Going flat or breast reconstruction
Scheduled to have bilateral mastectomy next month. I am very much undecided if I want to have reconstructive surgery or not and go flat. If I go flat, I am afraid I might get depressed as my body will be very different. With plastic surgery, I’ve read of women having so much pain and needing to do more procedures afterwards. I don’t want to deal with pain anymore and possible procedures in the future. For those women who have decided, how were you able to make your decision?
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@greatjoy, welcome to Breastcancer.org! We're sure others will chime in with their experiences and support soon. In the meantime, here are some articles from our main site that might help you in making your choice:
Talking to Your Surgical Team About Going Flat
Podcast: Talking to Your Doctor About Going Flat
Hope these insights help you along the way. Wishing you the best!
The Mods
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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.
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abigailj - Thank you so much for your comment. I saw a plastic surgeon and he suggested to put expanders in and from there I still have the option to go flat, implants or tissue. He said seeing it might help me decide what I really want. At that time I thought that was a good choice given that I am still undecided. But now I am have sleepless nights about it.
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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!
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@needs.a.nap Thank you so much for your comforting words! I have been thinking about your question on how I want to look/feel moving forward. I am pondering about it. It’s scary for me - all these procedures, pain, changes in the body and etc. I have been telling myself what you said - eventually I will be healed.
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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?
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