Mastectomy and Implant on one side only.

i had a unilateral mastectomy and have not regretted it. The first plastic surgeon i saw told me that an implant will never match a natural breast. If you are looking for symmetry you won’t get it with a unilateral implant. A double mastectomy, when not medically necessary, doubles your risk of surgical complications and the reconstruction on the healthy breast could be problematic (there’s always risk with any surgery). Have you considered flap reconstruction? Using your own tissue for reconstruction.

SpecialK,

What about removing the healthy breast to prevent cancer spread and achieve symmetry. Can they deny that? I want the other one removed during my diep flap especially since you can only do this once. I also don’t want to go through this all over again

Plum...Thst is exactly what I did for symmetry...totally covered by insurance. Your plastic surgeon should be guiding you on this issue.

annc - bi-lateral mastectomy should be a covered option, the way the law is written - and that is also what I did. I had a long history of cysts and aspirations, had bi-annual surveillance for many years, and a palpable 2.6cm tumor that was completely missed by mammography. I was originally offered a lumpectomy by my surgeon, thought about what to do while waiting for my genetic testing to come back, decided to do the BMX. My rationale was that imaging failed me and I had “busy" breasts. My surgeon was totally on board and offered a skin and nipple sparing procedure. Turns out my “prophylactic" sidemastectomy revealed both ADH and ALH, the cancer breast had IDC, DCIS, cancerization of the lobules, and I had surprise positive nodes, missed by MRI. While breast cancer doesn't spread from one breast to another - contralateral disease is considered a new primary - I figured if my body could make cancer on one side, it could sure do it on the other. For me, BMX was a form of personal risk reduction, but for others preservation of the unaffected breast is important - this is definitely an individual decision. There are also some surgeons who will refuse to remove a “healthy" breast, so finding a supportive surgeon is key. It is important to note that bi-lateral mastectomy does not always prevent local recurrence, it can still happen.

Plum, when I had my MX 14 years ago, I had a small implant added on the 'good' side. It provided a similar shape/fullness to my implant reconstructed breast, resulting in a better match in appearance. Texture and feel, not at all. An implant that is placed behind the breast tissue can't be felt - the breast still feels like a natural breast and still has the movement of a natural breast. By contrast, an implant reconstructed breast is all implant with no breast tissue, so it will feel somewhat firmer and will have much less movement.

That aside, I was glad that I had the small implant added both from a symmetry standpoint, and because it allowed me to go just a tiny bit bigger (more fullness, really, rather than a larger cup size) which was a bit of a bonus for someone with very small breasts - I look better in clothing with this slight increase in breast size.

Where are you in Canada? Healthcare is provincial so each province has it's own rules. I am in Ontario and here OHIP covers everything related to the breast with breast cancer and anything done for symmetry on the contralateral side.

I had a lift and an implant....you don't need to choose because the procedures are for different issues. I got an implant on the mastectomy side and a small one on the natural side for size symmetry. I got a lift on the natural side for vertical symmetry because at 50 plus, the natural one hung lower than any sub pec implant would hang.. I got fat grafted and transferred to help the issue that Beesie mentioned...the fat gave me more softness and natural movement on the mastectomy side and lower shaping symmetry on the natural side. I had a lot done but I was totally worth it...love my breasts as they are now!

I understand...the fat was just an added benefit. The lift and implant on the natural side had the biggest impact on symmetry.

Again, your plastic surgeon, who works with reconstructive patients everyday, can guide you on what might work best. So rather than telling my doctor what procedures I needed, I told him what outcomes I needed to feel good about the results. He then told me what procedures would get me what I wanted. He also told me, from the beginning, that what I wanted could best be delivered via more than one surgery. I was all in from the beginning....it was not necessary to get what my friend calls the Cadillac version...but I just wanted certain results for myself.