Deciding to go flat or have reconstructive surgery

Hi I went flat following double mastectomy (no choice, COVID time plus my BMI too high). I am in my 70s so it isn't such a huge issue but you are only 54. I would say think twice about ruling out reconstruction. I do sometimes wish I had something. I tend not to wear protheses unless I need to look dressy except when doing aqua fit or swimming and then I wear knitted knickers as they are very light and easy to put in and out

Good luck xxx

Hi,

I had a double mastectomy with flat closure (without reconstruction) in March 23 by choice when I was 37.

I was lucky in that I had a year to think about my decision. When it was first mentioned, I was happy to go along with my doctors who only spoke about immediate reconstruction as it felt like the only real choice on the table. Then I started to do some research about flat closure and it appealed to me more and more and when I weighed up my pros and cons, flat closure won every time. My doctors were very surprised when I told them (I got SO tired and annoyed of people telling me I might change my mind!!), but for me, it was 100% the right choice. Sure, as a single woman it makes my dating life a bit harder, but overall I have lots of body confidence, am very happy and I don't feel any need to wear prostheses. Some of my pros/cons pre-surgery were:

Cons of reconstruction: more future surgeries as implants need to be replaced every 5-10 years (I didn't have enough body fat for other types of reconstruction), higher risk of complications post surgery (implants not placed properly, infection, implants move, implants rupture, etc.), implants not natural and I try to put only natural things in my body, I'm very active so would implants make running/high intensity sports uncomfortable

Pros of flat closure: quicker recovery and return to sports, more comfort when lying down (lying on my front is so comfy!), no more bras/sports bras

Cons of flat closure: no boobs

If you have any questions about flat closure I'm more than happy to answer them. It's a very personal choice, so follow your gut and do whatever you feel is right for you. There is a useful mastectomy gallery on the BRCA chat website where you can see different types of reconstruction/not which might help: https://brcachat.com/gallery/ x

Thanks for your reply,

It’s a very difficult decision to make. I appreciate your thoughts , maybe there will always be a little twinge of regret,  I don’t know. I’ve actually looked at the knitted knockers ,’such a good idea! Thanks again for your insight, greatly appreciated.

xx

Hi ,

Thanks for your very detailed reply. Wow you seem like a positive and confident lady! I don’t carry the BRCA, I have the PALB2 gene, which I found out at the beginning of chemotherapy, so have had a little time to consider my options. I too do not have enough body fat  for other reconstructive procedures, so it would have to be an implant. Recovery time is a big factor for me as the consultant was talking about expanders and how long to have them in for and having to have more surgeries.. I’ve had other surgeries with a fair amount of scarring on different areas of my torso, this is maybe a reason why I would want reconstruction. I have a husband who is very supportive who wants me to be well, happy and healthy. I’ve had a rough time with chemotherapy as I’m also suffering from sciatica which flared up at the beginning of chemotherapy and has made it extremely difficult because of the amount of pain it’s caused. Another reason to choose to go flat. 
I looked at the link you sent which was interesting and helpful. 
Im very overwhelmed, hopefully I will get to a decision and that will feel like a weight lifted.

I will probably have more questions , so i will take you up on your offer ! 

It is nice to hear someone be so positive and confident. Thanks so much again, so helpful xxx

Hi

I'm 5 weeks post mastectomy with reconstruction, my recovery has been good but unfortunately they found another large lump in the breast tissue they removed so with no clear margin I'm having another operation to remove everything and going flat in my right side....it's a blessing in disguise as I'm finding the implant very uncomfortable and it's very hard and heavy, I'm unlikely to get another reconstruction due to lack of skin that will be left after my next operation. I am usually a very sporty person and think the implant wouldn't be comfortable to exercise with. I've already brought myself a "boob" from m&s, they have a nice little range for mastectomy ladies. I hope this helps in some way...but remember everybody's journey is different. Take care. X

Hi tcatz, I had a single mastectomy with diep flap reconstruction a couple of weeks ago. I will be having a reduction of the healthy breast at a later date. I am 62 and knew this is what I wanted, as soon as the options were explained to me. I am really happy with the result and can't wait to have the other side sorted out. Not sure how long I'll have to wait for second surgery, as I have to have radiotherapy first. It's obviously a really personal choice and I wish you well moving forward. Xx

Hi,

Thanks for responding, I’m sorry you are having to have yet more surgery, but hopefully you will be comfortable and recover well.  I just can not get to a decision. Yesterday I was definitely having implants, today I’m not so sure and thinking more of staying flat. I had chemo on Wednesday and it’s definitely not helping me with any rational thinking, only 1 treatment left . I’m sure I will get there 

Thanks again for your time and support, it’s really helpful to hear people’s thoughts and experiences. I hope your surgery and recovery goes well. Take care xxx

Hi I'm 52

And was told at the start of my treatment back in 2022, that I could have reconstructive surgery when my chemo and radiotherapy was finished,

So at the end  of 2023 I ask my breast surgeon if I could talk about reconstruction, he said not with me you can't  I will refer you to a plastic surgeon 

I was told implants weren't suitable for me, and would have to have flap surgery,

I was a size 36gg so I'm left with one enormous boob, which I'm self conscious about as even with a prosthetic breast in, the weight of my natural one pulls all my clothing over to the right side and can get uncomfortable.

Im 5 ft 2 and a size 16, a little overweight, I have a few health conditions affecting my whole spine and just had a new knee,

my plastic surgeon told me he can't do reconstructive surgery on me till I lose 3 stone,

but would consider reduction on my other breast but only down to a dd,( I don't really see the point in that, ) or understand how he can do this surgery but not reconstructive, without losing weight first

He told me to come back in 6 months.

Im the meantime, I asked if they would consider me for a mastectomy, they have put me on the waiting list.

I seen the plastic surgeon the other day and got told off for not losing weight

( I've gained a few pounds since being on tamoxifen)  I told him I was on the waiting list for a mastectomy, 

He said what you doing that for that's a bit drastic, I said you seem unwilling to help so it's my only other option,

he said i cant do surgery till you lose weight if it was to remove cancer thats different, but i have to follow guidelines so you need to lose weight, (i am trying)

my weight didnt seem to affect me getting a new knee this year, or getting a mastectomy as I've received a date for December this year

Bearing in mind if I lose 3 stone I would have no belly left to use for reconstructive surgery.

So it looks like I'm going down the mastectomy route, I'm a little bit nervous, but plus side I won't need to ever wear a bra again yey

I was told to ask for a second opinion about reconstructive surgery,  but I'm not sure about it anymore as my last plastic surgeon has made me feel a bit bad about myself so not sure it's worth putting myself through it, 

After reading your post Rose222 I feel a bit better about my decision