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Topic: Anyone regret going flat?

Forum: Living Without Reconstruction After a Mastectomy — Discuss prostheses, swimsuits, bras, and other options for women not having reconstruction or waiting for reconstruction.

Posted on: Aug 23, 2019 10:03AM

StAuggie wrote:

I'm finishing up chemo next month and will have to make a final decision about whether or not to do reconstruction. I'm planning on having both breasts removed. I do not want implants, so I'm choosing between going flat or DIEP fat grafting.

A few weeks ago, I was just fed up with the whole multiple surgery, lengthy recovery idea and just wanted to put cancer behind me, so I decided to just go flat. My concern is how I am going to feel later. I realize that no one can tell me how I'm going to feel about having no breasts, but I don't want to make the decision to go flat and then regret it later; from what I've read, its better to start reconstruction right away or at least leave skin, if they're able to, and then have it later.

If I go flat, I would probably wear some type of prosthetic to give the appearance of having breasts, at least in public. Not sure that I want to mess with the hassle of prosthetics, but in all honesty I don't think I can be comfortable without them in public. I just keep going in circles and haven't been able to come to terms with either option.

Dx 4/12/2019, IDC, Left, 1cm, Stage IB, Grade 3, ER-/PR-, HER2- Chemotherapy 5/9/2019 AC + T (Taxol) Surgery 10/29/2019 Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
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Nov 2, 2019 02:58PM Yogatyme wrote:

I Spy, I am so, so sorry you are struggling so much. A friend has an autoimmune disorder and does everything humanly possible to manage it, but it is a bitch!!

Yogatyme Surgery 3/2/2019 Prophylactic ovary removal Dx 7/19/2019, IDC: Papillary, Right, <1cm, Stage IA, Grade 2, 0/5 nodes, ER+/PR+, HER2- Surgery 8/12/2019 Mastectomy: Left, Right
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Nov 2, 2019 06:51PM Aussie-Cat wrote:

I Spy, I'm also really sorry for what you are going through. I hope that the surgery helps you to feel so much better!!!

Diagnosed with nerve pain (post mastectomy pain syndrome) July 2018. Twin sister died of breast cancer May 2019. Surgery 6/19/2018 Prophylactic mastectomy: Left, Right
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Nov 3, 2019 05:53AM windingshores wrote:

I "went flat" and have no regrets. I don't wear any kind of prosthesis. There are actually some clothing options I didn't have before. Lands End makes a bathing suit specifically for those who went flat. I have other health problems and did not want to stress my body with any other procedures, and I really felt fine about going flat anyway.

Dx 2/2015, DCIS/ILC/IDC, Right, 1cm, Stage IA, Grade 3, 0/3 nodes, ER+/PR+, HER2- (FISH) Surgery Lymph node removal; Mastectomy: Right Surgery Mastectomy: Left; Prophylactic mastectomy: Left Hormonal Therapy
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Nov 3, 2019 08:52AM Gigicommon wrote:

I went from a natural DD cup to flat without reconstruction. I tried knitted knockers once and I could never convince myself to wear my fitted prosthesis. It all just felt foreign and unnecessary. I've been wearing some kind of bra since I was about 10 years old and flat feels freeing to me.

One thing I have found fascinating is the number of folks I have engaged in conversation about my cancer journey who, while looking directly at me, will ask me what kind of cancer I had. The first time it happened I was talking to a woman who knew me from my big breasted youth. The fact that she didn't notice made me question if anyone really noticed. I do try to camaflouge the extra skin the surgeon left behind but, other than that, I wear cute blouses/dresses (cute is always important to me) and live my life.

For me flat was an easy and right choice but I understand that the decision can be very difficult. Don't be pressured by anyone. This is your body, your life, your decision.

