Question: to reconstruct or not to reconstruct?

I am new to this site, which was recommended by my support centre. My Dx was in early March and I have had WLE and SNB and a further rexcision only to be told, last week, that I need a Mx. The BS and my BCN both recommend reconstruction as I do not need RADS or further treatment. I am due to meet with the PS tomorrow for a consultation. I am not convinced that reconstruction is the best choice, although all of my close female supporters (who do not have BC) think it is. I have read all about the various types of surgery and they all sound frightening. I have found little about a simple mastectomy without reconstruction, and have not heard from women who were content to be Amazons. I’d like to hear from anyone who had a similar dilema, or found it difficult to make up their mind.


Hi Yankeegirl,

Welcome to the Breast Cancer Care discussion forums, where I’m sure you’ll get lots of good support.

I have put for you below the links to some of BCC’s publications which may help you with your choice regarding reconstruction. If you feel you would like to talk to someone in confidence about this, then please do phone our free helpline, lines open Mon - Fri 9-5 and Sat 9-2. 0808 800 6000

Reconstruction animation:

Reconstruction discussed:

Take care,
Jo, Facilitator

Hi Yankeegirl
I was dx on 20th April and will have my mx on 24th May. I was like yourself searching for information re whether I should reconstruct or not reconstruct.
After much searching on the internet,I have made a decision of not going ahead with the reconstruction as I am so scare of it that it makes my skin curl. I just hope I have make the right decision. My PS told me 40% women take up reconstruction and 30% later on and the other 30% never.
The recovering time taken 8-10weeks rather than 4 weeks if just have straight mx.(Can’t afford the recovering time as got twins about 15 months old).
Sorry I can’t of much help but can keep you update of what it feels after the op. When is your mx?


I had a mastectomy but wasn’t able to have recon straight away owing to chemo and rads. I had a tissue expander put in but it couldn’t be filled up at all until a few weeks after surgery so had the first few weeks totally flat. Now it’s about half the size of my real one so have to wear a prostethis to even me up. (I’m not big, about a B/C cup) Personally I am looking forwards to having my recon despite the pain and inconveniece of the surgery.

I very much just got on with things following the mastectomy but it is annoying being limited to what tops I can wear. I have a good prostethis but you have to wear bras with pockets in them and cut quite high. I’m really looking forwards to being able to wear a normal bikini, strappy tops and normal bras. I’ve found the bras to be more expensive and then swimwear is very expensive to have the pockets in it, £40 for a simple tankini.

I guess it depends on your outlook on life and whether you wear tight/low tops, have big boobs and ultra body confident. It’s very much personal choice.

If I had the choice I would have the recon straight away as 1 op is easier than 2. However could you ask about a delayed recon? Or just have an implant not the other types of recon.

Em x

HI Yankee
i had a reconstruction TRAM flap, where they take muscle and fat from your tummy and create a breast mound with it, unfortunately they do tell you that it can go wrong and mine did, when i first saw it in the hospital after i woke up i was delighted, but then necrosis set in and the tissue started to die off at my cleavage and under my arm. Personally i dont feel it was worth it, but i know a lot of women who are delighted with their results, I am not sure whether they still offer the TRAM flap recon using muscle i think they just use fat from your tummy if you have enough! (i did!) after approx 5 years i think from this op, i still feel pulling in my tummy area, and i cannot lift anything too heavy. I would ask if poss to view photos of recons, or ask your breast nurse if you could meet with someone who has had the surgery that you are being offered.
dont want to put you off but i think its best to hear both sides, of it.
Caz x

My choice was no reconstruction, and I lived very happily with one breast for 7 years with a false one in my bra. since then I had to have a 2nd mx, and with none, I feel fine, now with a double pocketed bra with soft silicone false ones. I feel comfortable and no one who does not know,knows, and those who do, don’t think about it. Fine in a swim suit too.
All the best with your choice

Are you being offered a skin sparing mx ?
i had chemo first to shrink my tumour; good response but still needed mx due to central position of remaining lump, and also I’m smallish so a lumpectomy wouldn’t have given a good result.
Early this year I had a skin sparing mx, and lymph node removal, with expander implant put in during the operation. It was very slightly filled with saline so although i wasn’t by any means symmetrical, there was some shape there. I was in for 3 nights, and feeling pretty good physically by the time I got home. I was fit to drive within about 10 days.
After about 2 weeks I began to have more fluid put in (it takes literally a mi nute through the little port at the side). Soon after, I had 15 x rads. There was a slight hardening of the area following that, but no major problems. After rads I had a final saline inlfation - felt a bit tight for a few days but ok really.
Early June I’m having the saline implant removed and a silicone one put in. I expect to be in hospital just overnight.

