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Breast Cancer Awareness: Expert Guide

ELLE's Nina Garcia on her double mastectomy and what the doctors don't tell you

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Opting for a preventative double mastectomy is a tough call to make. Even if you've tested positive for mutations to the BRCA genes, which can increase the risk of breast cancer, there still are so many what-ifs and unknowns that can cloud the mind. Which is why we tapped an expert guide for this special Breast Cancer Awareness issue: Nina Garcia, ELLE editor-in-chief and Project Runway judge, who underwent her own preventative double mastectomy earlier this year. Here, she reveals the pros and cons that guided her decision and what the doctors don't tell you. Plus, if you're battling breast cancer or a breast cancer scare, she opens up about the importance of sharing your story—and, if you're a mother, how to have "the talk" with your children.

Nina Garcia, photographed by Mark Abrahams

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Q&A

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What factors should a woman consider before having a preventative double mastectomy?
It is such a personal choice. I would never presume to know someone else’s situation. I made my decision to have a preventative double mastectomy after weighing the time, costs, anxieties, and risks of surgery against the time, costs, anxieties, and risks of not having surgery. Not having the surgery meant a lifetime of mammograms, biopsies, lumpectomies, and the constant thought of “Is today the day I get cancer?” Of course, it was a terrifying decision to make, but once I imagined a life without constant worry, I knew what I wanted to do. I feel so much gratitude for being able to make this choice for myself—I think that helped my recovery, being so thankful.

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What can a woman expect in the recovery period that the doctors don't tell you?
The doctors give you an overall picture, but there are many details they do not even know to share. When you get any type of breast surgery, your body goes through an immense transformation. If you choose to get implants, you will have temporary expanders that are filled every few weeks. This means you’ll be changing sizes quite often, and undergarments are key to making this tricky process a little more manageable. There are a few brands that make the post-op process easier: EZBra, AnaOno and Nordstrom (which has a breast prosthesis program through which they offer fitting appointments and match you with post-mastectomy, -lumpectomy and -reconstructive surgery camisoles and bras) as well as nonprofits like Fashion Fights Cancer, Bright Pink, and Living Beyond Breast Cancer. You might want a loose-fitting zipped hoodie that you can get in and out of with minimal effort. If you’re returning to work, blouses and jackets will be your friends, as they make you feel the most protected. Oversized jackets are very much in style now, and they acted as my armor that kept me safe while I was healing—while helping me still look and feel professional. Having a big pillow to sleep with is key; getting a seatbelt pad is a great idea. These little tips and tricks aren’t part of what doctors explain to you. I’m lucky to have gotten so much advice from friends, colleagues—even strangers!—who went through the same thing.

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For someone who may be afraid to tell people, what advice do you have to share?
Sharing your story will open you up to a community of women who have experienced what you’re experiencing, who are there to support you and build you up. I was hesitant to go public with my own story, but once I did, the texts, emails, calls, and notes all flooded in, sharing so much love, encouragement, and even humor.

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On the flip side, any advice for the friends and family of someone going through this?
If you’re uncomfortable discussing it, don’t. But talk about something else: Share any book or television show suggestions—there is a lot of downtime during recovery. Visit your friend or family member going through it, and make sure she knows you’re there for her.

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Any tips for mothers who are unsure of how tell their kids? How did you do it?
This was difficult for me. My sons are old enough to understand the situation but young enough that I didn’t want them to have to. But after talking with my husband, who was my rock during this entire process, I was able to have an easy conversation with my kids. I didn’t make it a somber moment, but instead brought it up while we were all together and let them know I was having surgery to make sure I stayed healthier longer. They had a few questions, which I answered honestly, and then we moved on to what we were eating for dinner. Every family is different, but I think being honest (to a degree—you don’t need to go into too many details) is the best way to tackle a difficult situation like this. I’m glad I was upfront because the love and care of my husband and sons was all I needed to get better quickly.

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Not having the surgery meant a lifetime of mammograms, biopsies, lumpectomies, and the constant thought of 'Is today the day I get cancer?'

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