I wrote this story to raise public awareness of “Tubular Breast Deformity,” (Dictionary S. M., 2012) and the emotional pain experienced by the women who suffer from it. The process to correct it is long, expensive and must be performed by a plastic surgeon specifically trained to deal with the problems it presents. Due to lack of funding some women are never able to undergo the surgeries and live their entire lives deeply ashamed of their bodies. This condition greatly impacts a young girl’s sexual and social development as well as rendering a numberof its victims unable to nurse their children.
The deformity only showed when she took her shirt off, and for that she was grateful. In fact, the only time she really worried about it was in gym class when the possibility of a communal shower might expose her hidden shame. Her mother had never mentioned it but she had to know it existed. Her father just sat in his chair watching television and there was no way she could ever ask him. Confused, she quietly bore the pain of her difference inside but on the outside she lived like it wasn’t there. Summer was always the hardest, all the tan shoulders in spaghetti strapped sundresses only made her more aware of her shortcomings. She was careful to buy clothes that hid it and never went without her padded bra. Sometimes in the privacy of her bedroom she would try on her tank top without a bra and look in the mirror, hoping for a miracle. But she never looked like any of the other girls she knew, and at seventeen she knew she never would.
At twenty-four, she saved her money until she could afford an operation. They did it cheaper at the medical school, so that was where she was going. It didn’t matter to her if they were students because there would be a real doctor helping them. It didn’t matter to her that this thing still had no name. All she knew was that she would be the same as everyone else. For the first time since puberty, she would go to the beach in a bathing suit and feel pretty. They sent her home after they finished. Heavily bandaged, she drifted in and out of sleep, and loved herself more than she ever had before.
At twenty-seven, she knew there had been a mistake. She could feel it through her skin and wondered daily when it would burst from her body. Her normalcy, the only thing she had every truly wanted, would now be taken. Her first thought was how bad could it be, but she knew she was wrong. She scheduled an appointment with one of the best doctors she could find. He told her she had a congenital deformity, and that students should not have tried to correct it. As she listened to him explain a series of operations, the deep sadness of adolescence engulfed her again. She had no insurance and no money, so there would never be even one operation. Powerless she told him, ‘thank-you,’ and got up to leave. It may have been the honesty in her stare or the mono-toned resignation in her voice, but the doctor did not turn her away. He kept explaining how he was going to fix the one thing she knew would always be broken. He said it didn’t matter if she had no money, he would do the work for free. He said he would pay for the operating room space and anything else she needed. She asked him why he would do this for her, all he said was “it’s my job.”
The third and last operation was over and she was home. There had been over 800 stitches total and months of healing between them but now it was over. The doctor had worn special microscope glasses so he could sew her back together with the utmost care. He assured her the tiny closures meant there would hardly be any scarring. He promised her that for the rest of her life she would be just like all the other women in the world.
She left for the ocean the very next day. As she stood in her hotel room cutting the edges of the bandages so they wouldn’t show the phone rang. It was the doctor. He asked how she was, she told him she was at the beach and was fine. He told her not to get in the ocean and told her to rest, she promised him she would.
Later, as she walked down beach in a haze of pain medication, she realized she was lost. She looked around and didn’t recognize anything or anybody. She tried to remember her name and couldn’t. She tried to remember where she lived and couldn’t. Her chest hurt and she didn’t know why. Stopping at a public restroom, she entered a stall and closed the door. She reached behind her head and untied the strings at the back of her neck. The bathing suit top fell forward and she looked down to see the fragile bandages encasing each small perfect breast. Her head felt funny and she didn’t understand why. Why was she bandaged? She didn’t feel sick, just a little light-headed. She knew she was a young woman; her skin was smooth, her stomach taut and flat. She wondered why her perfectly beautiful body was bandaged. A sense of panic began to grow inside the pit of her stomach. What if she needed medicine? What if she had cancer and was dying? What if people were looking for her? Should she go to the police and tell them she didn’t know who she was? No, she thought, they will think I am crazy and lock me up. I am not crazy, just lost.
She decided to keep walking up and down the same section of beach until she could remember who she was or someone recognized her. She left the restroom turned left and headed back she hoped, to where she started. Every hotel looked the same as the next, she scanned the beach hoping to see someone waving and calling to her: “where have you been” they’d ask, “we were beginning to get worried.” But there was on one so she just kept walking back and forth all day.
