“I’m going to shut my eyes—I don’t think I need to watch,” Teal said as she lay on an examination table in Lenert’s sixth-floor office. Lenert used a magnet to find the ports she’d placed under Teal’s skin during surgery, then injected each tissue expander with 80 milliliters of sterile saline.
“It feels like getting your blood drawn,” she told Teal. “Sometimes when the needle goes through, it makes the muscle jump, but it doesn’t hurt much.”
Each time a patient comes in for a tissue expansion, Lenert puts in more saline to make her breasts a little bigger. When the skin has stretched to a size the patient likes—in Teal’s case, a “B”—Lenert takes out the expanders and uses the original surgical incision to insert silicone implants. Some patients require two expansions; for others, it might take six. The final procedure is done in the operating room, four or five months after the initial surgery.
“D cup?” Lenert joked, as she pumped in the saline.
Teal laughed: “Dave will thank you.”
This was a part of breast reconstruction Teal had never seen, and she wasn’t sure what to expect. She held onto a nurse’s hand.
“Not too bad, right?” Lenert asked.
“Not bad at all. I didn’t even feel a thing. It’s the anticipation, as always.”
She left the room to get dressed and checked a mirror on her way back in.
“These are big!” she said, laughing. She had one or two more tissue expansions to go and realized she really would have bigger breasts than the ones she started with. The implants would take some getting used to.
Teal chose to have a double mastectomy with reconstruction. Lenert used tissue expanders to stretch Teal’s skin and muscle to make room for silicone implants. Photograph by Brandon Bray
The goodie bags for Ashley’s eighth-birthday party are almost ready. They’re pink, like the tiny breast-cancer-awareness ribbon on Teal’s sunglasses and the water bottle she always has with her. Ashley wanted only girls at her party this year, so Teal offered to paint their nails. Her daughter went online and picked out glow-in-the-dark nail polish.
Teal’s mother is in town for her granddaughter’s birthday and brought presents for all of the grandkids. She got Nick a new Nerf gun. “Don’t shoot it in people’s faces—or it’s gone,” Teal tells him. His twin sister, Ellie, got a Swimsuit Barbie and wants to dress just like her.
Ellie found 50 cents under her pillow after she swallowed a front tooth. Somehow, Teal told her, the Tooth Fairy hears about these things. Teal was glad the tooth was out: She may be a good surgeon, but she wasn’t about to pull her daughter’s tooth.
Teal has thought about whether she’d have had the mastectomy if she didn’t have children, if it were just she and Dave, but she can’t come up with an answer. Her happiest moments are watching the kids at the playground or dancing in the living room. She wanted to do the surgery when they were still young, before Ashley was old enough to start thinking about her own breasts.
She couldn’t imagine how tough it had to be on other kids to watch a parent go through chemotherapy. At this age, all that mattered to Ashley was that her mom would be home from work while she was recovering and get to meet her at the bus stop.
It’s been about three months since Teal’s mom finished chemo, and her hair is coming back. She has about an inch, and it’s gray, which she’s having trouble getting used to. She hasn’t seen her real hair color in years.
“You guys have to feel this,” Teal tells the kids when her mom takes her wig off. “It’s the softest hair when it comes in after chemo. I always make my patients let me feel their heads.”
The kids ask if they can wear Grandma’s wig, and Teal takes some photos. Ellie thinks she looks like a rock star.
“Did you get a haircut?” Nick asks.
“I got a haircut,” Teal’s mom says. “Sort of.”
Next: "The next day will be better, I promise."