Going flat or breast reconstruction

otter

I've been down this road twice, and each time I've chosen mastectomy with what I now know is called an "asthetic flat closure." I guess you could say I've had bilateral mastectomies, 18 years apart.

On my first go-round, my surgeon was a highly regarded breast surgery specialist who told me she did approx. 300 breast cancer surgeries per year. ("Too many…," she said.) She referred me to a reconstructive surgeon she often worked with, just so I would know the options. He said an implant was the only realistic option for me because of scarring from previous abdominal surgeries and my reluctance to mess with my back. At age 55 and having breasts that were barely A/B, going flat wasn't scary. I'd even used photoshop to blur out my left breast on a selfie, just to see what it would look like. (Okay, that's weird.) My surgeon checked with me one last time in pre-op, to make sure I didn't want her to leave any extra tissue "just in case." Nope — perfectly flat, and that's what I have.

The second round began this past December with a dx of high-grade DCIS, resulting 3 wks ago in another mastectomy with flat closure (again, my choice). I'm still dealing with a pesky J-P drain that's producing/collecting too much fluid to be pulled yet. This was a different surgeon at a different medical center. I'm left with a mostly flat incision but a bit of a bulge (half a ping-pong ball) near my sternum. I've read that's the most difficult area to manage surgically when attempting a flat closure.

Again, at my age (now 73), comfortably married, and not especially bonded to my breasts after all this, I'm fine with being flat. I've been going without a bra around home anyway, "dressing up" only when out amongst a judgmental public. I do wish my stomach hadn't become so obvious these past few years, because now it sticks out whereas it didn't 18 years ago. 🙄

mary9999

Had the surgery Thursday - liposuction and fat injection on one side and lift/reduction on the other. The lift and reduction looks pretty good. Almost too perky but I guess in time there will be some sag to make it look more natural.

The mastectomy side where he did the fat injection shows no perceptual change. I have all this bruising from the lipo and pretty much nothing to show for it. I think the doctor and I share the blame for this. He had originally told me he likes to use the fat injection to add a bit of volume after placing the implants. I asked him more than once if he could do just the fat injection and eventually he said he could but the best he could get me to would be a small B cup.

The skin I had (at least in the doctor's opinion) resembled a breast with no volume on top. I don't really see any difference now. IDK what happened to that fat but it doesn't show. DH thinks the doctor lied to me. I think he was trying to give me what I was asking for but he had to know the result wouldn't be satisfactory.

we did discuss possibility of going back and doing an implant and possibly more fat injection at the same time.

So I guess I'll need to heal and then decide whether I want more surgery. or get some sort of prosthesis for the left side.

What I have now is better than one flat side and a saggy D cup on the other side. From what other say, and what the doctor says I could probably get the mastectomy side to be approx the size of the lifted side but it won't be real pretty. However it seems most of the women who do reconstruction don't regret it.

If I do go back and do the implant with a bit more fat injected, I'll have the soreness from lipo but not the drain like I have now from the lift.

Any advice or insight is appreciated.