Surgeon doesn't believe me ...

I think most insurance allows for a second opinion or even a third for surgery. Maybe try a female surgeon. It is most important that you find someone who is able to make the effort to try to understand where you are coming from whether they are male or female. I've been thinking a lot, lately, about this breast oriented society we live in and how women are often defined by the size or shape of their breasts. Do we want breasts because men expect them or do we need them because they are an integral part of our self image? How much pain are we willing to put up with? How many surgeries? Would we be less likely to suffer a recurrence if we choose this or that? These are hard decisions but the one thing I am certain about is that I wouldn't want anyone to make them for me and I wouldn't want to wake up with any surprises. Maybe even put the decision and surgical plan in writing.

My BS is recommending BMX for my extensive LCIS in both breasts and ILC in the left. I was adamant about no recon and she respects that. If you feel this surgeon does not respect what you want, find another. Too many women come out of surgery to find out that extra skin was left that they did not ask for. This is unacceptable.

I just fired a PS because he was really pushing me to do reconstruction and wouldn't shut up about implants. Now I'm shopping around for somebody else who can get me a nice 'flat' finish because with this guy and his attitude, I was concerned that he might "rush" the job with me and not clean me up the way I've specified.

I really wish I'd hired a PS to close after my BS did my BMX, but at the time I didn't realize that this was even a thing and no one mentioned it. I'm stuck with horrible puckers, divots, dog-ears and flaps probably until next year. It's ugly and embarrassing. I don't even know what I'm going to do when it comes time to go back to the gym on a regular basis.

Hi christmas718:

When I asked breast surgeon #1 about her plan, she said she would try to achieve a result as flat and smooth as possible, unless a delayed reconstruction was presently intended and planned. Breast surgeon #2 agreed with this approach, and given my zero interest in reconstruction, she achieved flat and smooth (without the aid of plastic surgeon.)

Unfortunately, others have not been so lucky and it is an outrage. There are members here where who specifically requested no reconstruction, and asked to be made as flat as possible, but their breast surgeon did not comply with that request (i.e., made no attempt at flat). Instead, the surgeon substituted his judgment and intentionally left large amounts of extra skin for the purposes of a delayed reconstruction, because he thought the woman would change her mind or he thought she should seek reconstruction because of his value system, despite her express wishes and statements to the contrary.

If you have any doubt that your wishes will be respected, do not hesitate to find a different breast surgeon.

Be sure your surgeon understands that you will not change your mind and and respects your wishes to be as flat and smooth as possible. Until such time as the medical profession does a better job in this area, to avoid any possible misunderstanding, some here have recommended documenting the choice of non-reconstruction and the desire for a surgical result that is as flat and smooth as possible and feasible in writing in your medical records, and/or on your surgical consent form. Request copies of all such documentation for your records. It is also good practice to remind the surgeon of your choice in pre-op.

Best,

BarredOwl

Finland has a public health system, so I was unable to ask for a second opinion (actually, could have, but it would have been very expensive and difficult, the one private cancer clinic I know of is over 400km distant). The surgery for my grade 3 very high Ki67 and HER2+ tumor was delayed over a week, because the surgeon refused to believe I did not want reconstruction --- ever. Sent me home to "think it over again" grrrr. Of course she left lots of extra skin when she finally agreed to do the mastectomy. And I'm stuck with it, because I'm scared any new surgery would make my lymphedema worse.

Some surgeons are so full of their own egos that they truly could care less about their patients' wishes and quality of life. God only knows how much higher chance of relapse/mets I have because of her arrogance in delaying the surgery.

tessu is kind of stuck, no choices in Finland with their public health system.

My BS strongly recommended that I meet with PS before making my final decision to go flat. I was very clear about my decision and declined.

I absolutely agree with poster who said to get it in writing that patient requests no extra skin or fat, because future reconstruction won't be necessary.

My BS put my request to be "completely flat" in writing on his own. He was obviously protecting himself in case I changed my mind at some point.

I think in the case of my BS, he's been practicing for over 30 years, and has seen women change their mind in his experience.

I also highly recommend showing your BS a photo of what you want to look like after surgery. You can find numerous pics on the Internet. Also, requests photos of his work on women who opted out of reconstruction

Oh, that's the perfect idea. I'm going to save some pictures I found on the internet of women who have results like I would prefer, and take them to me when I meet up with my second PS. This guy is SUPPOSED to be an expert working with cancer survivors. We shall see...

Though I have a different diagnosis and treatment outcome than you, what I did when I was facing surgery decisions was that I met with three different surgeons.

It was important to me to ask questions and ask myself how comfortable I felt with them.

Was I just another patient to them or did they really seem to care what was best for me and what I wanted?

Interestingly, the second breast surgeon I met with was a woman and I found her to be a lot more indifferent and rougher during the physical exam than the male surgeons.

If you have any doubts whatsoever, see other breast surgeons and interview them.

Going into surgery, I felt very safe and confident with my breast surgeon and am very grateful I didn't impulsively go with the first breast surgeon or the first woman breast surgeon I met.