BMX w/ "flat reconstruction" in 1 operation options?

Susan303
Susan303 Member Posts: 15
edited February 2015 in Living Without Reconstruction After a Mastectomy

I'm a newbie having trouble researching my flat mastectomy options. I'm 54, 190 lbs, and my breasts are size "G", I was looking at breast reduction surgery because I have advanced scoliosis, and the weight off my chest might postpone a 7 level fusion, but last month my sister was diagnosed with stage 2 lobular breast cancer. My mother and grandmother have also battled breast cancer and while I did not test positive for the bracca genes, it seems practical for my spine and my future to simply let the girls go.

My problem is this, and please forgive me if I am in the wrong forum. I asked a plastic surgeon who works with my general surgeon if he could just make my mastectomy scar flat with no dog ears at the time of mastectomy surgery instead of breast reconstruction, and you would have thought I was asking him to go against his Hippocratic oath. :) I'm having trouble finding information on what I want and would appreciate any related book, video, website information or if there is someone who has experience in what I'm researching, I'd really appreciate hearing from you. Thanks.

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  • Moderators
    Moderators Member Posts: 25,912
    edited January 2015

    Dear Susan303, welcome to BCO, where you'll find a wealth of information and support.

    You'll find many other relevant topics under Living Without Reconstruction After a Mastectomy that may interest you to read and post to as well as your own topic. "Dog Ears" can be not only unsightly, but uncomfortable too. If not possible to achieve first time around, they can be rectified by simple surgery later.

    We are sure others will give their experiences and insights on your question. Your surgeon should be willing to do as you ask, provided you are informed of all aspects. On this forum you will be able to gain the required information to make a correct decision for you. It is your body and YOUR choice.

    If you are not happy with your surgeon's attitude, we hope you are able to seek another surgeon who understands your point of view. We read too often of members who have had surgery only to find the surgeon decided to allow for a later reconstruction with skin sparing (leaving a saggy chest) rather than the expected neat flat chest they expected. You need to be firm - to the point of having your surgeon sign an agreement to do as requested, or go to another surgeon.

    We hope you find the answers and responses to help in your decision process.

    All the best

    The Mods

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  • glennie19
    glennie19 Member Posts: 6,398
    edited January 2015


    of course, you can go flat in one operation,, if you can find a surgeon who will do it.  For some reason,, they think we all need "breasts".  **sigh**  I am one who was left with excess skin,, cuz surgeon thought I was going to have recon.  There are others on this board with the same problem.   You have to be very clear what you want.  Take pictures.  Tell them you want to be flat like a 9 year old boy.  Look at the flat and fabulous website or facebook page for pictures. And look for other surgeons who will cooperate with you.    Another website:  breastfree.org   

    And I should say that sometimes it is not easy to make you perfectly flat on the first go.  Sometimes there is an accidental dog ear. Ariom can tell you about that.  But you should not be left with a lot of excess skin (like me) which will require another surgery to make me perfectly flat. 

    Keep us posted.

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  • Nomatterwhat
    Nomatterwhat Member Posts: 587
    edited January 2015

    I too, am 54 and had ILC.  It can be done if you find the right surgeon and make yourself, without a doubt, absolutely 100% clear that you want to be flat.  Me on the other hand, my surgeon did not understand the words "make me flat as a pancake", because she said I was so young and now I have to have another surgery to finish the job.  Glennie has posted the best websites above. 

    Keep us informed.  

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  • Ariom
    Ariom Member Posts: 6,197
    edited January 2015

    Hello Susan, so sorry you have to be here, but very glad you found us!

    There are a growing number of women arriving on these boards who are opting out of having reconstruction. There are also many of us who are living either flat and fabulous or as a Uni, like me, with just one beast removed, many opt for breast forms, but there are also many who do not. It is absolutely up to the individual. We are also seeing women who are being "deconstructed", some of whom were coerced into reconstruction, some who were not really given the option of going flat and still others who really weren't given enough information on the pros and the cons of reconstruction surgery.

    There are a number of threads here about this very subject and I am sure there will be others along to share their experiences with you.

    There is breastfree.org, which is a site run by one of our members which has lots of information including pictures of women going flat. There is also Flat and Fabulous on Facebook, many of the women who are on that page are members here too.

    I would agree with the Mods, if you aren't feeling in synch with your surgeon, can you find another? This is not something to be trifled with and feeling confident with your surgeon is very important.

