It is quite possible that someone in Windsor has a set of my nipples. My own fault for not letting John Buckle, consultant maxillofacial prosthetist at Wexham Park Hospital near Slough, know that I had moved house. But not to worry, he is making me a new batch.
Four years ago, I had a mastectomy and two years later I opted to have reconstructive surgery. I don't remember now whether I was given the option to have it all done in one go - removal and rebuild - but I wouldn't have gone down that route in any case. I was just mad set on getting the breast removed and the cancer gone. Afterwards I felt sad and bereft and very sorry for my poor chest with its long, bumpy scar. When I took a bath, I used to pour in gallons of bubbles so I couldn't see what wasn't there. But gradually I came to be all right about it.
About a year later, though, I decided I didn't want a badge of courage, thanks, I'd rather be a bit more pneumatic. That's how I ended up with a gravity-defying, expertly constructed breast to look down on when I took a bath.
On one of the follow-up visits to Tony Armstrong, a perfectionist of a surgeon, he talked about having a nipple made "to finish the job". I barely listened as he explained how they could work the skin that had been grafted from my back to complete the front of the breast, to construct the point of the nipple and then tattoo round it to create the areola. I'd had two major operations, and two minor ones to remove a new lump and to take out a valve that connects into the silicone implant. Enough already - so he put me in touch with Buckle, who I came to refer to as the "Nipple man of Slough", an epithet he uses now for himself.
On my first appointment I sat in a poky little room with a chaperone from the Women's Royal Voluntary Service (hospital protocol for anything of this nature), while Buckle explained the procedure of making a stick-on silicone nipple for my bald new breast.
"First I measure the size and shape of the remaining nipple because some are very obviously the left or right nipple, and then reverse the whole shape and structure so it is mirror image. If the woman has had a bilateral operation I can show her a range of nipples to choose from. I had one woman who had had both breasts removed and I showed her lots of nipples but she couldn't find one she liked. Eventually she said, 'Would it help if my twin sister came in?'. Of course it did - I made them to match her sister's and she was extremely happy." The next step is to make a cast, fill it with silicone, then hand paint it.
Buckle has been working in prosthetics for 29 years, and although he still creates noses, cheeks and other facial parts, the bulk of his work is nipples. Around the room, there are dozens of plastic bags on shelves containing the casts of women's nipples, occasionally men's. "I had to make one for a man who had been badly burnt, and one who had had breast cancer."
He is quietly proud of what he does and is keen to let women know that the service is available on the NHS. "It upsets me that some women are never aware they can have a new nipple made - there needs to be more communication. It can make a huge difference to a woman's confidence and sense of symmetry."
On the day I received my new nipple I was unexpectedly excited. Until I had started the process I hadn't realised quite how much I'd avoided looking at my breast in the mirror. So the moment of affixing the new nipple with artist's glue suddenly took on a huge significance. This frilly edged little piece of silicone meant no more hospital visits; the putting back together was over. "For some women," Buckle says, "this is a very emotional moment, it is the end of something and they cry. Sometimes I cry."
I was beaming when mine was finally in place. Undressed, a metre or so back from the mirror I had better looking breasts than 10 years ago. Dressed, I now had what is technically called "a profile"; a nipple shape under my clothes, a bit of perkiness, a reason to stick my chest out on occasion.
Nipples have huge comedic potential. For the most part, I've made light of it, although there is that same protocol as with criticising family goings on - it's fine for me to make fun of it, but anyone else doing it with too much hilarity could just be crossing the line. But really, how can you take it too seriously when you end up hunting for it in a hotel bed or, like another patient, think you've lost it for good only to find it two days later stuck to your bottom?
Now all I need do is re-apply the nipple with glue every two to three months. A tattooed nipple would have been longer lasting, staying on for "between 18 months and four years but it could be there for 10 years", as Gillian Thompson, a special practitioner of micro pigmentation and skin camouflage explains. "To make the point of the nipple they used to do a skin graft from the groin, but there were drawbacks in that the colour wasn't always right and you'd often get pubic hair growing out of the skin, which wasn't very nice. Now they cut the tissue that's already been repositioned on the breast and twist it and stitch it. Sometimes that's sufficient - sometimes they'll include a bit of cartilage from the ear or ribs. Then I apply the tattoo with iron oxide pigment."
As with every stage of breast cancer, there are no definitive best decisions. You do what suits you, and although there may be new developments, new drugs, better surgery available, even a few months down the line, you have to accept you did the best for you with the knowledge and mindset you had at the time. I'm sticking to my decision to have a transitory nipple, and, in best music-hall tradition, it's sticking to me.
