Reconstruction or not?

rladdley

Hello,
Two years ago I was diagnosed with BC and had a lumpectomy, radiation and tamoxifen. 
Last week I received the news that I have 2 separate cancers in the other breast.  Both Her2, one hormone receptive the other not.
The surgeon recommends a double mastectomy and reconstruction. I'm finding making the decision to have a reconstruction very difficult.  I  am 58, not partnered and a priest. Does anyone have thoughts? I am struggling with it all. Thanks, Roxanne.

Anj_j2020

Hi @rladdley You'll find a discussion I started last week called 'Going Flat with Pride'. The title is self-explanatory.

I'm 61 and single after a couple of marriages and another long-term relationship. The last thing I want to do is attract another man.

My surgery was on 18th August this year and I now have a thin, pink scar across my chest. It is not unsightly. Being flat is freeing!
I've seen so many posts about failed reconstructions, etc. As much as I like my surgeon, I really don't want to see him again.

My tumour was invasive, triple positive. An examination of the removed breast tissue found a tumour hiding in the other breast. Good decision on my part for a DMX.

Many women are going flat with pride. This is a movement called #beflat (among others).

Your breasts, your decision. But since you asked, I thought I'd give you the benefit of my experience.

Feel free to ask any questions you may have. x

Anj_j2020

...and check out this gutsy lady...

https://www.timesofisrael.com/performing-artist-poses-bare-chested-after-double-mastectomy/

Afraser

Dear @rladdley

I am not sure that your relationship status or your calling are particularly relevant, the one thing that matters is how you feel about going flat. One option of course is not to have any immediate reconstruction and consider it later when you have had time to experience being flat. Reconstruction takes time and can be expensive but many women have felt it was right for them (not anyone else) and are happy with the outcome. I’m mono-boobed and happy to be that way. I use a prosthesis as I would very obviously look lopsided otherwise but if my other breast had to go, I think I would remain unreconstructed. Age may be a factor - as one gets older, one may be much more accepting of one’s body, and love it however far it may slip below ‘the ideal’. It’s harder to be that wise and confident at 25! Best wishes whatever you decide. 

Anj_j2020

@Afraser

"I am not sure that your relationship status or your calling are particularly relevant..."

Except that you don't have to involve a partner in the decision making process, and don't have to worry about what they'll think of your new body. I found the men I knew (including the medical professionals) were the ones that questioned my decision, whereas the women were inclined to say they would also have a DMX without hesitation.

Afraser

Fair comment, but I assume the man in my life would honour my decision about my body! I’m all for shared decision making about things we actually share, but his body, his decision and vice versa. 

PV123

Hi @rladdley

i had bilateral mastectomies with no reconstruction in February this year.  I had her2 BC in one breast but I decided to get rid of both.  My surgeon was pushing for reconstruction but I flatly refused.  I am 60 this year and at this stage in life I wanted to simplify things, I also did not want to undergo any more procedures than required.

My husband and I have been married for 30 plus years but he was happy to go with whatever I wanted.  I guess as the others have said you need to be happy with your decision.  

Mazbeth

Hi @rladdley, it is pretty overwhelming trying to make these decisions. I had a BMX in June with expanders and I just had implants put in on Friday night. I knew from my diagnosis last December that I wanted the BMX. I did chemo first so I had lots of time to think it all over. I also worked with a psychologist to help me process everything. I realised that reconstruction was something I wanted, but this is a very personal choice. There is a great app that I used - BRECONDA - which helps in the decision making.
My surgeon was excellent in that he did not try to influence my decision regarding reconstruction in any way, however, he was very supportive of my decision to have the BMX. I also had very dense breasts, that were very difficult to image - mammograms did not show my tumour - so that made my decision easier. I am 54 and very happy with my reconstruction decision, but as @Afraser says, there are many individual factors to consider.
One important thing to remember is that you can have reconstruction in the future if you want to, you don’t have to have it now - you have time to think. My plastic surgeon has been fantastic and said to me that if I don’t like the implants, I can have them removed or try a different procedure. The point he made was that it was my decision and whilst I did not have a lot of choices in relation to treatment/surgery etc, reconstruction was totally my choice and I was in control.
The reconstruction is not urgent, so I recommend taking your time if you are unsure, ask your surgeon for the names of the plastic surgeons he works with and perhaps make an appointment to see one of them so you can talk through your options. I spoke with my plastic surgeon as I was having chemo so I knew what options I had etc. All the best for your surgery and I am happy to answer any questions. Take care Mx