    I am in Australia and the figures here with reference to reconstruction appear to be very different to the US, I saw my surgeon a couple of weeks ago for my 2 year check and during the conversation he mentioned that since he has been practicing here in Australia he has done 200 mastectomy surgeries, but only 2 of those women decided to have reconstruction.

    When I was Dx I knew there was no way I would want reconstruction, it just didn't feel right to me. When I asked my surgeon, just as you did, for a flat straight scar, he said he would do that and that the door was not closed if i ever wanted to change my mind. When I woke after the surgery my surgeon was the first face I saw, he told me "I did just as you asked, you have a flat, straight scar, I checked it with a spirit level!" in my drugged state I said "Wow, really?" he just laughed and said "No!" I actually still ended up with a "Dog Ear", my surgeon explained that it is difficult to make it all completely flat, especially when i was a little overweight with a "D" cup, unfortunately, not only did I dislike the look of the Dog Ear but mine felt like it had a bundle of cut nerves in it too, so it would zap and zing. I gave it a fair time to see if I could get use dto it, and then decided to have it removed. That was the best thing I have ever done, the difference is amazing. There are pictures of the process on breastfree.org if you are interested to see, before and afters.

    Please know, you are far from alone, in this decision to not reconstruct. There will always be people who can't understand how we can feel comfortable with this, but that is their issue, their problem, not ours! There has been much debate about this subject and although most agree that a large part of it is financially motivated, it also simply that, unless faced with the decision, no one, not even the surgeons have any idea of how they would react and what they would decide was right for them.

    I wish you all the very best with your decision and your pending surgery. Please let us know how you get on.

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  • Ariom
    Ariom Member Posts: 6,197
    edited January 2015

    Hahaha, Glennie and Nomatterwhat, posting at the same time! We have all given the same information.

    There you are Susan, there will be more of us with just as firm a belief, that flat is fine, who will come to support you. I think the idea of having a surgeon sign a document to say they will do what you have asked for, may just be a good idea, but I doubt you'd get many who would sign it.

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  • daisylover
    daisylover Member Posts: 310
    edited January 2015

    I can relate to what you are experiencing. I had BMX asking for "flat" results. I had a substitute surgeon arranged the week before my surgery - he tried to bully (my feeling) me into changing my wishes. When that did not work, he performed skin-sparing BMX. At some point, I will want to have this revised. I am 100% certain that my original surgeon, whom I really respect, would have left me flat. It was just unfortunate that she broke her shoulder the week before my surgery. Is your surgeon willing to do this for you? I think that is key.

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  • glennie19
    glennie19 Member Posts: 6,398
    edited January 2015


    Maybe if we all go to the same place for a revision,, we can get a discount!  Mwhahahahahaha!  There are so many of us.   :(

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  • Ariom
    Ariom Member Posts: 6,197
    edited January 2015

    I also meant to say that there have been women on the boards who have made the decision to go flat who have had a breast surgeon do the BMX and then have a Plastic surgeon do the closing.

    Edited to say: Take a look at "The Scar Project" some great powerful pictures.

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  • glennie19
    glennie19 Member Posts: 6,398
    edited January 2015


    That would be my plan, M,  if I ever had to do the other side.

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  • Ariom
    Ariom Member Posts: 6,197
    edited January 2015

    Glennie, I would happily use the same surgeon again, but would insist he go tighter under the arm to get the finish, I have now. the scar is so fine now, it has all but disappeared.

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  • glennie19
    glennie19 Member Posts: 6,398
    edited January 2015


    That's it.  We shall all go to Aus and use M's wonderful surgeon!!  Wonderful if my insurance would cover that? 

    hahahahahaha

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  • daisylover
    daisylover Member Posts: 310
    edited January 2015

    Glennie, charter a flight for all of us...

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  • bobogirl
    bobogirl Member Posts: 2,777
    edited January 2015

    Susan:

    Sending you hugs. This is a great document. You could print it and hand it to your next surgeon. Not the one you have now; the next one :)

    http://www.flatandfabulous.org/#!non-reconstruction-after-mastectomy/c4gw


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  • Susan303
    Susan303 Member Posts: 15
    edited January 2015

