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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 07:03AM

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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Jan 12, 2021 07:23AM Jaybird627 wrote:

Traveltext,


Unfortunately, some of us have no "choice" and when one chooses something one is generally okay with that choice. When something is forced upon oneself, that choice can be hard to swallow.


J ~

Jaybird. My hopes are not always realized, but I always hope - Ovid. Dx 3/5/2005, IDC, Right, Stage IIB, Grade 2, ER+/PR+, HER2- Surgery 3/5/2005 Lumpectomy; Lymph node removal; Mastectomy; Prophylactic ovary removal; Reconstruction (left): Silicone implant; Reconstruction (right): Latissimus dorsi flap, Silicone implant
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Jan 14, 2021 04:51PM msphil wrote:

Hello i found my lump in shower and then things went pretty fast diagnosed after biosy and 2nd opinion all while making 2nd wedding plans. Idc stage2 0/3 nodes 3 mo chemo before and after Lmast. But only wks after mast with reconstruction i awoke telling my fiance now husband screamingnin pain and high fever. He rushed me to E R was taken into surgery to remove the expander after only 1 filling. My body rejected it as foreign body. So settle for prothesis in my bras and bathing suits. Pleased with prothesis and its been 27yrs this yr Praise God.Got married after chemo 27yr Anniversary this yr also. Then 7wks rads and 5yrs on tamoxifen.

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Jan 26, 2021 07:27PM TenS4me wrote:

Hi All-

I'm a mess! I'm a two-time cancer survivor. The first time I had radiation on the right side; this time I had DCIS, so no treatment.

I had a double mastectomy March 2020 and had expanders put in. After two open wounds, three infections, five surgeries and two attempts at putting an expander in (all of this on the radiated side), I decided to go flat.

My plastic surgeon took both expanders out so I have one deflated breast and one that collapsed on itself because the radiated skin is so damaged. I was so shocked when I got out of my last surgery! I thought I would be flat...nice and tight! Now I'm finding out my right side is so damaged, they will probably have to do a flap....just so I can go flat! They have to remove the radiated tissue and then will fill in the gap with a flap. Then, I may have to have a flap on the left as well to "try" and match the right. I never wanted a flap, but I can't leave things like they are.

I'm going to see a new plastic surgeon in two weeks and pray there's another option. I'm also going to go to the U of M for another opinion.

I'm really worried...if the expander didn't work, why would I think a flap would work?

Thanks for letting me vent.

Barbara

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Jan 26, 2021 07:40PM - edited Jan 26, 2021 07:45PM by Jaybird627

Barbara, I had a lat flap. It's a mound, not completely flat. I've had 3 failed expanders due to open wounds. The flap was done after 1st expander fail , then flap with expander, that failed, then another expander (#3) with HBOT before and after and while that lasted 2 months that too failed. I'm back to a mound with no real options. I'm having the other side implant removed due to capsular contraction and I'm trying to match. If that doesn't work I may do another lat flap in the future. I recovered well from the lat flap. No real issues. I'm tight all around but I was after the BMX so not sure which surgery to blame. I just want balance as I hate wearing a prosthesis (the bra has to be tight which I hate). Good luck.


Edited to add: my PS said since it's my own body parts (skin and muscle) that's why the lat flap has held up. I had it done 12/2019, so a year ago. The flap was successful but my skin doesn't like the foreign objects. He said it's probably due to bacteria in my scar tissue. I will never have a successful expander/implant on that side.


J ~

Jaybird. My hopes are not always realized, but I always hope - Ovid. Dx 3/5/2005, IDC, Right, Stage IIB, Grade 2, ER+/PR+, HER2- Surgery 3/5/2005 Lumpectomy; Lymph node removal; Mastectomy; Prophylactic ovary removal; Reconstruction (left): Silicone implant; Reconstruction (right): Latissimus dorsi flap, Silicone implant
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Jan 27, 2021 04:11PM TenS4me wrote:

J- Thanks for sharing. I'm sorry you have also had issues. My plastic surgeon is a good surgeon, but horrible communicator. He never answered any of my questions and seemed to try and avoid bad news which is why I'm talking to other surgeons. I'm sure it will all work out, eventually.

