Keep changing my mind about recon

My PS wanted to do muscle sparing TRAM on me but I have a special needs teen at home that requires physical care from me. Plus I work FT. I had radiation after my mx and my PS said it really depended on how my skin fared before he would say yes to implants. Well I am about to have my R breast prophylactically removed and then about 8-10 weeks later I will have bilateral implants. Do what works for you. If your PS won't do implants , then find one who will.

I opted for implants from the start because a) the process is much simpler and requires less time off, and b) you don't damage your body elsewhere. The result is pretty good, even after rads that made one breast slightly perkier than the other. I had nipple sparing and went from 36DDD to 36C.

I'm with you on the tired of it from the time you're diagnosed every day is dealing with it in one way or another. I finally accept the Lt Mx and wanted immediate reconstruction my cardiologist cleared me but no surgeon would. Now Im panicking. They tell me the lymph nodes are clear from the ultrasound and MRI but my tumors are large and in 3 different areas. I wonder if they think I have a worse scenario inside I have surgery this Friday the 15th.

Hi reflect,

I chose not to have reconstruction (ten years ago!) and have been very happy with my decision. I did consider reconstruction and saw a plastic surgeon, but went ahead with a bilateral mastectomy without recon, knowing that if I changed my mind I could have reconstruction down the road. A year after my mastectomy, I started a non-profit website for women like you, who are considering not having reconstruction, and for those who are already living breast-free. It's called (not surprisingly) BreastFree.org. You might find it helpful to check out the Personal Stories and Photos there, as well as other information.

Best of luck, whatever you decide.

This is my first post - finally. I have been reading since last year because of all of the information and personal experiences and insights shared by so many. It has been invaluable to me.

Deciding on which surgery to have was such a huge stress/distress for me, and because of neoadjuvent chemotherapy, I had eight sleepless months to think about it. Against her advice, I initially wanted nothing more than another lumpectomy. Eventually, meeting with my PS convinced me that MX would be OK. Then I struggled over unilateral or bilateral MX. (I am single, was just starting to go on dates again, and this was my second diagnosis. The first was in my 30s when I was newly engaged. Our relationship struggled and ended as a result of BC and his lack of compassion and willingness to be more of a loving partner during my treatments and recovery. I was afraid of dating because of the cancer baggage.)

Eventually, I decided left uni MX. Amazingly enough, the worst part of the whole thing was the time spending struggling with the decision. In the days before surgery, I reached the state of whatever happens, happens. My PS and breast surgeon are in different states. My PS met my BS over the phone, and gave her instructions for sparing my nipple. It was her first time, her PA told me later. But I love my BS and wouldn't change from her willingly. My NS uni MX was a success and really much easier than I expected. I also had an OnQ pain ball, so no pain and almost no other pain meds, just one pill at night to sleep the first week.

Nipple sparing makes a huge difference. The position was a little high, but it looks like my breast was de-stuffed not removed. Because of another major delicate surgery I needed to remove another tumor elsewhere, I delayed recon until my skin loosening procedure this past March with fat grafting and my surgery coming up later this month.

I too am so sick of the cancer stuff, and have considered not having recon. But I have two different sides, and I struggle a little with finding bras and filling for the left that are comfortable (my area is sensitive to touch and pressure) and don't gap when I bend over in my yoga classes, and other things I participate in at the gym and elsewhere. (I have had some close calls with traveling/escaping fillers. :-) ) I think I would also like to date again, and not have to figure out how to balance my two sides every time I dress. Having both sides the same whatever it is makes dressing so much easier. (I am small breasted, so I think it is easier. I also like having one normal feeling side.)

Mostly, I have been fine as a flat - well ribby and concave - chested person. If I had had a bilateral NS MX, I would skip the recon. Because I have two different sides, and my PS is a good man and surgeon, who is the reason why I was able to have NS, which I am grateful to have, I have decided to try recon.

