No reconstruction

It depends. Some breast surgeons are incredibly skilled, so there's no need for a plastic surgeon. My breast surgeon was excellent. I told her I wanted to look like a 10-year-old boy—and she did it. I think I look just fine. But I'm in New York and went to a surgeon whose practice is limited to breast-cancer patients, so she has a ton of experience.

As others have said, it probably depends on the skills of the surgeon and on your own personal anatomy.  My surgeon was a surgical oncologist, and all she did was breast cancer surgeries. She told me she did about 300 of them each year.

My only contact with a PS was the consult I was given when I had not yet totally ruled out recon. I decided against recon, though; and in pre-op on the morning of my surgery, I reaffirmed to my surgeon that I wanted a flat, smooth scar with no extra tissue--no "dog ears." She said she understood; and that's what she did.

My mast (left) side is completely flat and smooth. It has been since I woke up in the hospital. Now, 16 months after my surgery, my scar is a straight, narrow, faint pink line that runs from my sternum to the back side of my under-arm area (not really through my armpit, but just beneath it). The scar is barely visible except on the chest wall under my arm where there was more tension on the suture line and it's a little bit wider.

I would classify the cosmetic results of my surgery as "very good."  I do have a small amount of flabby tissue (fat, really) just under my armpit, that poofs out a little over my scar line. It poofs because the tissue under the scar was scraped down to muscle and bone--the fat is gone. My surgeon said she tries to make the mast side look as much as possible like the other side (except for the breast, of course). She even sits her anesthetized patients upright in the OR, to see how the tissue looks with gravity pulling on it.  She assured me the poofiness could be fixed by a PS if I ever wanted it gone. I haven't bothered to do that.

I can wear all the same clothes I wore before, and even the same bras (depending on the prosthesis). I was small-breasted before (34B/36A), and my upper chest was flat anyway; so I can wear all my same tank tops, v-neck shirts, etc., because my scar is not visible.

YMMV, though. Ask your surgeon, or ask around about him/her. Maybe it would be a good idea to have a PS available.

otter 

   

I also had a breast surgeon-not a plastic surgeon.  I am completely flat,and my scars are minimal.

I'm another who had my breast surgeon do my bilateral mastectomy surgery. She had already done five previous surgeries on my breasts (excisional biopsy and two wide excisions on the right, then three years later two wide excisions on the left before I decided to have the bilateral mastectomy). She performed absolute miracles on my right side lumpectomy, where a great deal of tissue had to be removed, yet my breast looked great afterward, so I had a lot of confidence in her. When I decided to have the bilateral, I asked her to make the scars as cosmetically pleasing as possible. She did a great job, creating two totally symmetrical, thin horizontal scars.

My radiated side has had a small problem, but nothing that had anything to do with the surgery. I'm almost three years out from the operation and, up until about a month ago, still had a small amount of residual fluid just in front of my underarm, which slightly distorted the scar on that side (the fluid probably lingered because the drainage on the radiated side is compromised). The scar is much better now that the fluid has finally dissipated and is now almost totally straight, as it was immediately post-surgery. So 1Cathi, don't give up hope. Your radiated side may continue to improve, especially if you get some physical therapy on the radiated side to break up adhesions.   

I must admit, that at first I asked for smiley faces,  but he managed to change my mind...hehehehe

I'm getting a butterfly to join my two incisions in the middle then a ramble of organic viney things with leaves and flowers to each arm pit. Wow, that didn't sound very delicate did it! ? But I can do it in stages to make it a bit easier on the wallet.

I joke that I could lie on my back and you could eat a bowl of cereal out of the hole in my chest which looked nothing like what I had expected. I expected a flat chest like my friend but when I asked the BS she explained with the xrays that it was based on the location of my tumors and the margin requirements.

I had a surgical oncologist from UCLA do my surgery and my chest looks great.

barbe1958, your tatoo idea sounds great.

elaine

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