Having healthy breast removed for cosmetic reasons?

Nan3

I was diagnosed in my early 40's and now I am mid 60's. At the time of diagnoses I had a modified radical mastectomy and immediate reconstruction with implant. I had excruciating pain for two years and then went to another plastic surgeon who removed my implant and replaced it with a much smaller one. The implant I had was hideous and painful, the new one was not hideous, a much better match is size to my existing breast, and the pain was reduced by about 70%. The first implant was all under the muscle, this plastic surgeon did not place it completely under the muscle. The initial surgery 24 years ago left me with permanent pain to some degree. 

Five years ago I had my implant removed hoping I would never have pain again. Most of the time I am pain free but occasionally it will ache at the site of the surgery. I will never regret having the implant removed and I will always regret having immediate reconstruction. I was talked into it by the doctors and I wish I had a chance to heal physically and emotionally from my diagnosis, surgery, and chemo before considering reconstruction. I had the head of plastic and reconstructive surgery do the immediate reconstruction at a major teaching hospital with a cancer center. So much for believing you will get the best treatment at big name hospitals.

I my remaining breast is a B cup. I hate bras and I hate wearing a prosthesis. It makes me very hot in tue warm weather, bras all feel constricting and I have tried every kind of bra imaginable. I buyvery comfortable  bras and bralettes, not designed for mastectomy patients and  have a pocket sewn in. I can't wait to get it off. My chest is very sensitive and I am much more comfortable braless, which I can do all winter because of layers. Summer is on it's way and I am getting anxious. 

I would like to have a simple mastectomy. I am slim and just be flat or wear very 2 small prothesis. Is this a crazy idea? Would Medicare pay for it when it is really for cosmetic reasons? And would a plastic surgeon be the one to consult on this. Any advice would be greatly appreciated.

Nan3

SpecialK

Federal law provides you the right to achieve symmetry with the breast affected by cancer.  If you have chosen to be flat on the cancer side, I believe that Medicare would cover removal of the other breast to achieve this symmetry, so the procedure is not cosmetic per se.  A plastic surgeon usually does the reconstruction portion of this type of surgery - since you are electing removal only a breast surgeon is the more usual choice.  Good luck!

Nan3

Thank you very much. I was thinking if just having reduction from a B to a very small A might not also solve the problem. I suppose I will consult a plastic surgeon and see what he says. I will go to the one who removed the implant for me. He is a wonderful surgeon and very kind. 

Thanks again