2024 marked an incredible milestone for me: 20 years as a previvor. Reflecting on two decades of navigating life after my risk-reducing surgeries, I find myself humbled by the journey—one filled with triumphs, challenges, and a profound evolution of self-love and resilience. Never did I think my 20th anniversary would coincide with yet another twist in my reconstruction story.

As we closed out the year, I felt a change in my breast. It started subtly—tightness, pain, and an unusual hardness in the tissue. When I did my self-breast exam, the signs became clearer. My breasts felt hard, sat unnaturally high on my chest, and appeared misshapen. Lying on my side at night brought a sharp, unrelenting pain. My gut told me something wasn’t right.

A visit with my plastic surgeon confirmed my suspicions: I had capsular contracture.

What is Capsular Contracture?

Capsular contracture occurs when scar tissue (a natural response to foreign objects in the body) forms excessively around an implant. This condition can cause the breast to feel tight, look distorted, and even become painful.

Severity is classified into four grades:

  • Grade 1: No symptoms; breasts look and feel natural.
  • Grade 2: Breasts feel firm but appear normal.
  • Grade 3: Breasts are hard, misshapen, and visibly abnormal but not painful.
  • Grade 4: Breasts are hard, misshapen, and accompanied by pain or tenderness.

For me, the diagnosis came with a mix of emotions: frustration, fear, and an overwhelming sense of déjà vu.

A Reconstruction Journey Full of Challenges

Reconstruction has never been easy for me. I started with implants, only for my body to reject them. During COVID, I lived flat on one side for two years. Later, I underwent a DIEP flap, but my left side failed. A latissimus flap followed, and while it brought some balance, it wasn’t the end of the road. Three years later, I faced revision surgery. Now, here I am, preparing for yet another operation in January.

With each surgery, I’ve asked myself: When is enough, enough?

Finding Strength in My Scars

Despite the physical and emotional toll, this journey has taught me to embrace my body and its imperfections. My scars are a testament to my strength and resilience. They are a part of who I am, and I no longer see them as flaws but as badges of honor.

Still, deciding to undergo another surgery wasn’t easy. The pain and discomfort, both physical and emotional, became too much to bear. I realized that my quality of life—my ability to live fully and without pain—was worth facing another procedure.

Mentally Preparing for the Road Ahead

Surgery is never just about the physical aspect; it’s an emotional and mental journey, too. How will I look? How will I feel? These questions are impossible to ignore. But I know I am not alone, and sharing my story is my way of letting others know they aren’t alone, either.

To all my fellow previvors, survivors, and thrivers: You are stronger than you think. Whether you’re considering your first reconstruction or your fifth, know that every choice you make for your body is valid.

This is not the end of my story—it’s simply the next chapter. And through it all, I remind myself: I am enough, just as I am.

— Tracy Milgram