You’ll have more pictures taken of your boobs than the average centerfold

Most plastic surgery websites show before and after photos. Often, it’s just one of each. For DIEP and other flap surgeries, they’ll often show both breast and donor site before and afters, sometimes from multiple angles. But even when they show a total of six or eight, that’s only a tiny fraction of the total number of photos they shoot.

They shoot when you first come in and then at your pre-surgery appointment. They do it again at all of your post-surgery follow-ups. If you have tissue expanders swapped out for implants, it’s the same process. And then, in my case, we did it all again during the DIEP. Every time, it’s a minimum of five shots: front on, turned 45 degrees and then 90 degrees to the right, then 45 and 90 to the left. If you go in for revisions, there will be more. And when you’re finally completely done, you have your final set.

And that’s just the in-office photos. If you‘re concerned about anything during recovery, or if you have any suspected complications, you can expect to text the office photos to show the area. Sometimes more than one from multiple angles. Since I had that hematoma, we had to send pictures a couple of times the afternoon I went home and then again the next morning. Then we sent more the afternoon after the wash-out and again the next month when one small spot on my incision didn’t want to stay closed. Later, because I picked up an infection after the DIEP, we sent a ton of photos over, not only of my breasts, but also my navel, which refused to heal after the DIEP, and my abdominal incision and area.

But wait! There’s more! Especially if you’ve never had major surgery, you’re likely to be surprised even by the normal stuff after mastectomy or a flap reconstruction. About day three or four, my bruises were spectacular. After my exchange, a circular bruise developed randomly on my lower side, almost like I’d been laying on something round. We never figured out what caused it. All those things? Pictures. The drains can put out some pretty gnarly stuff, stuff you aren’t sure ought to be coming out at all. And incisions can do some wonky things as they’re healing, especially right at the beginning and the end. I was thrown by how red the drain exit points were even after a week. So you send more pictures.

Beyond that, you’ll probably find yourself taking personal photos, either for posterity or memories or so you can compare over time. That’s especially true if you have expanders. Most of us seem to be unable to resist before-and-afters at each fill. Maybe you’re clothed for these and maybe you’re not. And then later, if you get nipple tattoos, you may opt to let the tattoo artist use them and you’ll likely take some yourself because they’re honestly super cool.

All that adds up to a remarkable number of boob photos – and the process can tweak a lot of

people’s hang-ups and insecurities. To begin with, almost none of these photos will be flattering. The positions they need to put you in to get clear shots of your breasts in the office might as well be designed to make everything that’s not boob look as horrible as possible – especially if you’re even a little fluffy. The lighting is studio-bright, so it brings out every pimple, age spot, wrinkle, and cellulite dimple as well as that little patch you always miss while shaving. If you’re a little older and/or have gained and lost weight and/or have had kids, especially if you breast fed, there’s a good chance you’re at least very aware that what once was perky and cute is somewhat less so at this stage of life. Mostly, we’re okay with that because life is life and bras exist and you probably don’t spend a lot of time half-naked in a brightly lit room with near-strangers photographing your chest. When that last part changes, you might find yourself super self-conscious. A lot of women don’t even look at the before photos, at least not until the final after photos are shot. If you do feel self conscious during the picture-taking, you’ll be naturally inclined to hunch a bit, which is the exact opposite of what they need you to do, and the resulting awkward posture just adds to the bizarreness of the photos.

But also, there’s the part where a ton of photos of your boobs are in digital storage – and possibly being texted or emailed from you to your provider. No matter how absolutely trustworthy your surgeon’s office is, we’ve all seen enough SVU to be aware that texts can be intercepted and servers can be hacked. So there’s definitely an element of “I can’t believe I’ve spent my adulthood thanking the universe for waiting to invent cell phones and social media till after I developed some sense and now I’m about to text out my ninth boob photo in three days.”

Speaking of SVU, there’s another, very serious aspect to breast cancer that I’m not sure most people think about: the experience for those who’ve already survived sexual assault or abuse. In that case, an annual mammogram can be difficult enough. In fact, that’s absolutely why some women avoid or delay them – and then wind up with stage three and four cancers that could have been caught at one or two. If mammograms are tough for those folks, just imagine what having to pose for photo after photo must be like. Some SA survivors would rather die. Some, I’m quite sure, do.

We live in a society where bodies, particularly those of women and girls are hyper-sexualized but also hyper-criticized. Female breasts, for reasons that defy all logic, are sexualized often to the point of fetishization – but also none of them are “right.” Too small, too big, too round, too flat. Too bouncy, too visible, not visible enough. Too perky to be real, too real to be attractive. Growing too early, developing too late. Overdeveloped, underdeveloped, under-boosted, over-boosted. The amount of emphasis we put on boobs is outrageous. So, too, is the bullying, harassment, criticism, and body-shaming that goes with our cultural obsession. So, no matter how body positive you are or how able to consider the experience merely a clinical necessity, all those photos can be a lot. My best advice is my usual advice: do what works for you.

Lean into it and pretend you’re shooting for Vogue or look at the wall and pretend you’re in Bali. Shrug it off as a necessity and keep moving. Admire the photos – or don’t. If you find the photo-taking particularly daunting or difficult to deal with, find support from people who understand.

And should you find there’s a photo you really love, keep it. Frame it if you want. It’s totally up to you.