What I Am No Longer Willing to Carry

What happens when a “successful” reconstruction doesn’t feel like home—and the system makes it nearly impossible to choose something else?

It’s been four years since my double mastectomy and reconstruction. From the outside, this could easily look like a finished story. In reality, it hasn’t felt that way to live inside it. That’s the strange thing about implants—they can appear successful while still not feeling like home.

Physically, everything looks resolved. My surgeons did remarkable work, and there is nothing technically wrong with my reconstruction. But my implants don’t feel like me. They feel cold, ripply, and heavy, and they are larger than what I’m used to. It’s a subtle but constant misalignment that takes up more of my attention than I want to give.

When I was diagnosed, everything moved quickly—too quickly to fully understand what life inside those decisions would feel like later. The priority was clear: remove the cancer. Everything else followed from that urgency. In that pace, the options presented to me were already narrow. Implant reconstruction was framed as the path forward, rather than one choice among several. Tissue reconstruction wasn’t meaningfully discussed, and going flat wasn’t part of the conversation at all.

I moved forward without fully understanding that implants are not a permanent solution. They require ongoing maintenance—replacement, monitoring, and the possibility of complications. At 42, that likely means multiple additional surgeries over the course of my life. What appears complete is, in practice, an ongoing cycle.

Over time, I began to explore other options that might feel more aligned: smaller implants, tissue-based reconstruction, or removing implants entirely with aesthetic flat closure. My instinct led me toward going flat, and I scheduled a surgery date. At the same time, I wanted to be certain I had considered every option, so I requested a referral to an out-of-network specialist for tissue reconstruction.

I submitted a Medical Network Adequacy Provision (NAP) Exception Request Form and waited. What followed was weeks of back-and-forth between Cigna and Scripps—delays, missing information, resubmissions. At one point, each directed responsibility to the other. I found myself coordinating calls between them just to move the process forward. What should have been straightforward began to feel like a second job inside the healthcare system.

Ten business days turned into two months. The request was ultimately denied, and I was redirected to in-network surgeons within Scripps who only offered implant reconstruction—the very option I was trying to move away from. My only remaining path was to appeal and wait again, this time through a thirty-business-day review that would likely stretch into months. It stopped feeling like delay and started to feel like a closed loop.

Appealing would have meant staying inside that system longer. Instead, I sought out information independently and spoke with a leading breast reconstruction center specializing in microsurgical procedures using the body’s own tissue. Their work is highly advanced, but understanding that option also meant understanding its scale: a six- to eight-hour surgery, multiple surgical sites, several days in the hospital, and weeks of recovery, followed by additional procedures for revision.

Logistically, it would require traveling out of state, stepping away from my business, and coordinating significant support. Financially, it would mean taking on the full cost without insurance coverage. More than anything, it would mean continuing to invest time and energy into managing and rebuilding this part of my body.

At a certain point, it stopped feeling like a path toward resolution and started to feel like a continuation of the same cycle—one where there is always something to adjust or refine. I realized that what I was responding to wasn’t the quality of any one option, but the ongoing requirement to remain engaged in that cycle at all.

That recognition clarified my decision.

I am choosing aesthetic flat closure, in part for medical reasons. It allows for more direct awareness of my body, without layers that can obscure subtle changes. Given my history, that matters. My tumor was not identified through routine imaging; I found it myself during a self-exam after earlier reassurance that nothing was concerning. By the time it was taken seriously, it was invasive. That experience fundamentally changed how I understand risk and the importance of being able to trust my own perception.

Flat closure reduces barriers between my body and my awareness of it and allows for clearer monitoring moving forward.

The decision is also aesthetic and personal. What draws me to flat closure is its simplicity. It feels clean, resolved, and aligned with how I want to move through the world. I grew up in a culture where breasts were something to shape and emphasize, and later, in the professional dance world, appearance became even more deliberate—constructed through costuming, padding, contouring, and form. This choice feels like a departure from that framework.

Femininity, for me, has never been dependent on a specific physical form. It exists in how I carry myself, in my presence, my heart, and in my relationships. That has remained consistent through every version of my body.

Removing my implants does not diminish that. It removes something that no longer feels necessary to carry.

Choosing to go flat is not a loss. It is a decision to step out of an ongoing cycle of revision and to stop organizing my life around maintaining a version of my body that never fully felt like mine.

My body has already been through enough. I am no longer willing to carry anything that requires me to keep rebuilding it.