part of the reconstruction process after mastectomy is putting in an implant (tissue expander) to stretch what remaining skin you have, larger. The skin isnt enough because they slice you in a cat’s eye shape and take the nipple (cancer usually follows the milk ducts – hence being called ductile). once they sew you up, its puckered and has to be stretched back out with a saline implant that they can add saline to over weeks/months and make larger. when its large enough, they do another surgery to remove it and put in a permanent implant – either saline or silicone depending on what you decide. After thats all healed, they can form a new nipple either with a flap of skin they pinch and sew, or by taking a chunk of your ear cartilate and implanting that under the skin. i opted to not take any more body parts and do the pinch bit.
once thats all healed, once your new boob has stretched abit and had a chance to drop (sag) you go in and get a tattoo to define the parameters of your new nipple. except that i havent done that yet. Except that my new nipple has all but flattened out and is nearly indistinguishable. Except that my boob hasnt ‘dropped’ much and is still more like a softball than a breast and is still under my chin rather than sitting well with its neighbor. and my doc wants to put a larger implant in, since i’ve gained nearly 20 pounds since my chemo and my natural breast is now larger than the implant (which was larger than the natural breast a year ago)
i feel weird about the whole issue actually. i dont know if i even want a tattoo there – unless i can find a good artist (which i think i can) its going to look completely fake (which i can deal with) but also flat. like the difference between a dye job on hair all the same color, or natural hair which is made of many colors.. your nipple isnt a flat pink or brown. also.. it means the tattoo guy has to compare it with teh real one. somehow i dont mind showing my fake breast to the various people who need to see it – sans nipple its more like them looking at my back or my elbow if that makes sense? maybe i’m just tired of everyone and their dog seeing my naked chest. my partner said i should get a lady bug tattooed on there instead or a sunflower.. and at one point i seriously considered it. i mean…why not? its never in a million years going to look like its twin. why not do something wacky and so completely different? but now i’m becoming conservative again so i dunno.
maybe i dont want a new nipple because that will signify the end of my cancer journey. maybe i dont want it to end – of course i want the cancer to end. what i mean is.. maybe i dont want to say – this is it. this is the best its ever going to look, the best it will ever be. the finality of it is perhaps something i dont want to face. who knows… i’ll take it as it comes i suppose. maybe i’ll be one nippled till i die 