Dx 9/20/2017, IDC, Left, 1cm, Stage IIA, Grade 2, 1/7 nodes, ER+/PR-, HER2+ Surgery 10/25/2017 Mastectomy: Left; Prophylactic mastectomy: Right Chemotherapy 1/2/2018 AC + T (Taxol) Hormonal Therapy 6/27/2018 Arimidex (anastrozole) Targeted Therapy Herceptin (trastuzumab)
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Nov 3, 2019 01:43PM rljes wrote:

I totally agree with Windingshores - I have no regrets going flat, and didn't even consider prosthesis. I did have to over ride my BS and demand to have both breast removed. I have several auto immune diseases, skin disorders, so that was a factor. It also alleviated some of my upper back pain due to my heavy breasts. The only issue is that I have to keep an eye on my tummy bulge. I can see it now. Ha.

I'm 61, divorced and happy with my decision. Now that its been 2 years, I'm considering tattoo's to cover the scares. Nothing this exotic (see photo) but you get the idea!

Finished Chemo March 2018, No reconstruction "Going Flat" Dx 6/26/2017, IDC, Left, 3cm, Stage IIB, Grade 2, ER+/PR+ Dx 8/22/2017, 1/7 nodes, HER2+ Surgery 8/22/2017 Mastectomy: Left, Right Chemotherapy Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy Herceptin (trastuzumab) Hormonal Therapy
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Nov 5, 2019 08:20AM Abelian wrote:

i am 8 months post BMX with no reconstruction and very happy to be flat. I had scar revision surgery about two months ago to remove redundant skin and under arm bulges. I have been fitted for bra and prosthesis but don't use them.

As others have said, nobody notices, even though I was rather large before. Some clothes actually fit better now.

Good luck with your decision.

Dx 1/18/2019, IDC: Tubular, Right, 1cm, Stage IA, Grade 1, 0/4 nodes, ER+/PR+, HER2- Surgery 2/25/2019 Mastectomy: Right; Prophylactic mastectomy: Left
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Nov 5, 2019 11:38AM JCC4958 wrote:

Dear StAuggie: I had BMX six years ago and have never regretted going flat. I had so many surgeries every two years and just couldn't stand the thought of more. It is a process when you decide to go with implants or the flap. There can be complications and more surgeries involved. Make sure you get all of the pros and cons from your surgeon on each procedure.

You do not have to make a decision right now. Most insurances will cover it years later should you decide. I actually had to fight with my surgeon. She couldn't understand my decision. I have never regretted it. I do have several varieties of prosthesis but find myself not wearing anything at all most of the time. Take your time and make the decision you feel most comfortable with. Don't let anyone pressure into making a decision before you are ready. Prayers for you on your journey. JC

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Nov 5, 2019 04:50PM cfrank wrote:

I had a mastectomy one year ago..just one breast. I choose no reconstruction because it involved so many other surgeries and drs visits. I have a prostetic but I never wear it.. Im very comfortable..there are a few things I cant wear because its too obvious. But I love my flat side!!

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Nov 5, 2019 07:36PM HopeWins wrote:

confused516 - I don't know if this will help, but offering a perspective. I'm also 5'8" and 150lb, just like you. I read, researched, read more, drowned myself in statistics and case studies and as much info as I could find after deciding on bmx. I leaned towards DIEP because I wouldn't have to deal with implants and figured the recovery wasn't much worse than dealing with TEs for a few months. I had my surgery 8/22.

I think I was right on the recovery. Its rough for a week or two but doable. I'm not positive I was right about DIEP being right for me. The first PS was skeptical about having enough tissue and said- we'll need to do quite a bit of fat grafting and you'll be smaller. The far more experienced surgeon said - it will be close, but probably just enough to recreate what you have. I thought I'd be ok with being a little smaller if that was how it ended up and went with PS#2.

I used to be a C. I'm now more like an A. No cleavage and some concave areas. I know I didnt go flat, but I feel like I did. I've had people ask - Have you thought about whether you're going to have reconstruction? My BS has said 3 times - you definitely had more breast than belly. I REALLY struggled getting dressed/leaving the house after surgery. I need to have revision surgery, but it would probably take 4 surgeries minimum (lipo to other parts) to get enough fat to fill in these flat areas. I'm not willing to do that. In addition, after the big surgery, I learned my PS is booking 6m out for revisions. Its depressing, honestly. I need closure. I'm debating leaving it as is. I'm debating switching surgeons. I'm debating adding an implant. I see the PS next week and will discuss this with him.

