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Rejecting Reconstruction after Breast Cancer: Managing Stigmatized Selves

After a mastectomy due to breast cancer, a woman faces a choice about whether to undergo cosmetic reconstruction of her breast(s). In choosing reconstruction, women restore not only their bodies but their socially acceptable selves. In spite of this, most choose not to have reconstructive surgery. Though they are in the majority, not much is known about these women, and about what they do to navigate through life with a body that does not meet expectations of femininity. In this project, I use the case of women who choose not to have reconstruction and not to simulate their missing breast(s) to explore the boundaries of the socially acceptable body. Drawing on interviews with women who did not have reconstruction, examination of depictions of bodies on breast cancer organization web sites, and content analysis of their discussion board postings, I analyze women’s choices not to reconstruct their breasts and place those choices in the context of modern breast cancer culture, which promotes an ideal ‘survivor’ body. I find that these women emphasize concerns about stigma and authenticity and that these concerns are expressed through appearance changes that vary across public and private settings. This research extends our understanding of deviant bodies to understanding the stigma of socially incomprehensible bodies. Further, it makes explicit the assumptions about selfhood that are implied by both current popular perception and sociological work on stigmatization.