    Thank you so much ladies! I really felt like I was from another planet, and thought I'd be lucky if maybe one person responded.....so what a pleasant surprise! I have seen both sights breastfree.org and flat and fabulous sites, but it's hard to find images of larger women going flat to show my Dr.s. I was going to instant message "Sara" from F & F on facebook but I chickened out. :) Arion I was hugely encouraged by the fact that your surgeon does 99% flat surgery. My general surgeon is a lady I respect as she removed a lunchbox size tumor from my husband's stomach and she works with this plastic surgeon who is well qualified in reconstruction but unlike Arion's Dr., I feel he's willing to make an exception to do the same reconstruction anchor cut on me just without an implant/expander he usually adds in as the first stage of reconstruction or in breast reduction. I get that a Dr. should do what they know best, but I think I may need to get a second opinion from a breast team that has actually already done what I want. It's just that if I go to any plastic surgeon sites (Other that sites for Female to Male transgender "Top surgery") I can't find Any that list flat reconstruction as an option. It's like I can't find the right words to put in the Google search command. I am very lucky that I have time to research...I don't know how to reply to all of you but just knowing you are there and understand is a huge weight off my shoulders. So many thanks. And Arion, thanks for telling me about your dog ears. I'm glad to know that even if they appear they can be dealt with in a much less complicated follow-up visit.

    And thank you for your good cheer...your destination revision party sounds great! :)

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  • glennie19
    glennie19 Member Posts: 6,398
    edited January 2015


    Susan,, message Sara!  We are all sisters here and want to help each other.  I know,, somewhere I have seen pics of larger women with no recon,,,, try looking for mastectomy scar tattoos.  I remember one woman who had a butterfly tattooed over her port. Her daughter was in the photo with her and she was a larger woman.  Cannot remember where I saw that pic.

    not surprised that you cannot find "flat reconstruction" on Google.  Doctors probably don't advertise that!  They want to recon! There is more $$$ in that. 

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  • Chloesmom
    Chloesmom Member Posts: 1,053
    edited January 2015

    I just told my BS to make me look like a 10 year old boy. Asked him to do his best to leave no dog ears although I understand it is harder to do in heavier women. One BS wanted to bring in a PS to finish the surgery. I shopped for one with LOTS of experience and didn't need the PS. Wish you well. Love my new streamlined look!

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  • Ariom
    Ariom Member Posts: 6,197
    edited January 2015

    Hello Susan, go ahead and message Sara, the girls are really helpful. I know it feels a bit weird, but really, you've found yourself in a really supportive environment here you can ask anything. We have all been where you are now.

    So glad you are feeling a bit more comfortable now, there really are, so many of us around. I belong to a BC support group in my little coastal town and of the 23 members, there is only 1 who has reconstructed. She is very happy with it and I am pleased for her. I don't have anything against recon and if that is what a woman wants, all power to her. I just object to being defined as "unwomanly" because I have only one breast. It sure hasn't changed the way I feel about myself and if it bothers someone else, that's their problem.

    I may be wrong, but I doubt you will find what you are seeking in a google search. I believe it will be by approaching a breast surgeon directly, that you'll find out if they are willing to perform the surgery you want.

    Let us know how you're getting on.

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  • Ariom
    Ariom Member Posts: 6,197
    edited January 2015

    Chloesmom, that is fantastic! I am so pleased you got what you wanted!

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  • Susan303
    Susan303 Member Posts: 15
    edited January 2015

    Thanks Chloesmom I hadn't considered going without a plastic surgeon. I may still need a team that has one, but I'll now also be open to just an experienced BS. I'm going to try researching BSs and maybe breast centers and teams. I'm also going to point blank ask this current PS for some before and after images of other flats he's done. :) Is there a site or page that show's recommended Dr.s by geography? I'm in North East PA, so NJ and NY are also options.

    Thanks Glennie 19. I'll try mastectomy tattoo for images too. I know I need to see images of larger women so I have a realistic expectation of results. It's hard to find images of anything other than straight line scars, so I think this should become an up front question when I speak to potential surgeons.

    I agree Ariom, that reconstruction isn't a right or wrong issue, but simply an individual preference. I know, for me, that a sorta kinda, almost like breast that doesn't have the nipple sensation as before would only make me homesick for what I lost. I also know that an angry scar would make me feel like I was being punished.

    You ladies are invaluable in your encouragement not to accommodate my surgeon, but to keep looking until I find one that can accommodate me. Thanks again! :)





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  • glennie19
    glennie19 Member Posts: 6,398
    edited January 2015


    Susan, you may want to wander around on the Surgery forum and see if anyone has any recommendations for you. You could start a new thread there:  surgeon recommendations for PA/NJ/NY   and see if you get some responses.  There are a lot of women on here from that area.  Also pop over to Bonfire of the Goddesses thread.  Those ladies are a hoot!  And many of them live in that area,, so they might have some recommendations for you.

