Reconstruction after mastectomy?

Hi everyone,

After six months on a neo-adjuvant trial of letrozole plus palbociclib, followed by two failed attempts at a lumpectomy plus some nodes removed, I have now been told I need a full mastectomy.  The most recent MRI suggested the tumour was 3cm, hence the decision to go for a wide local excision, but when it was removed, it was actually more than 6cm and the second op to have a cavity shave didn't get rid of it all either. 

It's been a long process since diagnosis last September and I'm feeling rather frayed at the moment.  Now I have to decide whether to go for implant reconstruction at the time of surgery or not and I wonder if anyone has any thoughts on this, or any experience they may be willing to share?  On the one hand, I can appreciate how having reconstruction straight away might help me psychologically, but I am worried about possible side effects of subsequent radiotherapy.  I've played the odds of the trial and the chances of success with the lumpectomy and lost out on both counts, so I am just thinking that knowing my recent luck, I will end up with side effects.  I'm 58 and my bikini days are over, so I am thinking I just leave it for now, but I am conscious that how I will feel about losing my breast after surgery may present a different set of challenges and I won't know how I will react until it has happened.  I know the decision has to be mine, but that feels rather lonely at the moment and in my current state of mind, I just can't think straight.  My surgeon and nurses are brilliant, as are my family and friends, but I would appreciate some thoughts from others who have experience as patients.  

Any thoughts would be most welcome.


  • Hi. I didn’t have reconstruction because my friend said she wish she hadn’t had it done at the same time as a mastectomy. They used her back muscle and five years on it still feels tight. I was offered a different type but still have not had it done. Hardest part is getting a comfy bra but when the prosthesis is in it’s like having my old boob back and it warms up and feels the same. Bit odd when I don’t wear a bra on hot days but u get use to it. I’m told I can have a reconstruction whenever but I’d rather have a new knee. I’m 58 too. Hope that helps x

  • Hello Loobylou16,

    I am 10 week's post Mastectomy without reconstruction.  My Cancer returned after 8 years and I simply just wanted it gone!  Initially, I thought yes, I will go for immediate reconstruction, but then my next thought was, let's just wait and see how I manage without my Breast.  I think as Gwills says, once the Bra and Prosthesis is in place you wouldn't know.  Right now I cannot wear my Bra for longer than an Hour  because there is still a lot of healing to be done, but when I put it on, well, I feel brilliant.  Clothes do look a bit funny though because I am very lopsided with one Boob.

    It is a very personal decision though, but sadly I have had so much surgery in my life, that the thought of any more fills me with dread.  I was a bit concerned how my Husband would react when he first saw me, but there was no need to worry because he didn't even flinch and said I am still the same to him.

    Even after just 10 weeks, I know I can do this.  Perhaps if this was the first time with Cancer, I would be thinking very differently, but it's not.  I am also 58 and yes I no longer wear Bikinis, but there are Tops etc. that I have seen online that look good for when you go on Holiday or Swimming.  I was sent various soft Prosthesis from Knitted Knockers which is a lovely Charity and it all seems Ok for now.

    I am going to my Nephew's Wedding tomorrow and have decided to wear the Bra just for the Service then put a scarf over me after that.

    Not sure if my response is useful to you.  It is a big Operation and the Body and Mind need time to adjust to it, whatever you decide.Bikini



  • Thank you Gwills, it's helpful to hear it feels OK once the prosthesis is settled in. I'm worried about going back into work (I'm a secondary school teacher) but it sounds like it will be OK once I get used to it.  

  • Thank you DamBella.  Your response is very useful and it's good to hear the positives from you both.  I didn't know about Knitted Knockers but it sounds good!  I hope you enjoy the wedding and good luck with your continued recovery. x

  • The prosthesis you get (the proper one) when you get fitted with a bra at the hospital is the best one. It’s not a softie it actually feels and weighs like a real boob. It’s amazing. My only complaiWink is the nipple on it is a bit small. Ha 

  • I can live with a small nipple!  Smile Thanks Gwills. xx

  • I'm having a double mastectomy in two weeks. I googled double mastectomy and was quite shocked at what I saw as images. Today I was at the hospital for pre surgery checks and they told me not to google. Having seen pictures of reconstruction without a nipple , I don't think I'll go for it. I don't know much as only just researching it but a nipple less breast would be like an alien being on my body and might traumatise me more. I just need to get slim and will be able to wear Calvin Klein barrettes for once as they didn't fit me. I feel so much better after being at the hospital today, they are all so lovely and make you feel special. I have two different cancers in both breasts and don't have cancer in the family so it s weird but it'll be good for the surgeon, apparently my condition is very rare. All the best to you 

  • P.s On Letrozole and no side effects and I take anti psychotics and anti depressants

  • Hi, Cuba I had a double mastectomy over a year ago. Being flat doesn't bother me too much but I am in my early 70s. My scar looks fine and I never had any post-operative problems, not even drains. For special occasions I use prosthesis. If I was younger I would probably go for the reconstruction but as it is I don't miss the weight of my previous j cup. There is a flat chest facebook site with some lovely-looking ladies on it. Good Luck whatever you decide x

  • Thank you so much.