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Mar 21, 2017 11:48AM
The best part is, if you decide you don't like being flat or can't get used to it, even years later, there are still options to reconstruct.
You can always have tissue expanders placed (even if you don't have a skin sparing mastectomy) or look into the various flap surgeries at that time if you decide you're just not comfortable being flat and want to reconstruct.
Yes, that's more surgery and that does come with risk of complications or unsatisfactory aesthetic outcomes (as does any breast reconstruction or augmentation procedure), but if it turns out you're genuinely not happy or comfortable being flat or wearing prosthetics, it's still an option to take.
It's not a one shot deal, so that's always a good thing.
As for the weight, the best way to have long term results is to make long term changes to eating and exercise habits; diets tend not to work because, once someone loses the weight, they often go back to their old eating habits and food choices, and stop exercising as often, so the weight comes back.
It's got to be something you're really ready to change and stick with for the rest of your life to keep the weight off. The first couple months are usually the hardest, because changing and breaking bad habits is pretty dang difficult (there are so many days I just DON'T WANT to go to the gym but I force myself to drag my butt in there unless I have a legit reason not to--like I'm actually ill or injured--and just do the thing. I might grumble and grump and probably look really annoyed the whole time I'm there, but I always feel better after it's done), but after that it gets a lot easier as your changes become your new, better habits.
I know, for me, my biggest issue was/is portion sizes.
What I considered a 'normal' or 'reasonable' portion of something was usually 2-3 times the size the portion should have been, so I was eating a lot more in calorie content than I was burning off, which kept me heavy.
I also grew up with that mantra of, "clean everything off of your plate, even if you're full" and "it's rude to refuse food when it's offered" which doesn't help as that easily leads to large portions and overeating because you feel like you have to finish and can't refuse more food if it's offered. It's been super hard to just slow down and stop eating when full if there's food left on the plate and it's taken me a LONG time to realize that it's perfectly okay to not eat 100% of what's on the plate, it's fine to refuse seconds, and there's nothing wrong with a portion size not being massive.
Cutting way back on 'snack' foods (cookies, cakes, and sweets especially) and replacing them with healthier options (fruit, vegetables, nuts, etc...) helped a lot as well; I still got my snack, and I got some actual nutrition out of it instead of empty calories from sugar.
In addition to that, I also discovered, after really taking honest stock of my behavior, that I eat when I'm bored. The first thing I do when bored is head to the kitchen and look for something to snack on, which is an incredibly bad habit and leads to eating far, far too much food over the course of the day. I've started telling myself, sometimes out loud, "You're not hungry, you're bored, find something else to do." Even if the something else is just having a big glass of water or chewing gum or taking the dogs for a quick walk or sometimes just wandering around the house for a few minutes, it's still better than grazing on food when bored. I can't keep food at my desk at work or I'll just eat pretty much for 8 hours straight AND not realize I'm doing it!
And, honestly, I'm also just lazy. Given the choice, I'd sit on my butt all day at work then go home and sit on my butt watching TV or playing video games. Being that inactive also helps pile on pounds. I got tired of that, and tired of just generally getting winded easily, so I went and got myself a membership at a gym that's conveniently a 5 minute walk from where I work; most days I go in the afternoon on my lunch break, but occasionally I just go after work as I have to pass the gym to get to my car so I have no excuse not to swing in. :D
Either way, given my tendency to eat a lot and be super lazy, I had to really make the concrete decision to fix both issues long term and not just until I lost the 30lb I need to lose (at minimum!), it's got to be something I'm committed to long term and to making actual permanent changes in my behavior as opposed to 'diet changes' that I'd just ditch once I hit my goal.
Prophylactic BMX no recon, June 2016, due to strong family history of BC. NF1 positive.