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  • glennie19
    glennie19 Member Posts: 6,398
    edited January 2015


    See pic of Jane Fox:   http://www.greatreporter.com/content/tattooists-turn-scars-butterflies

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  • Nomatterwhat
    Nomatterwhat Member Posts: 587
    edited January 2015

    Susan, make sure the people you pick are in your insurance network of providers.  It can get very expensive if they are not.  I agree with Ariom, if they don't like my flatness, then don't look!!!!  I didn't choose to have BC, but I can say that I have done my best to deal with it and stay positive along the way.  What I hate are the pity looks.  It is all I can do not to wave a finger at those people. 

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  • Susan303
    Susan303 Member Posts: 15
    edited January 2015

    Thanks Glennie19! That photo of Jane Fox is so natural and even with her fun tattoo you're really drawn to her smile. She's obviously someone who is happy in her own skin which is something I aspire to. :) I appreciate any sites I can research and appreciated the thread suggestions. (I didn't actually read the thread rules and wasn't sure if you were allowed to talk about specific Dr.s.) :)

    Nomatterwhat. I'm so with you there! I have a BCBS Traditional plan in PA and was told by my Ins. that if a Dr. in another state participates with his local BCBS, they're considered in network...so that will probably be the first thing I check in my search. Then once I know specifically what I want done, I'll make sure of what I'm financially responsible for. There are some Dr.s that say they "accept your Ins." but aren't actually "in network" leaving you holding the bag for any price differences, which I can't afford...so thank you for the reminder.

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  • glennie19
    glennie19 Member Posts: 6,398
    edited January 2015


    I'm not 100% sure if you can talk about specific doctors, but I think I have seen names mentioned.  If you post elsewhere, tell people to PM (private message) you with information if they don't want to post it on the thread.

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  • Susan303
    Susan303 Member Posts: 15
    edited January 2015

    Ariom,

    Could you ask your support group if any of their Dr.s have websites I could research that discuss or show the flat option? I'm hoping that since going flat is more common where you are, maybe your Dr.s websites have the information I'm looking for.

    Glennie19,

    I can't find Bonfire of the Goddesses. How do I get to that thread?

    Thanks again ladies. :)


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  • glennie19
    glennie19 Member Posts: 6,398
    edited January 2015

    https://community.breastcancer.org/forum/7/topic/763848?page=294#idx_8797

     

    I hope that link takes you there!  Firekracker and Ducky and a few others live in the PA/NY/NJ area. 

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  • Ariom
    Ariom Member Posts: 6,197
    edited January 2015

    Hi Susan, I don't have another meeting till next month, but I just did a bit of a search for Aussie Doctors pictures and really could not find anything for non recon, just a site that repairs bad results and that was a bit gruesome:) I know my surgeon, who does many Mx surgeries, doesn't even have, a website with pictures. When I told him of my decision, he explained how he does the incision and I told him I wanted a straight flat scar. I did have somewhat of a "DogEar" after the surgery, which I don't blame him for, but I had that revised, after the first year. My scar was exactly what I asked for, he even continued the scar slightly across onto my other breast and explained that I had some sun damage on my chest that he was able to repair with the extending of the scar. I couldn't have been happier with that, as I did have a little puckering from a lifetime of sun worshiping and now it is flat and smooth. Just a small bonus! LOL

    I searched all over the internet for pictures, when I decided I wasn't having a reconstruction, but apart from Breastfree and the Scar Project, I didn't find much at all. As we all know,there are a huge amount of recon pics, but I guess there are only so many ways to present a non recon chest. I will ask the girls in my group, but I doubt there will be any websites with pictures. I will let you know if I find any sites for you to look at.

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  • glennie19
    glennie19 Member Posts: 6,398
    edited January 2015


    Good you mentioned the Scar Project,,, that's another place to look for pics.

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  • Ariom
    Ariom Member Posts: 6,197
    edited January 2015

    I think the Scar Project is amazing! It has both recon and non recon pics and I personally, find the non recon pics, so powerful. There are some Mx tattoos there too!

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  • glennie19
    glennie19 Member Posts: 6,398
    edited January 2015


    The butterfly that I put over one of my HX scars is starting to fade,, but I have really like having it.  I need to start using the temp tattoos more,,, they make me happy!!  Wondering if they will rub off fast with the swell spot,,, but heck, I guess I'll just try it and see how it goes.

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