I feel dirty.

I know that probably sounds strange, but knowing this cancer is inside me makes me feel dirty. Like there isn't enough soap, enough scrubbing, or enough showers in the world to make me feel clean again.

Every single day I struggle with the decision to have a double mastectomy.

Every single day, after going through all of the emotions, all of the fears, and all of the "what ifs," I come to the same conclusion.

It's the right decision.

That doesn't make it any easier.

I have another appointment scheduled with the plastic surgeon so I can finally get a clear understanding of what will happen when she performs the Goldilocks procedure. Last time, she explained it, but I'm fairly certain I stopped hearing anything after the sound of my own sobbing filled the room.

This time I have questions.

Lots of them.

Will I be able to wear a regular bra with prosthetics?

Can I keep the bras I already own and simply buy inserts, or does everything I own become useless? Since bras are usually supported by... well... the girls... will they even stay in place?

Will I still be able to walk into Walmart or Target and buy a bra off the rack, or am I destined for those beige "medical" bras that seem to have been designed sometime around 1974?

Will I ever have cleavage again?

I never realized how much cleavage meant to me until I started thinking about losing it.

Funny the things you discover are important only when they're about to disappear.

Can I choose reconstruction later? Maybe next summer? I think she mentioned that during our last appointment, but honestly, I couldn't hear much past my own tears.

Then there are the practical questions.

How long before I can go back to work?

What is recovery really going to look like?

What will I be able to do, and what won't I?

And then there are "Side Boobs 3 and 4."

You know exactly what I'm talking about.

The sisters that showed up as I gained weight.

The plastic surgeon mentioned they might become more sensitive after surgery, or maybe she said something else. I honestly don't remember. That's another thing I need clarified because right now all I have are fuzzy memories mixed with anxiety.

These are all questions I should have asked during my appointment.

But the truth is, I wasn't mentally capable of asking them.

Sometimes surviving an appointment means simply making it through the appointment.

I also have pre-operative physical therapy coming up. I'm not entirely sure what they're planning to do with me. It's not like I'm having a knee replacement where I need to strengthen a joint before surgery.

Maybe they'll teach me exercises.

Maybe they'll prepare me for recovery.

Maybe they'll answer questions I don't even know I have yet.

I'll let you know after I find out.

That's becoming a recurring theme in this journey.

"I'll let you know."

Because every answer seems to uncover three new questions, and every appointment reminds me that this journey isn't just about removing cancer.

Questions I'm Taking to My Plastic Surgeon

I left my last appointment realizing that cancer doesn't just steal your peace—it steals your ability to think clearly. I had so many questions, but somewhere between hearing the words "double mastectomy" and trying to stop crying, they disappeared.

This appointment will be different.

I've written everything down.

About the Goldilocks Procedure

• Why do you recommend (or not recommend) this procedure for me?
• What results can I realistically expect based on my body type?
• How much breast shape and projection can be achieved without implants?
• Will I still have a breast mound, or will my chest be mostly flat?
• Can the Goldilocks procedure be combined with fat grafting later if I want more volume?
• If I decide later that I want more reconstruction, is that possible?

About the Mastectomy

• How much breast tissue will remain after surgery?
• How will this affect my risk of recurrence?

Cosmetic Results

• Can you show me before-and-after photos of patients who had the Goldilocks procedure with fat-grafting reconstruction and a body type similar to mine?
• What will my scars look like?
• Where will the incisions be placed?
• How symmetrical can I expect my breasts to be?
• Will I likely need revision surgery?

Risks and Complications

• What are the biggest risks in my case?
• What complications do you see most often?
• What is the risk of skin loss?
• What signs of complications should I watch for after surgery?
• How often do your patients require additional surgery?

Recovery

• What should I expect during the first week after surgery?
• How long will I have surgical drains?
• How painful is recovery, and how is pain managed?
• When can I:
  • Shower?
  • Sleep on my side?
  • Lift more than 10 pounds?
  • Drive?
  • Return to work?
  • Exercise?
  • Will I need physical therapy to regain shoulder mobility?

Sensation

• What sensation will I lose after surgery?
• Is there any chance of preserving sensation?
• Do you perform nerve preservation or nerve grafting techniques?
• What kind of numbness should I expect long term?

Long-Term Expectations

• How will my chest change over time?
• Will aging or weight changes affect the Goldilocks reconstruction?
• Will I need future surgeries?
• What type of follow-up imaging or surveillance will I need?

Coordination of Care

• Who should I contact if I have concerns after surgery?
• How many Goldilocks procedures have you performed?
• What have your outcomes been?

Lifestyle Considerations

• Will this surgery affect my posture or balance?
• Will I be able to wear regular bras, or will I need specialty garments?
• What clothing or supplies should I have at home before surgery?
• Are there activities I may never be able to do comfortably again?

Questions About Your Goals

Share your priorities with your surgeon and ask how the procedure aligns with them. 

• My priority is avoiding implants—is the Goldilocks procedure my best option? Are there other options besides the Goldilocks procedure, and why wouldn’t those be considered? 
• I want the shortest recovery possible. Is this the right choice?
• I want to minimize future surgeries. How likely is that with this approach?
• I want to maintain as natural an appearance as possible. What can I realistically expect?

Finally, At the End of the Appointment

• "If you were advising a member of your own family with my diagnosis and goals, what would you recommend and why?"
• "What questions haven't I asked that you think I should?"
• "What are the main trade-offs of the Goldilocks procedure compared with going flat, implants, or flap reconstruction?"

As I sat making this list, something occurred to me.

A month ago, I didn't even know what a Goldilocks procedure was.

Now I'm researching fat grafting, learning about surgical drains, wondering if I'll ever wear one of my favorite bras again, and asking what my body will look like a year from now.

Cancer has introduced me to an entirely new vocabulary—one I never wanted to learn.

But if asking these questions helps me walk into surgery feeling even a little more prepared, then every one of them is worth asking.

And if you're reading this because you're facing the same decisions, maybe they'll help you, too. You're welcome to borrow my list and take it to your own appointment. Sometimes the hardest part isn't finding the answers—it's remembering the questions when your heart is breaking.

It's about learning how to live in a body that is about to change forever.

Until next time... keep finding joy in the ordinary, hope in the hard days, and strength you didn't know you had. 

Thanks for walking this journey with me.