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What They Don’t Tell You About Preventive Mastectomies

YouBeauty’s fitness expert Tracy Hafen has elected to surgically remove her healthy breasts in light of her high risk of breast cancer. Here, she weighs the downsides of the surgery.

Courtesy of Tracy HafenTracy Hafen and her son during one of their famous family push-up contests.
What They Dont Tell You About Preventive Mastectomies

Prophylactic mastectomies are not for the faint-hearted. I made my initial decision to get one based on the negatives of getting cancer. I knew little about the surgery and recovery process. Once I started meeting with the surgeons, however, the negatives of the surgery brought me to the decision-making table all over again. Two realities most disturbed me:

MORE: How to Assess Your Breast Cancer Risk Factors

1. I may never be able to do push-ups again.
Your pectoralis major is the main chest muscle that allows you to push your arms forward or bring them across your chest. During the first surgery, after they have removed the breast tissue, they lift the pectoralis major muscles up from the chest wall and use them in the breast reconstruction process. These muscles are no longer used as chest muscles for strength and movement. Instead, they serve as protective layers between the breasts’ skin and what will be the implants. If you place implants directly under the skin, you’ll likely get hard, lumpy scar tissue, and there is a high risk of complications and infection. Most surgeons will not even perform the surgery inserting implants directly under the skin.

As part of the first surgery, surgeons insert expanders in the chest to gradually stretch out the pec muscles, so that they can cover the future implants. In order to keep the pec muscles from compressing the implants and making them “jump around” (as my surgeon put it) with arm movement, they may need to “quiet down” the pectoralis major by cutting nerves to make it less active.

What got me most was when my plastic surgeon said, “You won’t be focusing on push-ups after the surgery.” What?! Push-ups are practically a part of my identity. I do at least 30 a day. I love them. Our family even has push-up contests—including ones in public, such as at Disney World (the photo above shows me with my son during one of our famous push-up contests). This alone was almost enough to change my mind about having the surgery, but my surgeon reminded me that the pectoralis minor muscle, over time, will strengthen and can take over much of the lost pectoralis major function. He noted that he has many athletic patients who ultimately find no problem doing what they enjoy. Still, I may not be able to win the family push-up contests anymore. I went through all of the other options with the surgeons. They can use other muscles, but they have even more serious downsides. For me, no other option is any better.

After weeks of struggling with this issue, this is how I think about it now: “Hey, I’m a trainer. I’ll still have my pec minors, and I’ll develop them to the full extent I can and then go with it.” My guess is that although I will initially notice a big difference in my workouts, and I may need to change some of the focus of my exercise routines, I will not notice a big difference in my daily life otherwise. That’s what I’m hoping for anyway.

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