A plastic surgery waiting room can be a very interesting place. I remember how uncomfortable I was the first time I visited Dr. Welk’s office in July of 2012. I didn’t want people to think that I was one of “those” women who are chronically unhappy with their bodies and will go to great lengths to achieve the impossible goal of physical perfection. Further, the plastic surgery office is unsurprisingly swanky. It’s not like the cancer center isn’t nice but in the plastic surgery office, patients dress better and so do the people who work there. For my first several visits, it was as if I could hear an imaginary cash register, “cha ching!” over and over. There were so many patients in the waiting room. Later, I would learn that this is only true toward the end of the year when people are trying to get the surgeries that are covered by insurance finished before the start of the new year when they have a new annual deductible. In other words, they are trying to save money.

I didn’t know until recently that my husband hated going to my plastic surgery visits with me. John didn’t want anyone to think he was one of “those” men, the men who want their wives to look better and are willing to pay money to get a prettier wife. He was ashamed on behalf of men who believe their wives to be defective after mastectomy. At the time I was making a decision about whether I would have reconstruction or not, John was pretty clear that he wanted whatever I wanted. He was absolutely sincere.

I haven’t felt uncomfortable in Dr. Welk’s office for quite some time. A big part of that is I made peace with the fact that I opted for reconstruction and as part of that, I made big strides forward in making peace with the imperfections of my own body, including my imperfect mind that wanted to have my lost breast replaced.

A couple of weeks ago, I saw a woman in the waiting room. I immediately noticed the unnaturally tight skin on her face. She was greeted by a woman in a white lab coat whom I’d not previously seen. I thought to myself, “That must be the Botox lady.” (I think a more accurate and respectful title is “medical esthetician”.) The patient smiled at her across the room and said, “You’re my secret weapon!”

I immediately felt sad for her and if I am being completely honest, a tad superior. I know I had a tip off being that we were in a plastic surgery office but really, the unnatural look of her face was no secret. If she had a secret weapon, Botox is not it.

I think a lot of us kid ourselves about things we don’t feel good about. When I’ve been overweight, I’ve used long duster length cardigan sweaters to cover up lumps, bumps, and wide hips. But really, adding clothing doesn’t hide size. I may have been hiding a fat roll or two but I wasn’t hiding the fact that I was overweight any more than that woman was successfully hiding the fact that she wasn’t 25 any more.

I have some vanity. I dye my hair because I don’t want to be gray. I wear make up, stylish clothes, and moderately impractical shoes 3-4 times per week. I like it when people assume that I am younger than my actual age. When I find myself, as I was, judging people in a plastic surgery office, I find myself in a dilemma. There are lots of people who would question my values, how I live my life, and how I spend my money. With reconstruction, I find myself asking, “At what point does my seeking breast symmetry become elective surgery?” And I mean “elective” in the figurative sense. Insurance would cover subsequent surgeries if I were to decide that my breasts were not “matchy matchy” enough in my own view. Intuitively, I believe that I am done with this unless I have a complication that needs to be addressed. But I have been swimming in gray waters. Reconstruction is done when I say it is done and there is no hard boundary. I imagine that there are people who opt for surgery after surgery after surgery in the quest for putting things back to right.

Almost all of us engage in excess. When is the excess balanced out by sacrifice and altruism? When is a little vanity balanced out by respect for oneself or others? When is wanting to feel pretty self expression and when is it self-oppression? There are no formulas for identifying the precise tipping points for these questions. We have the extreme examples on each side. The rest of us live our lives in the gray areas.

Today I had a liberating thought. I just have to make my own decisions as a person, a mother, a wife, a friend, a psychologist, a writer, a consumer, and a voter. Worrying about a woman getting Botox is not going to help her. She may be using her “secret weapon” in an unhealthy way. I will likely never know for sure. But I don’t have to because I can focus my efforts where they count.

Minding my own business is the secret weapon that I am working on, to protect myself from the negative self judgment that ripples out toward other people.