Tracey Derrick - plaster cast of her chest post-mastectomy - self portraiture: photography

Today’s photograph from Tracey Derrick‘s body of work, 1 in 9, is a photograph of the plaster cast she made of her chest, post-mastectomy. Through the tender replication of her chest, she somehow manages to both powerfully AND gently obliterate the media’s ‘requirement’ for women to ‘build themselves back together’ into a state of ‘normal femininity’ —- and instead presents us with a portrait of herself simply as she is: pure, unencumbered, real and unutterably and beautifully herself: unique!

Whether we choose reconstruction, to wear breast prostheses or go breast-free, the power of choice lies in our hands: it is our choice, and our choice alone.

If you would like to share your story about your post-mastectomy body
and your new, YOUnique normal,
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Reconstruction after mastectomy

There are various types of reconstructions that can be offered to a patient after a mastectomy. There are many factors that need to be considered before one can decide on a reconstruction and this needs to be discussed between the patient and the surgeon. Each person is different and the type of reconstruction is based on many various factors including:

  1. The choice of the patient as discussed with the surgeon and multidisciplinary team
  2. The type of cancer
  3. The location of the cancer
  4. The build of the patient
  5. Involvement of the nipple
  6. Whether the patient will still need radiotherapy or not


There are many types of reconstruction, most of which are available in South Africa. Reconstruction can be done as an immediate reconstruction or a delayed reconstruction.

  1. A flat chest: many people will request a flat chest. Women will often choose this procedure as it is a fairly quick operation with minimal pain post operatively and has a low risk of complications. A prosthesis with a special mastectomy bra can be fitted a few months after the operation. The patient can also have a reconstruction a few years after having a flat chest mastectomy, this is known as a delayed reconstruction.
  2. A reconstruction using expanders: this is where an expander is placed beneath the muscle in the chest wall. It is then inflated every few weeks until it reaches the appropriate size. An operation to remove the expander and replace it with a prosthesis will follow.
  3. An immediate reconstruction using prosthesis: this is done in certain cases where a skin sparing mastectomy is performed and the tissue is immediately replaced with a prosthesis.
  4. Reconstruction using body tissue:
  5. A flap from your back (latissimus dorsi flap) – the surgeon will make a new breast by using the muscle, skin and fat from your back.
  6. A flap from your abdomen (a TRAM flap) – the surgeon uses part of the muscle with its skin, fat and blood vessels to make a new breast.
  7. A flap from your abdomen (a DIEP flap) – the surgeon takes only the fat and skin from the abdomen to make a new breast. This procedure often has a very good outcome as the breast looks and feels natural as it consists of fatty tissue.
  8. A flap from the thigh (TMG or TUG) – the surgeon will use the fat, skin and muscle from the thigh, either making use of the outer or inner thigh.

Once a mastectomy with reconstruction has been performed, a nipple can also be made. This would be done only once the reconstruction has entirely healed and would involve small procedures. A tattoo can be done to give the nipple areolar its colour.

Reconstruction is a very personal decision and the patient should not be rushed into something that they do not feel comfortable with having. It is important as a patient to look into the various options that are offered before making a decision.


Sr Lieske Wegelin

ABC - Advocates for Breast Cancer - Breast Course 4 Nurses

South Africa & Breast Cancer: Reality Bites

D I D    Y O U   K  N O W  ? 

  • 15 % of the population use Private Sector Health: they are served straight away upon diagnosis.
  • 85% of the population use Public Sector Health have to wait…


Basket of Services - Breast Cancer in South Africa

Women in Private Sector care have access to the entire ‘basket’ of services:

  1. Surgery
  2. All forms of treatment
  3. Supportive care
  4. Breast reconstructive surgery
  5. Breast prostheses
  6. Lymphoedema service

This is, however, not always the case for the Public Heath Sector.

Saying that, even women in the Private Sector can miss out on receiving full cover from their medical aids for their actual cancer diagnosis and all associated treatments if they don’t carefully inform themselves by making sure to read the FINE PRINT of their policies! If they don’t thoroughly know the conditions of their medical aid policy, they will end up joining the treatment queue with their sisters in the Public Health Sector.


If 85% of our women are in the public sector how many of them are lucky enough to get the full ‘basket of services‘?

Breast Cancer - Basket of Services

Once again, it is our responsibility to equip and empower ourselves – as well as our sisters – with the knowledge necessary to make sure we have our rights met!

Taking my new boobs into the bush


Three years after a bilateral mastectomy I opted for reconstruction. And three weeks after surgery to insert the tissue expanders, I set off on a 4×4 rooftop tent camping adventure in the remote Namaqualand/Richtersveld, an area of stunning natural beauty, but very far from civilization.

It was flower season and Namaqualand was a breathtakingly lovely patchwork of colour. The Richtersveld too in its lonely desolation is a very special place. On the downside, there are dangers lurking in the form of snakes and scorpions. Camping sites are rustic in the extreme. No showers, so a bath means  lathering up with biodegradable soap and wallowing in the Orange River. A visit to a bush loo entails shouldering a spade and heading off with one’s roll of biodegradable paper.

A city girl – or old bag of 60 to be accurate – and camping novice, I approached this safari experience with some trepidation, especially in view of my boobs in progress, of which I am inordinately proud. Pre-mastectomy I had what is euphemistically termed a boyish build. Post recon it took a while for me to become accustomised to my voluptuous new shape. Now I feel like a glamorous Fifties film star!

But, with lots of tissue oil, spare plasters, and a bottle of Pink Happiness perfume given to me by a dear friend after the op, I was good to go. I had the blessing of my lovely plastic surgeon. “Just don’t do any bungee jumping” warned the sister doing my “inflations”. I assured her nothing was further from my mind. I also packed a wide spectrum antibiotic and a satellite phone for emergencies. Luckily I didn’t need either of these.

I had the perfect excuse to take it easy, and apart from holding the odd tent peg and rooting about in boxes for provisions, I relaxed while my wonderful husband did all the hard work.

Before breast cancer I very much doubt if I would have been up for leaping out of my comfort zone and roughing it on a trip like this. But when confronted by your own mortality you truly realize the importance of living life to the full and grabbing every opportunity to see and do new things while you can. In two weeks time we are off to the Kgalagadi, and are planning a trip to Botswana for next year.

Thank you to my amazing Reach for Recovery friends who encouraged me to go for reconstruction. It definitely helped me heal, both physically and emotionally, and has given my confidence a huge boost.

Thanks to Avis Perks for this contribution.

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