Hind sight from a woman who was told she was borderline for DIEP, I don't know that I'd recommend it. It's not just about potentially going smaller. The results are less predictable. They're not "round" for lack of a better term. I've got divots and the inner/upper areas are skin on ribs. There's a lot more scars with DIEP. That part isnt a huge deal to me, but it is to some women and I don't love the numbness under my arms from the incisions that go almost around to my back. I haven't worn a v-neck in 3 months... it's just difficult to adjust to.

At the end of the day, nothing will ever be the same. I'm not super proud of my body, but I did have really good boobs before BC. Nothing will ever compare to my old ones. I'm just trying to find a mind/heart/self-esteem balance with a new me. DIEP wasn't what I hoped it would be, Implants definitely have their downsides. Flat is a super admirable choice, but not right for me. It's really hard. Not sure if you're aware but there are hybrid surgeries that combine DIEP with implants. Not many surgeons do it, but it is an option that's been successful for thinner DIEP patients. I learned about it recently.

I wish you the very best! It's so hard!

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Nov 7, 2019 09:49PM mybee333 wrote:

I too have had a lot of problems that I relate to my implants. As someone who already had auto-immune issues I was a very poor candidate for implants. But no one mentioned that at the time. I’ve developed further difficulties and what I had worsened to the point where I too spend most of my off time laying down reading, watching TV, phone surfing or just napping. I no longer date and I hardly exercise at all because I pay for it afterwards and have next to no muscle recovery. I’m exhausted I can hardly keep up my house. My implant from UMX is ruptured and has capsular contracture and I’ve only had these implants for 7 yrs. What they say is that about half of women who get them have complications by the 7-8 year mark. In 10 years every woman should get them replaced or removed. Implants are much more hassle than anyone ever tells us. Explanting hopefully in December. I do have concerns about finding a doctor that can do a good explant as well as a nice smooth closure without dog ears. I’m having a little trouble finding somebody who can do that. So I’m wondering even about just doing the explant and then having a revision later although I really, really do not want another surgery. I had seven at the time I got BC.

Don't wait for the storm to pass, learn to dance in the rain. ~ UMX w/ silicone implant reconstruction. Multifocal -IDC, DCIS, Pagets. Dx 4/6/2011, IDC, 1cm, Stage I, Grade 3, 0/1 nodes, ER+/PR-, HER2-
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Nov 8, 2019 02:54PM rljes wrote:

mybee333 - I am sorry to hear that no one told you about complications when one has immune/skin disorders. I understand completely how you feel. Having auto-immune diseases complicates recovery when going thru chemo & BMX. I turned down radiation - Chronic fatigue and pain is a way of life for me. 2 years after my BMX I still have to sleep with a pillow under my armpit.

Hindsite - I should have had the Plastic Surgeon sew me up instead of the BS.

Finished Chemo March 2018, No reconstruction "Going Flat" Dx 6/26/2017, IDC, Left, 3cm, Stage IIB, Grade 2, ER+/PR+ Dx 8/22/2017, 1/7 nodes, HER2+ Surgery 8/22/2017 Mastectomy: Left, Right Chemotherapy Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy Herceptin (trastuzumab) Hormonal Therapy
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Nov 29, 2019 03:06PM squatchmama wrote:

StAuggie,

I am newly diagnosed and looking through this thread to see how everyone deals with this.

First, thank you all for being so open and helpful in this forum. I thought cancer was cancer. Now I know differently.

57 and already small breasted so I don't think flat would bother me too much. It isn't my choice to do any of this but with that being said I am here doing it. I would have thought that I would be happy to have an option to have somewhat larger breasts but not this way. And I already deal with autoimmune disease 10+ years so the chance of that becoming uncontrollable or God forbid getting another one from implants doesn't appeal to me. But I am still undecided even with all that said. Ugh. I will keep reading your experiences and I thank you all in advance!

Shelly

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Nov 30, 2019 12:19PM 1redgirl wrote:

It will be 2 yrs in March since I had my mastectomy. I also had lymph node dissection removing 12 nodes. 1 had cancer. I was told that morning after surgery by my surgeon and nurse navigator. They both knew I would refuse any further treatment as I did 25 yrs ago.