Take care,

Barbara

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Feb 9, 2021 12:38PM Nola70115 wrote:

Thanks to everyone here, this thread is really useful. I am waiting for the biopsy to come back on a possible recurrence, but I think it's pretty clear there is something there and I'm going to need more surgery. I originally went with direct to implant surgery when I had my BMX because I didn't want to have to keep having more procedures. The cancer was only on one side, and could have been removed by lumpectomy, but I felt like it was inevitable that it would recur if I kept my breasts so I just wanted them gone. The cosmetic result is fine, if not great. I have some dog ears. I never got nipple tattoos. I just didn't want to think about it or have to keep getting more work done. The implants have never stopped feeling like something shoved under my skin. They are subpectoral so any time I flex that muscle I feel them. I really don't like the feeling.

So I'd like to be rid of the implants, but every time I look at what goes into the surgery for a flap I cannot get behind it. I have enough scars already. Cutting into healthy parts of my body to take tissue and put it somewhere else --- I just can't. No judgement on anyone who does have flap surgery, that's great for you. I just can't do it myself.

That said, I don't know how good I would feel about being flat either. I insisted on implants that were much smaller than my natural breasts had been, because I hated my 38G natural breasts, and they had always been a source of embarrassment to me. I like the smaller size, but I have to admit that having them small makes it hard to fit clothes to me. I gained weight during chemo and without natural breasts to absorb it, all that extra fat settled around my waist, so now my waist is bigger than my bust line, and my proportions are all off. I can't wear anything with a waistline. My level of comfort with my body is not good. I haven't gone without at least tank top outside the shower for seven years. I try not to let my kids or my husband see me without a shirt on.

So that leaves me with going flat. And wondering how I would deal with that emotionally when I'm already kind of a mess on this issue. And I'm learning here that if I want to wear a prosthetic, I would have to have a bra on tight so it would stay in place. I haven't worn a bra since my BMX and I'm not keen on going back. And apparently you can go flat and still have the scars feel tight, or have complications that need further surgery. It's likely I will need radiation this time around and it might wreck my skin. I just want to not feel my breasts aching every minute of every day. Ugh writing all this out I see I need to get some therapy to work on these self image issues. I went to a therapist before but I need to find one that has experience with breast cancer patients.

Age 40 at first diagnosis, 47 now. I've got an autistic teenager and a toddler to live for. See my 2014 blog at snarkforthecure.wordpress.com. Dx 4/15/2014, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (FISH) Surgery 5/15/2014 Lymph node removal: Left; Mastectomy: Left, Right; Reconstruction (left); Reconstruction (right) Chemotherapy 6/20/2014 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 9/1/2014 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 2/8/2021, IDC, Left, <1cm, Grade 2, ER+/PR+, HER2- (FISH) Dx 2/22/2021, IDC, Stage IV, metastasized to liver
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Feb 9, 2021 02:15PM Juju-mar wrote:

TenS4me,

You mentioned U of M - is that Michigan?

Julie

Dx 8/27/2020, IDC, Right, 6cm+, Stage IIIA, Grade 3, 2/4 nodes, ER+/PR+, HER2- Surgery 10/2/2020 Lumpectomy: Right; Lymph node removal: Sentinel Chemotherapy 10/27/2020 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxol (paclitaxel) Radiation Therapy Whole-breast: Breast, Lymph nodes
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Feb 9, 2021 04:40PM BlueGirlRedState wrote:

Nola - something I asked about but was not available where I was 4 years ago, computer visualization. If technology can age progress a child, it seems like it would be possible to show you what you might look like flat. I think a friend was able to see what breast reduction would look like.

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Feb 10, 2021 12:12AM akmom wrote:

Nola, so sorry you are having to go through this again. Personally I feel the best thing about being flat is not having to wear a bra. To me that makes up for the fact that my belly is bigger than my chest. I have found ways to minimize this with clothing - vests help, and loosely gathered shirts or strategically draped scarves. It really is surprising how people don’t even seem to notice the missing breasts. Not once have I seen anyone so much as glancing at my chest, and nobody has ever asked questions or seemed uncomfortable.