As a footnote, the first time I went through BC, I was firmly a lumpectomy+rads girl. I didn't even want to learn about anything else. I was so happy with those results. I had three scars, a port scar, one short curved scar on my breast, and a hard-to see scar under my left arm from ALND. (That one made me faint for the first week, and ended being the one that healed into near invisibility.) I ended up with a new tumor in the tumor bed of the original, but I had 14 good years.

I don't know if this helps. I do understand the difficulties of making a decision. It is a very personal choice, however, the biggest difficulty with that is that you have to decide first before you can find out if that is the right choice for you. It is good to remember that you can always take more off, but you can't put it back. Not the way it was before, and not easily.

Reflect and LM - Hugs and best wishes to each of you.

I initially chose BMX with TEs to Implant. I wasn't told about some of the things I feel I should have been told about and immediately regretted my decision.

1) The pain of the TEs was unbearable.. like the iron throne in your chest. I couldn't breath and 3 weeks post surgery was in agony from them still.. all unfilled. (I'm a red head and don't have a high pain tolerance, they should measure if you can handle the pain)

2) If you do implants, you'll have to replace them every 10 years and also do massage work on them as your body will try to calcify around them. To some this massage is no big deal, but I don't want to have to even touch and massage fake boobies.. I hated touching and doing self checks as well on my real ones.. again.. would have been nice to know.

3) I wanted to be an A... I told the PS I wanted to be A. The PS put in TEs and basically told me my body would need to be a B/C at least. (I was a 34DD previously)... um.. NO.. that is NOT what I wanted... I didn't want weight on my chest.

4) coming on here a lot of women complain about the implants and sleeping sideways and feeling them shift... There's also the issue of infection rate and complications. Again.. not discussed with me.

5) if you do reconstruction you will have to have more mammagrams...period. I don't want to add to radiation ever again if I can help it.

So after 3 weeks of horrible pain, I had them removed. I'm flat as a board now and totally fine, I still feel like me and there are some really cute clothing options and best of all.. no more surgery or worry from mammagrams. I like being flat. I googled Keira Knightley and that helped decide things. There are a lot of cute women out there flat as boards. Or go to Flat and Fabulous on Facebook to see chicks rocking the flat.

lisey - exbrnxgrl addressed several of your points and I also want to reiterate that everyone should make the choice that is best for them as individuals, but I wanted to elaborate on some of your points. It is not that implants have to be replaced every 10 years, it is that the manufacturers warranty expires at that point. If the implant has a rupture due to defect the manufacturer has no obligation to provide a new implant gratis beyond the 10 year point. My SILs both have implants from the 80's - they have never been replaced. Don't know why your PS did not listen to you - you should have been able to go direct to implant if you wanted to recon small - implants are as small as 130ccs and would have fit behind your pectoral, given you the desired size, and should have been far less painful for you. I am so sorry your wishes were disregarded. From what you have posted you seem to be much happier without recon, and I am happy for you. Sometimes you have to know what you don't want to find what you do want. I have been both reconstructed and flat (on one side - for a 7 month period, then again for an 18 month period) and I know that I needed to pursue recon until I ran out of options. It is definitely a personal choice. Some PS advise massage, some don't - it is definitely not universal. I have had two different PS and their approaches to a lot of things differed. Some people have a tendency toward capsular contracture, some don't. Rads can complicate that, and it happens with more frequency in radiated reconstruction - and even in a radiated breast with a lumpectomy. I have had an implant on the right for 5 years - no massage and no contracture. I am a petite person and I had a big implant, 650ccs, until my recent downsize in May to 435ccs. I didn't have any issues with tightness or scar tissue that formed around the implant in anything other than a normal way. Because my current PS had a good look when she opened the pocket to place the new smaller implant, I can say that with confidence. I can sleep in any position - my implants don't shift because they are pretty tight in the pocket. I don't know anyone with implant reconstruction who has mammograms, and I have been on this site for a long time. There is no breast tissue to image after mastectomy and MRI is usually done to check implant integrity. Those who have had lumpectomy, or a uni mastectomy do continue to have mammograms, but not those who have had a BMX.