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I went flat. It was a very easy decision for me. There was not a reconstruction option that seemed right to me. I knew I didn't want implants, and DIEP seemed like too big a procedure with too long a recovery for me. My DMX surgery was quick and my recovery was easy. I also liked the idea that there would be nowhere for a recurrence to "hide". Most people don't even notice that I am flat as I don't wear clingy clothes. It takes a while to get used to, but for me it's the best choice. I like that I will not have to go through revisions or other adjustments.

Hi @greatjoy ,

I think it’s a really good thing that your doctor talked to you about going flat. I’ve heard that some doctors don’t always present it as an option, and I think it’s so important to know all of your choices. I was scared and unsure of what to do as well, and honestly, no one can make that decision for you.

I had a severe panic attack the night before surgery and again while they were prepping me. I chose to go flat because cancer had already taken a year of my life, and I just wanted to move forward and get back to feeling as “normal” as possible. I didn’t want to go through more surgeries, tissue expanders, and then have to replace implants years later (they’re usually recommended to be replaced about every 10 years).

When I woke up from surgery, the very first thing I said was, “I want to see what it looks like.” I tried to look, but everything was wrapped, and I could only see a little. The following week, when the drains were removed, I saw my chest for the first time. I had an idea of what it might look like from photos I’d seen online, but it was still a shock. It helped to have my surgeon there with me.

It didn’t really hit me until my first shower, and even now it can still be hard to look at. I’m still struggling a bit—it’s only been a little over a month. That said, I recently got my prosthetics and chose them one size smaller than what I used to be. They look and feel very real, and they’ve really helped boost my confidence and helped me feel like myself again. (check with your insurance, mine were covered and 4 bras).

There is also delayed reconstruction, so if you ever decide you want implants later on, that option is always there.

I hope this helps, even just a little. ♥️

Hello @greatjoy. I know this is really hard and scary. It’s so hard to make decisions under stress, and having a cancer diagnosis is pretty stressful!! And reading on here can be helpful yet overwhelming at the same time as many post about all the issues they have. You may have some of the same issues or none at all. We are all so unique.

I consider myself fairly wimpy and I dreaded all the pain and discomfort I expected to have. I was pleasantly surprised by how minimal the pain was … I know it’s so different for each person but I never had pain above a “3 out of 10” and most of the time it was a “0-1” during the weeks and months of healing. The discomfort on the other hand, that sometimes felt too much. It’s hard to explain. I keep trying to think of an appropriate analogy but haven’t found one yet.

Being totally honest, the tissue expander was very uncomfortable for me. Not painful so much as incredibly foreign feeling and not something my brain could ignore. It took my body many months to finally settle down and feel comfortable after each surgery. I had some issues with “cording” and internal scarring that contributed to my discomfort, then I started developing a “frozen” shoulder issue. So in the moment, I was sometimes very miserable from discomfort and annoyed at not being able to simply move on with my life, compounded by side effects from the hormone treatment. But once they started filling the tissue expander, I liked having a breast shape again and could see the potential. That helped me endure the discomfort, seeing the potential for a “new and improved” chest.

Another thing … I knew I would have lots of family support and flexibility with work during this whole process. Under other circumstances, I might have chosen to go flat to have the least amount of recovery time and a lesser amount of doctors’ appointments, to minimize the disruption of my life. I’m very practical by nature and this really felt sort of frivolous to spend so much effort on reconstructing my chest. I had such mixed feelings going into this. It’s interesting that I don’t have regrets though.

Have you been able to speak with others who have gone through something similar?

Hi @greatjoy. I’m so sorry you are having to be here with us, with these difficult decisions. It’s a lot to weigh out.

I think I felt similar to @abigailj in wanting to look as close to the same as possible. Since I was having a mastectomy anyway, here was my chance to actually go a bit smaller so I had a single mastectomy with tissue expander, then the eventual implant and the other side reduced.

I also wanted to continue being physically active and didn’t want any long term issues from surgeries that might limit me. Now that I’m finished with my surgeries and have healed, I’m so glad I did it. I’m glad my plastic surgeon nudged me to get fat grafting also. He could see the outcome from the start, whereas I had no clue. I hadn’t really even looked at pictures to get an idea and I realize now that I absolutely should have asked to see pictures of his work!! Thankfully it all turned out well but yikes, I was a bit trusting.

Healing takes time and it’s challenging to stay patient with it all … but eventually you will be healed and this will be in your rear view mirror so to speak. It’s strange but life really does move on. So how do you want to look/feel moving forward? My implant side looks a bit weird (with a hollow depression above the implant and a lot of visible rippling) but with a bra and clothes on, it’s good enough. I’m not self-conscious and I’m not constantly fiddling with my bra or clothes to make sure I look okay. It just looks normal with clothes on, and it even feels normal now. (Disclaimer: my vision has started to get worse so maybe I don’t look as normal as I think, ha ha).

I also knew I probably wouldn’t need radiation or chemo, so that had a bearing on being willing to do reconstruction. And I was otherwise very healthy so it seemed like I would tolerate the surgeries and heal well, and thankfully I did.

I know there’s a lot to consider as you make these decisions. I wish you all the best with whatever you decide!

I wanted to have as close to the same body as possible- for me personally that was important and well worth going through the additional procedures (minor discomfort from those). Everyone has their own perspective on what’s most important to them in dealing with this - I encourage you to discuss your options and fully express your feelings to your breast and plastic surgeons. If you can, meet with more than one PS to make whatever you decide is best for you.