Painfully, she lowered herself down on a towel. More than likely it had been abandoned by some sun soaked vacationer who would show up again in the morning hoping to find it still there. Beside it was a beach bag with a pair of pink flip-flops sticking out of the top. The sun was beginning to sink over the horizon and she still was no closer to knowing who she was, the pain in her chest was getting worse and she was too tired to walk anymore. She closed her eyes and lay back on the towel, tears started to trail down the sides of her face. There was nothing else for her to do, as soon as she rested she would find someone and turn herself in. They would put her in a hospital for people who were crazy and she would never know who she was.
She turned her head and looked at the beach bag next to her. She hoped whoever left it would get it back. She thought about getting up and carrying it back to the hotel behind her to turn it in at the desk. It was the kind of thing she was sure she would do. She stood and picked up the towel shaking the sand from it as she did. Grabbing the handle of the bag, she headed toward the hotel to do her last act of kindness before they took her away.
The desk clerk looked up at her and smiled. “Did you finally get enough of the beach?” he asked as she set the bag up on the counter.
“Yes, yes I did,” she said in a half stammer. “I found this bag; I think maybe someone in your hotel left it by accident.” she blurted out awkwardly. Her lips were dry and she was thinking she should have looked inside to see if maybe they had left a drink too.
Taking the bag from her, he looked down into it and retrieved a small pink wallet the same color as the flip-flops. “Boy, are they lucky it was you who found this, most people would have just left it there or worse taken the wallet and then left it,” he spoke as he unbuttoned the snap allowing it to fall open. She was leaning on the counter now, wondering how she was going to tell this nice person she was completely crazy and possibly very sick and wondering if there would be a big scene when they came to pick her up.
“Are you OK?” he asked.
Her heart began to race; here it comes, she thought. He knows. “Tourists,” He muttered under his breath as he pushed the bag, wallet, towel and all back at her from across the counter. “They drink all day and then I get them.” He turned and walked off.
Then she saw it, peeking at her from just inside the worn canvas bag. It was her image, smiling back at her from a driver’s license. Relief flooded her as she scooped up all she knew of herself and headed over to a bench in the corner of the lobby. Sitting quietly and letting her fingers fumble through bits of paper, loose star lite mints, some sticky pennies and cigarette cellophanes she found a small square room key with 815 printed across one side and a picture of the beach on the other. She pulled out the wallet and opened it; she looked at the picture of the girl on the license. It told her nothing but who she was and where she lived. That was enough for now.
She took the elevator to her room and went to bed. It must have been after midnight when the phone rang. Her voice cracked when she answered.
“Where have you been? The concerned voice questioned her, “I was beginning to get worried.”
“I was at the beach.” she answered.
“You didn’t get in the ocean, did you?” was the reply.
It all came back then. It was him, the doctor. She looked down at her chest.
“You should rest.” he said.
“Uh huh”, was all she managed to get out. She gingerly tugged the corner of a bandage until it was loose enough to lift up. There they were the last stitches; his tiny black threads tied in even tinier black knots that had given her back to herself.
He was asking her about medicine. She nodded into the phone. “I promise to rest” she heard herself tell him before hanging up.
For the next two days, she stayed in. By the third one, she felt well enough to take a short walk on the beach. This time, she carried her bag. Her chest no longer hurt and she hadn’t needed the pain medicine at all the night before. She reached down, picked up a shell and dropped it into the bag. She would take it back as a gift for the doctor. She knew it was over now, this time for good. She knew she would never find herself alone and lost on the beach again. She smiled and bent down to grab another pretty shell.
[i]A developmental disorder of breast shape and growth in which the breast assumes a constricted shape. It affects ±1:200 women, who are often very self-conscious about their breasts. It is associated with herniation of breast tissue into the nipple areolar complex (NAC), constriction along the lower pole of the breast causing a poorly defined inframammary fold. Often the NACs are also lowered causing some sagging or patientosis. Usually both breasts are affected and asymmetrical, sometimes with significant asymmetry and severely deformed breasts.
Management Tuberous breasts are difficult to manage and usually take more than one operation to augment, lift, and reduce. A period of post-op settling is required before the tissue is fine tuned with secondary revisions.
Dictionary, S. M. (n.d.).
Dictionary, S. M. (2012, October 28). Tuberous Breast Deformity. Retrieved October 28, 2012, from The Free Dictionary: http://medical-dictionary.thefreedictionary.com/Tubular+Breast+Deformity
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