I was big breasted. I was also overweight. I decided before surgery not to have reconstruction. However, my surgeon left a bit more skin than he was happy with after looking at area. He wanted to go back in a fix that excess skin. I told him not to worry. Surgery is very hard on me. I have lots of trouble waking up. So, I decided to wear a sport bra most of the time and with a 50 lb loss in weight, my good breast is a lot smaller. So pretty much nobody can really tell and I do go to the gym each day. I wear tops that have flowers, patterns, sweaters, etc. It is just recently that I can leave off my arm band and chest band when I sleep. Before the lymphatic system felt bogged down. Just so much pressure. So it took nearly 2 yrs to get back feeling in my chest and arm when prone. I guess never say never.

I am 67, so I do understand those that are young wanting normalcy and so opt for reconstruction. My PT person had BC. Her cancer was genetic. She was very young and had reconstruction and looks great. However, at about the 8 yr mark, she had to go through it all over again. Apparently she was told years ago this would be the case. I could not go through all the surgeries she has had. Bless her and others.
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Dec 4, 2019 04:58PM DonnaDio wrote:

Not finding alot of posts on removal of implants! I have one in and one implant out from a removal three years ago because of a leak and then developed a horrid infection on the right side.. I never went back to replace it as deep down I just could not make a sane decision on what I wanted. I have immune issues and have no doubt that it is time for this one implant to come out. It is not easy to imagine what I will feel as my original scars of breast cancer was 2009. I know it is the right decision, but it is overall tiresome but i do not want to go through this again at 10 year mark as it happens. I also think my overall fatigue increased after my last surgery and implants are not good for me.

Surgery is tomorrow and hoping for the best!


Donna


Donna Life isn't about waitng for the storm to pass, It's about learning to dance in the rain. Dx 11/22/2008, IDC, Left, 1cm, Stage IB, Grade 3, 0/17 nodes, ER-/PR-, HER2- Surgery 1/21/2009 Lymph node removal: Left; Mastectomy: Left, Right; Reconstruction (left): Nipple reconstruction; Reconstruction (right): Nipple reconstruction Chemotherapy Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Dec 6, 2019 02:07PM - edited Dec 6, 2019 02:31PM by rljes

This Post was deleted by rljes.
Finished Chemo March 2018, No reconstruction "Going Flat" Dx 6/26/2017, IDC, Left, 3cm, Stage IIB, Grade 2, ER+/PR+ Dx 8/22/2017, 1/7 nodes, HER2+ Surgery 8/22/2017 Mastectomy: Left, Right Chemotherapy Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy Herceptin (trastuzumab) Hormonal Therapy
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Dec 6, 2019 02:28PM - edited Dec 8, 2019 02:52PM by Brooklyn1234

Hope your surgery went well, Donna! I'm following this thread with interest. I have an implant and experienced capsular contraction and around the 7 year mark I developed awful itchy nummular eczema/dermatitis on it and around my armpit, and also a bit on my other breast. I have a long history of eczema but only on my hands. Now that I'm getting surgery to remove a local recurrence on my mastectomy site, I'm having the implant removed.

My question is whether anyone going flat on one side has considered getting a dramatic reduction on the other side, just to make things more even? I'm a C cup, and am trying to decide between this and a nipple sparing mastectomy on the non-cancerous side.

Also, if anyone is interested in the implant -nummular dermatitis connection, here's a 2015 study of Japanese women post-mastectomy: https://www.hindawi.com/journals/psi/2015/209458/



Dx 11/1/2009, 1cm, Stage I, 0/9 nodes, ER-/PR+, HER2+ Dx 9/2019, IDC, Left, 1cm, ER-, HER2+ Chemotherapy Taxol (paclitaxel)
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Jan 23, 2020 04:59PM - edited Jan 23, 2020 11:18PM by DivaD

I understand that anyone who hashad a mastectomy is always a candidate for reconstruction, no matter how long ago the first surgery was performed. It seems there is possibly a better cosmetic result if there is s skin- and nipple-preserving mastectomy, but plenty of women have good results even if not.


