FLAT vs FLAP
Hello. I am scheduled for total BMX in 3 weeks. I scheduled an AFC. I was always adamant about going flat. But I do have a large round bellly even though I am active (or I was prior to chemo). Now I'm terrified i won't like or accept the way I look. Plus I'll be put in menopause so it'll make it harder to lose weight.
The flap sounds like a nice idea, but a 12 hour surgery when again there isn't a guarantee that I'll like the results seems nuts. Plus the longer recovery, the risks of complications (low they may be). I've had 5 months to think about this. But now I'm so panicked about either decision/ outcome. Neither is a good choice. And IDK what I can live with. And I don't want implants.
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Hi @rachell and welcome to Breastcancer.org.
We're so very sorry for the reasons that bring you here, but we're really glad you've found us and decided to post. You're sure to find our amazing Community a wonderful source of advice, information, encouragement, and support — we're all here for you!
While you wait for the responses from our other members, we encourage you to check out this page: Is Breast Reconstruction Right for You?
Additioally, have you considered going flat for now and making a decision later on if you want to have reconstruction surgery? Many women find that getting through initial surgery to remove the cancer first gives them the time and clarity to focus on what they want - or don't want - in terms of reconstruction. You can read more here: When Is Breast Reconstruction Surgery Done?
We're sure others will be by soon to weigh in. Welcome again and let us know if you need any help at all!
—The Mods
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Hi @rachell -
Welcome to the forum! We're glad you found us, but are sorry that you had to join this "club".
Reconstruction is SUCH a big decision isn't it? My 1st dx of b.c., I was terrified and just wanted to get the cancer 'out'. I didn't know if I wanted recon or not. My surgeon helped me decide to do a skin-sparing mx, which would allow me to make that decision later. This preserves some of the skin that might be needed for a flap if you later decided to go that route. Maybe that would be the best option? It still might mean that if you decided to go flat, you might want a tweak or two, but it would allow you to 'try out' being flat and maybe that would make your decision easier? You could get through all the treatments first and have a clearer mind to make your decision. Talk to your surgeon.
Good luck with your decision. It's hard. We've all been there.
Take care.
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@mandy23 hi. I have thought about skin sparing. But I think that would be harder to look at. And really, I don’t want more surgeries or revisions. And I’ve had 5 months to think about it. Which is part of the dilemma. I need the BMX ASAP. And I can’t imagine being out of this, then going back for more surgeries.
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Hi @rachell
Interesting. I was actually pleasantly surprised with skin sparing as I felt like there was still 'something' there. 😊 But then, I didn't think on it very long at the time.
If you really want to be DONE after 1 surgery though, you should likely go flat. Even with a flap surgery, it is very common to have a revision surgery afterwards….
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Hi @rachell. I had a BMX with aesthetic flat closure over two years ago. I wouldn't say I'm in love with my lack of breasts, but I am confident that I made the right choice for me. Surgery and recovery was fairly easy; I went home the same day and did not need anything stronger than tylenol. I am somewhat self conscious about my looks, especially now that's it's hot outside and I can no longer rely on bulky sweaters to "hide" my chest. BUT!!! I have discovered that NO ONE NOTICES. It was a real revelation to me. I suppose if I wore a tight tank top they would, but I didn't dress like that before and I don't now. People literally don't see that I have no breasts. I know this because people have expressed surprise when the topic comes up. I did have to give a lot of my clothes to my daughter because they don't hang right anymore, but I bought new tops that are flattering. Recently we had a staff picture at work and I had to hang it on my fridge because I look completely normal; it's true that you cannot tell I am flat.
I don't have a big belly but I do have a big butt and thighs, and it's still okay. My MO likes it because it makes her job (monitoring for recurrence) much easier but that isn't why I did it. I just didn't like any of the reconstruction options, more surgeries, etc.
Going flat isn't for everyone but it was the right decision for me.
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@maggiehopley Thank you for sharing your experience. It's weird because I really always thought I'd go flat and move on. I don't know where all this doubt came. I'm just not sure I'd get used to it. Also there is a very real possibility that I might nit like the aesthetics of a DIEP flap as well.
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