What I Am No Longer Willing to Carry

What happens when a “successful” breast 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. There’s a version of this story that looks finished from the outside. I’m living in the version that isn’t. That’s the strange thing about implants—they can look 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’re cold, rippled, heavy, and larger than what I’m used to. My chest is completely numb, which makes it hard to recognize them as my own. I keep noticing the distance between what is there and what I can’t feel, and over time, that distance begins to feel like a loss of its own.

At diagnosis, everything moved quickly—too quickly to 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 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.

At the time, implants felt like a way to restore some sense of normalcy. I moved ahead believing it would be the end of a chapter, without fully understanding what implants would require long term. They aren’t permanent—there’s ongoing monitoring, potential replacement, and the risk of complications. At 42, that likely means multiple additional surgeries over my lifetime. What felt complete at the time is, in practice, an ongoing cycle.

Over time, I began exploring other options that might feel more aligned: smaller implants, tissue-based reconstruction, or removing implants entirely. I’ve already had implants twice. Tissue reconstruction is not offered within Scripps, which further narrowed what was available to me. Still, my instinct kept pulling me toward going flat, and I scheduled a surgery date feeling certain in that direction.

At the same time, I wanted to be sure I had considered everything. I requested an out-of-network referral for a second opinion on tissue reconstruction. My plastic surgeon at Scripps referred me to a surgeon at UC Irvine, but insurance approval still stood between me and that possibility.

Cigna makes it sound simple: you want to see an out-of-network specialist? Fill out a Network Adequacy Provision form and wait ten business days for review. But that simplicity is only on paper.

Weeks passed in back-and-forth communication between Cigna and Scripps just to confirm the paperwork had been faxed and received. When things finally began to move, they didn’t move forward—they looped. At one point, Cigna stated that Scripps was responsible for review. Scripps, in turn, indicated it was Cigna. The request didn’t progress so much as ricochet between them, each side redirecting responsibility into the same void, with me in the middle trying to keep it from dissolving entirely.

I moved between both systems trying to get a straight answer, eventually coordinating them directly on conference calls that should never have been necessary from a patient’s position. What should have been procedural started to feel like a second job just to access care. Ultimately, responsibility for processing the request sat with Cigna.

Ten business days turned into two months. Cigna ultimately denied the request and redirected me to in-network surgeons who only offered implant reconstruction—the very option I was trying to move away from. No approval. No viable alternative. It was deeply maddening.

My only option was to appeal and wait again—this time a thirty-business-day review. It stopped feeling like a delay and started to feel like a closed loop, where the only available path was the one I already knew wasn’t right for me.

Appealing would have meant staying inside that loop longer, and I didn’t want to lose more time. Instead, I did my own research and spoke at length with the Center for Restorative Breast Surgery, a leading center for microsurgical breast reconstruction using the body’s own tissue.

What became clear was not only what was possible, but the extent of what it required: a six- to eight-hour surgery, multiple surgical sites, several days in the hospital, and a long recovery that often extends into revision procedures. It would mean traveling out of state, stepping away from my business, coordinating care, and absorbing the full financial cost on my own. More than anything, it would mean continuing to organize my life around managing and rebuilding this part of my body.

At a certain point, it began to feel like a never-ending cycle—always something to fix, optimize, improve, as if the right adjustment would finally resolve it. I didn’t want to keep appealing denials or structuring my life around revisions. I didn’t want this part of my body to require that much attention.

It was never about finding the right adjustment, but about how long I was willing to stay inside something that always needed it. I’ve decided I’m not staying in it anymore.

At its core, this is a medical decision, not a cosmetic one. Explanting will allow for direct awareness of my chest wall—no layering, no buffer, no distance between what is happening in my body and my ability to feel it. Given my history, that kind of clarity matters.

My tumor was not found through routine screening or imaging. I found it myself during a self breast exam. For years, I was repeatedly reassured that nothing about it seemed concerning, and it took nearly two years of monitoring and self-advocacy before it was finally biopsied and found to be invasive.

That experience completely reshaped how I understand risk. I don’t want to allow anything to interfere with my ability to notice, feel, and detect changes in my own body.

Beyond the medical reasoning, what remains for me is how this will feel in my body. Aesthetically, I find aesthetic flat closure refined and deliberate—unembellished, understated, and, to me, quietly elegant, grounded in what the body is rather than what it has been asked to represent.

Femininity, for me, has never been tied to a physical form. It lives in how I carry myself, my presence, my heart, and the way I show up for the people I love. That has stayed with me through every version of my body. Removing my implants does not diminish that—it simply removes something that no longer feels necessary to carry.

Choosing to explant and go flat is not a loss. It is an intentional decision to step out of an ongoing cycle of surgical revision and stop organizing my life around maintaining a version of my body that never fully felt like mine. There’s something freeing in no longer needing it to be anything more.