The model and the mastectomy: Baring scars then and now

Angelina Jolie highlights the trauma of double mastectomy
Angelina Jolie went public with her decision to have a double mastectomy. As Dr. Jon LaPook reports, thousands of American women also face that same choice in order to save their lives.
Oli Scarff

(CBS News) Even in the age of social media, few would release a stunningly revealing self-portrait for ALL THE WORLD TO SEE. But twenty years ago, one courageous woman believed she had a very good reason to do just that. Martha Teichner reports.

On Sunday, August 15, 1993, the cover story of The New York Times Magazine was a shock. The glamour layout, the mastectomy scar, and the message. You can't look away.

"The reason why I think it's startling and shocking is because the juxtaposition of the beauty and the scar," arist and former fashion model Matuschka told Teichner of the photograph, which she took of herself.

"It was a taboo subject in the early '90s. There was no press coverage, and there was no visual to go with the subject."

The image was intended to prompt a national conversation about breast cancer, but judging from the 1,500 letters The New York Times received in just the first week after the photo appeared, it was more of a shouting match.

"The negative ones were so negative that I was devastated," Matuschka said. " 'Now everyone has to know what I look like' -- meaning the person who's writing it -- 'and I've hidden it from my husband all these years, and now you had to expose it.'

"That was the whole point . . . to expose it and embrace it, and not be ashamed of it."

Twenty years later, the shouting continues. In May, actress Angelina Jolie announced -- also in The New York Times -- that she had undergone a preventive double mastectomy and reconstruction. While she was praised for her courage and candor, mastectomy photographs -- part of what's know as the Scar Project -- were removed from Facebook.

More than 20,000 furious people signed an online petition demanding that Facebook backtrack. Within days, it did . . . sort of, announcing that "the vast majority" of mastectomy photos would be permitted, but not all.

Judy Norsigian, the executive director of "Our Bodies, Ourselves," told Teichner, "It isn't just about whether the breast is there or not, it's the fact that it is a breast."

In its ninth printing, "Our Bodies, Ourselves," is the iconic guide to women's sexual and reproductive matters and a gauge of social attitudes.

"I think we live in a culture where large breasts are almost universally idealized," Norsigian said.

"Most of us are getting bombarded with imagery that suggest you need this hourglass figure, you need large breasts, you need to look like what is a very narrow beauty ideal."

What effect does that bombardment have on the decisions women make, when they're diagnosed with breast cancer -- not only whether to have a mastectomy, but then what? To get breast reconstruction, and if so, what kind?

More than 230,000 women will be diagnosed with breast cancer this year, according to the American Cancer Society. More than 39,000 women are expected to die of it. However, since 1993 -- the year Matuschka's photograph was published -- breast cancer death risks have actually dropped 30 percent.