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Updated: Nov 24, 2021

Why Women do not choose reconstruction, and questions to ask my plastic surgeon on Friday

You do not have to have breast reconstruction or use a breast prosthesis after a mastectomy. This is sometimes called “staying flat."

I have been researching a lot and found a great facebook group to help me learn why I might want to stay flat, and why others either STAYED flat or eventually went flat. I am hopeful that because I have had lot's of piercings, and tattoo's and I don't have auto-immune disease, and I haven't had cancer and don't need radiation/chemo that reconstruction will go well for me, but I won't be replacing again and again, and so I present to you.

Some of the reasons women have chosen to explant or to stay flat after DMX.

(But first check out the_no_nippie_hippie (also the_no_nippie_hippie ) )

and now the reasons (if you have another to add, please send me a message and I'll add it to my list)

  • After implants years ago, changes in health started happening to me, fibromyalgia, psoriasis, pain all the time. Body seemed to be reacting to the implants in a toxic way.

  • Not wanting to wear a bra

  • immediate reconstruction wasn't an option and no patients for excess pain and future surgeries.

  • Huge support from spouse regarding not wanting me going through a year of expander pain and a second surgery, just wanting me healthy

  • Against having foreign objects put in where malignant growth taken out.

  • Autoimmune reactions to expanders

  • Not wanting to put back what God had taken from me

  • Didn't want to worry about maintenance and not a candidate for DIEP

  • BII Breast Implant Illness

  • No bouncing around at the gym

  • Don't feel boobs are important

  • Didn't want to up the chance of infection

  • Didn't want long drawn out surgeries

  • Didn't feel there was a point in putting fake boobs in so others would feel more comfortable in my presence

  • Easier recovery

  • no extensive follow up

  • no worry about future surgeries and complications

  • uneven results of reconstruction and capsular contracture

  • Didn't want to swap out every 10 years

  • No boob sweat, no back pain, no mammograms

  • Body will fight foreign substances

  • Didn't want tissue failure

  • Implants were making me sick

  • Needed radiation after surgery and this can increase complications

  • Never wanted a mammogram again, didn't want breast implant illness

  • Already have an autoimmune disease, and because of cancer can't take MS drugs, need to exercise to keep fighting the corrosive effects of MS, extra surgeries would impeded ability to move and perform and may cause flareups to MS

  • An extended wait for reconstruction

  • No concern with pleasing other peoples eyes with boobs when I can just put prosthetics on if I want them. They are an accessory.

  • Prefer not to waste my life in and out of doctors offices.

  • I make decisions based on Health not Vanity

Honestly at this exact point, the thing that worries me most about getting fake boobs aka Foobs is that I wont be able to feel my loved ones hearts beating warmly against my own during hugs. Also I'm not particularly vain, I don't dye my hair, those greys are coming in all natural like, I don't do my makeup, I do however like tattoo's, but overall I kinda still want to look like like me.

I really like my hugs.

OK on to the next topic,

I am glad that in the last two years PALB2 has been linked to breast cancer because knowing is half the battle.

”So, who should undergo testing for the PALB mutation? If you have a family history of ovarian or pancreatic cancer or had a diagnosis of breast cancer before age 45, talk with a genetic specialist. And there is an online support group for those with PALB2 on Facebook as well.”

For more on the lesser known breast cancer gene. Aka my bad gene PALB2


My concerns:

I do not want to have flat pancake boobs, or have them flip,

I do not want multiple surgeries, or to have boobs in my armpits,

I want even sides

I am worried about complications, such as capsular contracture & nerve pain

Will I have any feeling in my breasts after my reconstruction?

Do I have options if I am unhappy with my reconstruction? Fat grafting?

  • What’s the best reconstruction option for me based on my body/shape?

  • How many surgeries will I need for this type of reconstruction?

  • Will I be included with the decision of size and shape?

  • Approximately how many visits will I have with you? Pre-post, fills, etc.

  • When would the first follow up appt be?

  • How long will I not be able to drive?

  • How long will I not be able to shower?

  • Overnight in hospital? If so, how many days?

  • Where would the incisions/scars be?

  • How long after the first surgery will the exchange surgery be?

  • OTM or UTM?

  • What supplies are provided?

  • What do you recommend buying for recovery to make it easier?

  • What brand implants do you use?

  • Is there a max on cc size

  • How long do I have to wear a compression bra?

  • Do I have to sleep in a bra for life?

  • How often do implants need to be switched out, and if they come out is it relatively easy to go to aesthetic flat closure?

  • How long will this surgery take?

  • Will my insurance cover this procedure?

  • What is the percentage of infection?

  • What is your flap or implant failure rate?

  • What kind of complications can occur with this type of surgery?

  • How long should I expect my recovery to take?

  • How long should I be off work?

  • How long should I not be doing things like vacuuming/reaching, sweeping etc?

  • How much discomfort/pain do women typically feel afterward?

  • What is in the implant

  • How will I be screened for breast cancer in the future, I've heard mammograms aren't safe with implants, will MRI's be done or ultrasounds.

  • How will your lymphnodes be monitored? Will the ones in your armpit and upper breast be removed?

  • What will the screening look like with and without reconstruction?

  • Will OHIP will pay for any and all reconstruction and if no will surgeon make he application to OHIP to have it covered.

  • I would also ask the time frame for reconstruction.

  • Will OHIP still pay if I wait a year or more to get reconstruction

  • Are there disadvantages to waiting a longer period.


And of a grief note. Mom it's been hard. Last week was a hard one. Kent's brother diagnosed last November at same time as you but with prostate cancer, had it spread to his bones. He had been in almost constant pain since just after you passed, and we were told to come visit as he wouldn't make it till Christmas.

I took a week off work, and we headed down on the 25th.

Kent and I were able to visit him at home a few days before he was transferred to Hospice on Tuesday. He survived about 23 hours at hospice and took his last breath in the presence of his wife and parents.

I'm so glad he had the chance to be surrounded by those who loved him but, knowing you did not was devastating. There were three different visitations, a full capacity funeral, and an after gathering at a nearby pub. The factory he worked at even lowered the flag to half mass.

Now we try to navigate our grief from losing you, and uncle Kev at once. Trying to fit in self care, and not lose my mind, and our lovely little 8 year old had to fake sick at school his first day back, so add some covid test to the stress, and hope we get his results today so we can send the kids to school tomorrow, so I can actually bring Kent with me to my surgery consult and not have to go alone and re-explain it all to him after.

Can't catch a break.

Consult tomorrow morning.

and a friend is going to bring us some Thanksgiving dinner.

First big holiday since you both passed.

Miss you.

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