnel – just like I used to feel. I want to say to them ‘hey, look at me, you can do this too!’”
Amanda says that since her operation she’s been more determined to make the most of her appearance. “I’ve managed to find fabulous, even sexy underwear and super swimwear. I’ve wanted to prove to myself that I could look good following mastectomy. I now joke with people I know, ‘if you haven’t got it, flaunt it!’” And Denise H’s wobbly confidence was boosted in an unexpected way: “For a short time after surgery I felt apprehensive about going out, thinking that people would notice that I was ‘different’. However, this was short-lived, because following a ‘workman’s’ whistle, I smiled to myself, knowing that what I’d believed for years was indeed true, that it’s a person’s overall appearance that is more important than any specific feature.”
You are who you want to be
Feeling confident in the way you look to others has a lot to do with the way you perceive yourself as a person. And this has as much to do with the ‘inner’ as the ‘outer’ you.
Cathy had a mastectomy and reconstruction using her stomach muscle: “I’ve realized it is still possible to like your body, even with significant scarring – in fact I’m probably happier with my body now because I love my flat tummy (I even had my belly button pierced to celebrate). Also the surgery changed my priorities and I’m more concerned now with how I feel than how I look. I’ve discovered that in order to be happy you need to like yourself, and once you are comfortable with yourself and can be happy, it has a knock-on effect on others.”
Perhaps the last word should go to someone who has helped another person through breast cancer. “Mom has always been beautiful, tall and shapely – and that can be a burden as well as a bonus, particularly as one ages or has to undergo surgery as she did,” says Elizabeth. “But the loss of a breast didn’t in any way change her. Not her loving, generous personality; nor her wise and warm spirit; or the irrepressible sparkle in her eyes. My father and I love her even more than before.”
Relevant Links
Visit the Mastectomy, Lumpectomy & Breast Reconstruction Shop and find breast cancer surgery bras, camisoles, and swimsuits, and a wide variety of natural breast forms (breast prosthesis) in all shapes, styles, and sizes, and related accessories.
Chat with women and survivors on the Mastectomy Message Board.
This article was reprinted by permission from www.thebreastcaresite.com, which is devoted to addressing the general needs of all who have been touched by breast cancer, including newly diagnosed patients and long time survivors, as well as their friends, family members and coworkers. Breastcaresite.com’s specific mission focuses on providing breast cancer survivors with accurate information about everything from post-surgery options and products to information about insurance and intimacy issues.
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