The Wad of Fat: A Secret Every Woman Needs to Know

For women diagnosed with breast cancer, perhaps facing mastectomy, there is a dirty little secret out there we need to know in advance, before surgery. It’s called the wad of fat. Listen up.

It’ll never happen to you, right? Wrong. You know the statistics.

I learned about the wad of fat after surgery and several post-surgical office visits to aspirate the swelling at the surgical site. The last time, the surgeon was out of the office so the nurse performed the procedure, and said, well, that’s it, you don’t need to come back.

But wait a minute, there is still swelling, I protested. Oh, that’s the wad of fat, she says.

The wad of fat ? It’s the wad of fat the surgeon leaves in case you have reconstructive surgery.

I wanted to strangle the surgeon. I wanted to give him a bra with a Smurf Ball sewn into one side and ask him to wear it around for a while to see how it feels.

You see, before surgery, the surgeon asked me casually if I wanted reconstructive surgery. No, I said, with confidence. Breast cancer runs in the family and what was good enough for Aunt Faye is good enough for me, i.e. a prosthesis. I also came armed with studies showing that women who have the surgery are less satisfied overall with their quality of life than those who don’t. I have my theories, which have to do with their self image and the type of men they choose to hang with.

I also knew that fewer than 20 percent of mastectomy patients opt for the surgery, and of those, a significant number do not have, as doctors like to call it, good results. I had looked at images on line of the procedure, which compared to a mastectomy is much more invasive, takes more time, and poses many more risks. So no, I insisted, it’s not for me.

The surgeon had told about one of his patients who, in her 80s and after a decade or more post-mastectomy, decided to go for it. I gave him my most vacant stare. I woke up after surgery not knowing about the wad of fat. Whatever happened to informed consent?

Every year I get a post card in the mail reminding me of my rights to reconstructive surgery under the Women’s Health and Cancer Rights Act of 1998. Fine, elective surgery is not an option. Removing the wad of fat is elective surgery.

If rock stars and news anchors are now “outing” about their baldness, and men shaving their heads in solidarity, why are women not also “outing” about their lopsidedness or completely flat profile? Why don’t we old feminists just “out” completely and burn the prosthesis along with the bra? What better reminder to the whole world of the prevalence of breast cancer and the need to find ways to prevent, rather than to cure, cancer, than to see women walking around with one breast or no breast?

Oh, and on the way out the door one day from the surgeon’s office, I overheard the reconstructive surgeon confiding in a nurse that he loved his job if only he did not have to deal with patients: women in deep angst about the pros and cons of reconstructive surgery.

Well maybe he should get a job sculpting in clay. Hands off of me, please.