Important to know how radiation/chemo will influence your ability to heal. sit with each possible outcome - you will find that decision that is right for YOU, and that you feel peaceful about.

Sending you healing prayers and lotsa hugs!!

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Jan 24, 2020 03:31AM blah333 wrote:

DonnaDio --- I used to look at the flat and fabulous group back when I used facebook. There are many women in that group that got on the flat path due to having to remove implants. You may find some comrades over there. I hope your surgery went well.

Age 35 at diagnosis Dx 9/2017, DCIS, Left, 6cm+, Stage 0, 0/2 nodes, ER+/PR+ Surgery 12/1/2017 Mastectomy: Left, Right
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Feb 8, 2020 07:18AM purple32 wrote:

I too am trying to decide ( by this MONDAY!) of whether or not to reconstruct. UNILateral MX planned ' soon' . I WAS thinking IMMED RECON w/ implants but for a number of reasons I am re considering. I have underlying health issues

I would like to ask this :
***IF need rads ( wont know of course until nodes ) how would that impact RECON? ALSO whether flat or not flat :
How does one take care of their own drains?I am alone - my husband passed 3 yrs ago ( Damn cancer !)

AND app how long does unilateral MX take- on the table?

Many Thanks to all of you brave ladies!

Laurie

LE on left from 5.12.12.LX DX 3/2012 IDC <1 cm stage 1 GR 1 ( 0/2 nodes) ER PR pos HER2- Dx 3/2012, IDC, Left, <1cm, Grade 1, 0/2 nodes, ER+/PR+, HER2+ Surgery 4/30/2012 Lumpectomy: Left
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Feb 8, 2020 07:21AM - edited Feb 8, 2020 07:23AM by purple32

rljes

LOVE THAT PIC!

Now if I didnt have lymphedema THAT would be my answer and NO RECON for sure ! Beautifull!
They should make such a bra ! Of course Iam going UNI so that wouldnt work for me either :>)

LE on left from 5.12.12.LX DX 3/2012 IDC <1 cm stage 1 GR 1 ( 0/2 nodes) ER PR pos HER2- Dx 3/2012, IDC, Left, <1cm, Grade 1, 0/2 nodes, ER+/PR+, HER2+ Surgery 4/30/2012 Lumpectomy: Left
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Feb 8, 2020 11:52AM 2019whatayear wrote:

no regrets! I’m very happy with my decision. My goal was a few surgeries as possible . I believe going flat helped me weather chemo and radiation as well. Less stress , less inflammation etx

5/6/2019 IDC 2cm, micromet 1/9 nodes, BRCA2+, ER+, PR+, HER- BMX 6/2019, A/C & Taxol 2019, Radiation, BSO - preventative 2/2020, Letrozole 3/1/2020
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Feb 10, 2020 10:42PM alto wrote:

My mx was about 45 minutes. No nodes taken, as they came out with the previous surgery.


Diagnosed at 42. Had symptoms of Paget's for years prior to positive biopsy. No Tamox because low% ER. Dx 11/2/2018, Paget's, Right, Stage 0, Grade 3, ER-/PR-, HER2+ (IHC) Surgery 11/11/2018 Lumpectomy: Right Dx 11/29/2018, DCIS/Paget's, Right, 1cm, Stage 0, Grade 3, ER-/PR- Surgery 12/19/2018 Lumpectomy: Right; Lymph node removal: Sentinel Dx 12/21/2018, DCIS, Right, 2cm, Stage 0, Grade 3, 0/2 nodes, ER-/PR- Surgery 1/16/2019 Mastectomy: Right
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Feb 11, 2020 12:26PM rljes wrote:

Hi Purple32 - what did you decide? I had a RN come out once a week and assistant come out 3 times a week to help me with my drains. (that social services set up that Health Ins paid for) I was suppose to change them twice a day - that didn't happen, since I live alone and no one to help on a daily bases. I was lucky everything turned out ok and no infections. Best of luck!

