Dear Mr. Savage,

I read your response to I Miss Her Boobs with dismay. You were honest in your inability to give good advice, but your answer rested on the assumption that this is just a sexual/cosmetic/emotional issue, when in fact it could be one of pure survival - the wife not wanting to extend the life-and-death struggle that all cancer patients go through.

The fact is, getting implants after a mastectomy is highly risky; complication rates for mastectomy patients are very high. One study shows that 46 percent of patients getting implants will need more surgery within three years of their reconstruction; numbers from similar reports (here and here, to start) show the same. Rather than bitterness towards the idea of breasts, I bet Mrs. I Miss Her Breasts is just happy to be alive and hopes never to see the inside of an operating room again.

Mr. Savage, I do feel sympathy for both husband and wife in this situation. Both are in mourning: he for her breasts and she for the security of a life without the specter of cancer. His wife has obviously been through some trauma and pain, and so has he. After something like cancer, both would want to be able to get their lives back on the track to normalcy, and of course that includes their sex lives. Now, however, both halves of this couple are in a different place than they were before, and dealing with this transition is never easy.

My personal experience underscores how difficult it is to get to a win-win situation out of something like this. As I underwent surgery after surgery to get breast implants that didn’t work, time after time, my husband felt my pain and discomfort to such an extent that he begged me not to try again after the second implant failure, the third implant failure and then the fourth implant failure. Yes, I had used eight implants. It was terribly upsetting to him that I was so sick because he thought I was only getting implants to please him. As we talked about it – and we talked a lot over that year and a half of constant surgery – breast implants were my way of trying to triumph over a disease that left me disfigured. Breast implants to him represented one step after another of chronic illness and he wanted me any way I was, as long as I was alive and not ill from implants and surgery.

Ultimately, I stopped trying implants and had natural tissue transfer surgery, which provided me with breasts I was pretty happy with. Perfecting nipple reconstruction and shape adjusting took a few more surgeries and with each surgery I could see that my relationship with my husband had become more strained. All he wanted was the security of my having a long life to share with him and he was offended that I thought that breasts were so important to him that I would risk so much discomfort and our relationship just to have them. It took a lot of time for us to heal our differences. And during that time we enjoyed finding other ways to please each other. That part was a wonderful journey for both of us and ultimately led to a complete recovery of our relationship. We’ve been married for over 46 years.

I hope that this couple talks to each other more so that the husband can fully understand why his wife doesn’t want to reconstruct. Whether this man likes it or not, breast cancer is now a part of this marriage. The compromise here shouldn’t be to accept a non-existent sex life but to embrace a new one. In time, exploring newer, more creative sexual activities may help him not miss those breasts so much. I know how possible this is, because I’ve been there.

Sincerely,

Sybil Goldrich