You are right that it is a self image issue, but of course knowing that doesn’t make it any easier to cope with. I hope you can find a way forward - and whatever you decide, I hope you will be comfortable with your choice. Warm hugs x

Surgery 2/11/2012 Lumpectomy: Right Dx 2/24/2012, DCIS, Right, <1cm, Stage 0, Grade 2 Radiation Therapy 4/9/2012 Whole-breast Dx 8/14/2018, IDC, Right, <1cm, Stage IA, Grade 2, ER+/PR+, HER2- Dx 8/14/2018, DCIS, Left, 1cm, Stage 0, Grade 2 Surgery 8/14/2018 Mastectomy: Left, Right Hormonal Therapy 9/10/2018 Femara (letrozole)
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Feb 15, 2021 05:51PM TenS4me wrote:

JujuMartin, yes, U of M is University of Michigan Plastic Surger

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Feb 16, 2021 11:34AM Lezza13 wrote:

After 8 years going flat, I have never regretted it. I have to concur I don't believe people notice the missing breasts. I love not having to wear a bra. The most important thing is not having to worry about getting breast cancer again with such little tissue left. I also did not want to worry about implants leaking or having to be replaced.I was not fond of my plastic surgeon in the first place. took two extra surgeries to remove extra tissue. But after 8 years, I have never regretted it.

Dx 12/30/2011, IDC, <1cm, Stage IIA, Grade 2, 2/23 nodes, ER+/PR+, HER2- Surgery 2/26/2012 Lymph node removal: Right, Sentinel; Mastectomy: Left, Right Hormonal Therapy 7/15/2012 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Feb 19, 2021 07:32AM jakm5 wrote:

Aw Nola, I am so sorry that you're having to deal with this a second time. It's always in the back of our minds, but with a total mastectomy, you hope it doesn't happen. You got this girl. Just same old, same old. Hug, hug.

I'm afraid I'm going to the be the outlier here and say that although I didn't go flat, I went small. I was never thin, but always small chested before (almost a B) so for reconstruction I stayed small. And I DO regret it. I also have the under pec implants, so yes, I feel them, but I can also have fun with my kids and grandkids flexing them like a beach bum! Never gets old. However, I also like clothes. I'm not a fashionable person and I only shop maybe three times a year, probably only twice, but I do like to feel good in what I'm wearing. I also work in a large office. boooooo. So now I have to wear a bra anyway in order to hold the pads needed to make my clothes look normal.

I've gained weight (sz 16 pants, XL to 1X top) and it's just hanging out from my diaghram on down. My belly is bigger than my chest, and let's not even discuss the bottom half. Unfortunately, clothing manufacturers always equate plus size with a large chest. I'm so frustrated, angry and mostly sad at trying to find pretty clothes that work for someone shaped like me.

If I had gone bigger, I would still feel them, no difference there; I still wouldn't have to wear a bra; I would fit and look better in clothes; and wouldn't be spending the morning in a pity party (because I've been attempting to shop online.) So unless you don't mind wearing a bra or figuring out how to make swim suits work, or are naturally thin, it could be an issue.

That's just me. Sorry for mucking up the gears, just being honest! That's why I'm here today - because I knew there would be others here that know the struggle, and it makes me feel less alone and sad. If 1 out of 8 women will be diagnosed with breast cancer in their lifetime, why do I see so many BOOBS out there? haha!

Hugs and blessings to all of us.

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Feb 19, 2021 08:28AM Nola70115 wrote:

jakm we are exactly the same shape/size. I have the same problem with clothes. It's really sad not being able to find anything that fits me, either in plus sizes or regular sizes.

Age 40 at first diagnosis, 47 now. I've got an autistic teenager and a toddler to live for. See my 2014 blog at snarkforthecure.wordpress.com. Dx 4/15/2014, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR+, HER2- (FISH) Surgery 5/15/2014 Lymph node removal: Left; Mastectomy: Left, Right; Reconstruction (left); Reconstruction (right) Chemotherapy 6/20/2014 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 9/1/2014 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Dx 2/8/2021, IDC, Left, <1cm, Grade 2, ER+/PR+, HER2- (FISH) Dx 2/22/2021, IDC, Stage IV, metastasized to liver
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Feb 19, 2021 06:21PM jakm5 wrote:

Hi Nola,

Yes, it really is depressing, isn't it. I almost went flat, but I'm single and thought maybe I'd regret it if I decided to start dating. I think we all just want normal. If you're having pain and discomfort, maybe the trade off of going flat would be worth it for you. I've been extremely fortunate and not had any after-affects of the reconstruction. For me, the only issue (so far, thank God) has been appearance. You know, we all make the very best decision we can with the information we have at the time. Whatever you ultimately decide, be confident that you did the right thing. Then if it does bother you later, make a new decision about how to deal with it then. I've only had these for 7 years, but I'm planning on rethinking it all in another 3.