Finished Chemo March 2018, No reconstruction "Going Flat" Dx 6/26/2017, IDC, Left, 3cm, Stage IIB, Grade 2, ER+/PR+ Dx 8/22/2017, 1/7 nodes, HER2+ Surgery 8/22/2017 Mastectomy: Left, Right Chemotherapy Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy Herceptin (trastuzumab) Hormonal Therapy
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Feb 12, 2020 10:12PM mconover wrote:

I am quite happy to be flat. Seven month's post surgery and I'm doing everything I was doing before. And really I was fully recovered in 4 months. I don't feel that anyone notices my flat chest. Of course I'm 70 and happily married, so don't need them anymore.

One reason I'm happy to be flat is this: so many people have disabilities, visible and invisible. So by being open about my breastless condition, I feel that I am able to empathize with and in some small way support those whose disabilities are more of a burden.


"Flat and Fabulous" is a Facebook group that I found very helpful.

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Feb 13, 2020 06:27AM purple32 wrote:

rjles

I decided no recon thank you!

Massgeneral called yesterday with surgery date of JAN 25th

VERY VERY concerned as I have ' other issues' going on and they said NO anesthesia consult except by anesthesia nurse via phone the DAY BEFORE!(it wasnt at all like this last time)
VERY stressed.

LE on left from 5.12.12.LX DX 3/2012 IDC <1 cm stage 1 GR 1 ( 0/2 nodes) ER PR pos HER2- Dx 3/2012, IDC, Left, <1cm, Grade 1, 0/2 nodes, ER+/PR+, HER2+ Surgery 4/30/2012 Lumpectomy: Left
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Feb 13, 2020 01:33PM - edited Feb 13, 2020 01:47PM by arby

When I had 33 rounds of radiation following a lumpectomy, the burn so compromised my skin that the surgeon said it wasn't an option when I had 2 recurrences. I also experienced "radiation recall" while on chemo for the 1st recurrence so that further damaged my skin. I 'm a blue-eyed blonde so my very fair skin burnt so easily. I hope and pray you won't need radiation. Surely there are other options by now. I appreciated HOPEWINS story. I am finally making peace with flat, but it is such an assault to feeling feminine. Invest in good prosthetics & bras, comfortable and pretty nightgowns , attractive clothes, ( I choose pretty patterned tops for camoflag) and a Lands'End Mastectomy swim suit and let staying active chip away at the huge changes in appearance and self image. You owe it to yourself.

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Feb 13, 2020 03:57PM rljes wrote:

Purple 32 - the only thing I regretted about going flat was not having a plastic surgeon sew me back up! You might look into it so you will have minimal scaring. My Breast Surgeon did it all - and I have severe nerve damage under my arm pit.

Finished Chemo March 2018, No reconstruction "Going Flat" Dx 6/26/2017, IDC, Left, 3cm, Stage IIB, Grade 2, ER+/PR+ Dx 8/22/2017, 1/7 nodes, HER2+ Surgery 8/22/2017 Mastectomy: Left, Right Chemotherapy Carboplatin (Paraplatin), Taxotere (docetaxel) Targeted Therapy Herceptin (trastuzumab) Hormonal Therapy
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Feb 14, 2020 11:13AM purple32 wrote:

THX rjles I really trust this BS - she is great.

LE on left from 5.12.12.LX DX 3/2012 IDC <1 cm stage 1 GR 1 ( 0/2 nodes) ER PR pos HER2- Dx 3/2012, IDC, Left, <1cm, Grade 1, 0/2 nodes, ER+/PR+, HER2+ Surgery 4/30/2012 Lumpectomy: Left
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Feb 14, 2020 03:23PM Lucy55 wrote:

I had a UMX in 2014 when I was diagnosed ...I wore my prothesis , but always wished I had a BMX ...so had the other MX last September ..and I'm so happy now ..I can choose to go flat at home , or dress up and wear my prothesis ..and I feel more balanced ..especially when I'm in my PJ's of a night..

It's a very personal decision ..but going flat was right for me.

Surgery 8/26/2014 Lymph node removal: Right, Underarm/Axillary; Mastectomy: Right; Prophylactic mastectomy: Left Dx 8/27/2014, IDC, <1cm, Stage IA, Grade 2, 0/4 nodes, ER+/PR+, HER2- Hormonal Therapy 9/14/2014 Surgery

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