kmakm

I had a BMX and knew I wanted a reconstruction from the start. It was a lengthy path to get there but I did. I had a DIEP and I'm very happy with the results. I have warm mounds of flesh that are part of me. This year I had my 'nipples' made, and right now I'm having my areola tattoos designed. They're not going to be traditional! So no regrets here.

The funny thing is, out the other side, I know that if I'd gone flat I'd be OK with it. This really surprises me as there's no way I would have countenanced this at the start.

My story with photos is in the 'Choosing breast reconstruction' group if you want to have a look. And like @Mazbeth I used the BRECONDA tool and found it very helpful.

Good luck with making your decision. All the best, K xox

arpie

Hi @rladdley - so sorry to see you’ve joined the club no one wants to join and also had a recurrence. Grrrr   The post @Anj_j2020 mentioned is here:
https://onlinenetwork.bcna.org.au/discussion/22950/going-flat-with-pride#latest

It is such a personal decision ... you can join the Reconstruction group, if you like, to chat with others to help you with your decision .... when is your surgery?

I am 68 now and always thought that IF I had a double, that I’d stay flat too.  I’ve never been keen on having medical procedures that I don’t really ‘need’ .... but that is just ‘me’!

as the others have said, you can make the decision later but some ‘prep work’ is often done at the point of initial surgery ... but I think you may already be leaning on the ‘no’ side ....

Just so long as you are totally comfy with whatever way you jump xxx 

take care and all the best fir the surgery xx

PS Where about safe you?  Town/city/area? You can add it to your profile.  We may have members nearby if you wanted to catch up for a chat/support xx

MicheleR

Hi @rladdley ,

if you are not sure you can ask to have skin sparing surgery to make reconstruction easier later if you decide. 

This is what i did. I suppose what it looks like is a deflated breast (i dont have a nipple). Not quite flat. I also have a concave area at the top of my chest where breast tissue was removed. Breast tissue is tearshaped and goes close to your collarbone. I didnt expect that so worth knowing about. 

After having a mastectomy and nearly through chemo i dont personally feel like going through another large surgery with expanders and things and am not uncomfortable with the way it looks. I think you forget the detail of pain so who knows in 6 months I may feel differently. 

The other factor of course is wearing a bra which may be tricky for a bit. If you dont mind appearance you can go braless or when ready still get a prosthetic. I confess that i have prosthetic and still not entirely comfortable wearing as im a little sensitive in chest area. 

Im 48 and im inclined to wear my scars with pride but once i go back to work and wear a prosthetic regularly that could alter my opinion too. 

I had  single mastectomy so I am lopsided at this point. It really is how you feel and not others. Being monoboobed is not a problem for me even without a prosthetic. 

It is a very hard decision to make at a time when your head is spinning. You could ask your surgeon for other options and see what you think. 

Michele

rladdley

Thank you so much everyone for sharing. I also joined the reconstruction group. I've now decided to just go with the mastectomy and have reconstruction at a later date if I want to.  The whole big surgery was just a step too far for me atm. Surgery now on Friday. 

Blossom1961

@rladdley All the best for Friday. I am monoboobed and will stay that way unless the other side turns nasty then I will go flat. I only wear my prosthetic when I feel like it, about 20% of the time. Other than that, I am happy to be healthy

arpie

All the best for Friday, @rladdley - I hope you have family & friends to help support you in your recovery....  you know the drill - make haste slowly & no heavy lifting etc xxx

Perhaps @Giovanna_BCNA could break this conversation up so @rladdley has her own post?  It will be easier to keep track of replies for you. 

Take care xx

FLClover

Good luck @rladdley! Hope it goes smoothly with a quick recovery 🍀♥️

Raich

Good luck with your surgery. I’m a uniboober and very small breasted so I’m happy to go lopsided and braless.
trust your gut feelings and know that you can change your mind. Xxxx