Till then, it's a bra with padding, thigh length cardigans, tunic tops or . . . no, just that.

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Feb 20, 2021 07:51PM Snowbaby09 wrote:

I had my DMX January 19 so I’m a month out and love being flat, no regrets. My incision looks great very please

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Feb 22, 2021 12:29AM Jksmahoney wrote:

Nola,

I went flat on 11/24, I was fitted for my prostheses on 12/31, and I am completely happy with my decision. My bras are not at all tight. In fact, they are looser than the bras I used to wear. I was fitted for them by a professional and she did an amazing job. My prostheses do have some weight to them but less than my natural breasts, and my back hasn’t had it so good since 7th grade! In fact, I would go so far as to say my prostheses are comfortable to the point of being comforting. That being said, I don’t experience hot flashes and I haven’t had my prostheses in the summer months, so I can’t comment on the heat situation. I too try to “hide” my flatness from my kids (8 and 12) as 2020 brought so much to deal with, I just want to spare them the reminder of my diagnosis. We each have our own reasons for our choices and we are lucky if we make a great choice the first time around, especially in these circumstances. So I wish you all the best with your decision and hope you will be happy with whatever you choose.



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Feb 23, 2021 09:51AM Lezza13 wrote:

Snowbaby2020 Glad to hear your surgery went well. I am sure you will enjoy being flat. After 8 years I still have no regrets.

Dx 12/30/2011, IDC, <1cm, Stage IIA, Grade 2, 2/23 nodes, ER+/PR+, HER2- Surgery 2/26/2012 Lymph node removal: Right, Sentinel; Mastectomy: Left, Right Hormonal Therapy 7/15/2012 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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Mar 3, 2021 07:33AM Juju-mar wrote:

Hello ladies, another question: for those that did a BMX, what was your recovery like? Could you lift your arms above your waist? Did you need help getting dressed, cooking, etc? I am currently having right side mastectomy in April, but seriously thinking of taking the left side off as well for peace of mind. But with Covid, I can't have my sister or anyone else come in to help. My husband will help, but he will have to go to work. I do have 2 teens at home who can cook and clean etc. Just wondering what everyone's experience is. How soon did you feel like you could do normal living things? Thanks!

Julie

Dx 8/27/2020, IDC, Right, 6cm+, Stage IIIA, Grade 3, 2/4 nodes, ER+/PR+, HER2- Surgery 10/2/2020 Lumpectomy: Right; Lymph node removal: Sentinel Chemotherapy 10/27/2020 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxol (paclitaxel) Radiation Therapy Whole-breast: Breast, Lymph nodes
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Mar 3, 2021 09:57AM Aussie-Cat wrote:

Hi Juju, I was able to lift my arms above my head the next day after my bilateral mastectomies but I didn't have any nodes removed because it was prophylactic. I was tired for a while and I had to sleep on my back for a while but I was able to do most things except carry heavy things or do hard physical work.

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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Mar 3, 2021 02:29PM Juju-mar wrote:

Aussie-cat,

Good to know! I wondered if they removed lymph nodes from the non cancerous side. I know they will on the side with BC. Thanks for your reply.

Julie

Dx 8/27/2020, IDC, Right, 6cm+, Stage IIIA, Grade 3, 2/4 nodes, ER+/PR+, HER2- Surgery 10/2/2020 Lumpectomy: Right; Lymph node removal: Sentinel Chemotherapy 10/27/2020 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxol (paclitaxel) Radiation Therapy Whole-breast: Breast, Lymph nodes
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Mar 3, 2021 06:49PM TXLorelei wrote:

Well, I’ve decided to go flat after my single MX.

This had been my initial gut feeling when I was diagnosed last summer, but talking with the doctors changed my plan to implants. Then everything got put on hold when the MRI showed positive nodes and I was put on neoadjuvent letrozole for 6 months.

I met with the plastic surgeon again yesterday and found out that he doesn’t recommend implants after radiation (which I’ll need). He suggested a lattisimus dorsi flap as an alternative, but the additional surgeries don’t appeal to me. Faster recovery by going flat sounds good

So now I’m back where I started. I spent yesterday evening researching prostheses wondering if cancer centers give info on local places to buy them. I do plan to knit myself a soft falsie to start with. I just want to get the MX over with!

Dx 7/7/2020, LCIS/ILC, Right, Grade 1, ER+/PR+, HER2- (FISH) Hormonal Therapy 8/11/2020 Femara (letrozole)

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