I wonder if you’d be suitable for similar ? Although my reconstruction is still a work in progress, I relish being able to wear normal swimwear, all my old tops etc., without a second thought.

Hi Yankee

I had a double mx and have decided not to have reconstructions. My Main reason for this was that I felt I’d been through enough and I actually don’t have a problem with my body image minus breasts. Yes of course I wish it hadn’t happened but I’m so glad to be alive and don’t want further surgery.

If I hadn’t had rads, it was one breast and no lymph node removal I might well have gone for it. It is a difficult decision and I can only say I found it very helpful to talk it through with someone on the helpline.

Elinda x

Hi Yankeegirl

I agonised over my choice, found it really hard. It is a tough one, and so personal. Like Elinder45 I also talked it through, and had several appointments to clarify things. This was really helpful in coming to a decision. My BCN was great in advising me of the questions to ask the PS. I found that the PS want to go for the best cosmetic result possible, which is fantastic-that is their job-but I needed to be clear about my priorities and be straight with them.

I didn’t want a flap recon at the time,(I may consider one in future) but I did want some reconstruction. In the end I opted for the same as onestop-expander at mx after chemo, then replaced with a gel implant about 6 months after rads. I have had to have it replaced again since and still wear a small prosthesis sometimes to even it up with the other. I have been in hospital for a few days each time, and up and about fairly quickly after the implants.

All the best with your decision
C x

Hi Yankeegirl
I’ve been an Amazon for 4 months and feeling fine (bilat Mx feb) but like Elinda wish it hadn’t been necessary in the first place! I couldn’t face the potential complications of recon, but wanted symmetry so that’s why I had both removed rather than just the BC one. I manage very well with small prostheses in sports bras & post surgery camisoles, but I’m not into fashion/highly groomed look, so it suits me. If you like wearing low necklines, etc then you might feel better having reconstruction rather than worrying about prostheses. Its the everyday life (when you are out of treatment etc) that has to work for you.
Good luck

Hi Yankeegirl

I too have had a huge dilema as to recon or not. In the end I decided not to go for an imediate recon. although with hindsight this would have been the less time consuming option. I’m now considering a delay recon. but am worried that I will lose the ability to do things. I am interested to hear how others have got on with lifting and sit-ups (are they still possible?) if the tummy muscles have been used.

Whatever you decide it is completely up to you and nobody need know any different.

You can websearch for photos of with or without.

All the best with making a decision that you are content with.


I didn’t have reconstruction after my mx in 2007, I am now on the list for tram flap surgery. At first I was so excited, but now must admit I have doubts. I would love to be free of the prosthesis but at the same time I am well and dont want to roc the boat. At the back of my mind I am afraid it might fail and be more bother than living with prosthesis. It is a bid decision.
Take care all
Carolyn x

Hi Yankeegirl

I had my mastectomy in November 2007 and no reconstruction due to needing rads and also my medical team wanted to make sure nothing came back. H

Having had plenty of time to think about it, I decided to have the unaffected side removed and re-built and this took place only 4 weeks ago. I had an IGAP where they take fat and skin from your bottom and make you a new breast. I went back to work today and feel completely fine. That’s only 4 weeks after having major surgery that took over 9 hours and from which for the first 4 days I felt pretty rough.

I’m still due reconstruction on affected side and I can safely say I’ve managed with my prothesis inside mostly normal bras and a few bras with pockets. I’m not that bothered in fact I feel pretty proud of myself for having got through what I’ve gone through and come out the other side. I’m a little nervous about having the reconstruction on the flat side but I’m sure I will go through with it.

I know it’s not easy to think about and decide what to do and you don’t have as much time as I had but I did manage very well with a flat side until the time came for reconstruction. Whatever you decide to do though is the right thing for you - if you don’t have it now, you can always have it at a future date.

Amy xx

Thank you all so very, very much for your comments. I cannot say how good it makes me feel to hear from you all. There is very little in this whole ordeal that is ‘good’ (is there anything other than knowing you will be free of cancer for some time?)so knowing there are ‘sisters’ out there who help one another through every phase of BC is marvellous.

I am a fashionable, fashion conscious lady, but too old to flash my flesh anymore, and I am also too chubby to be seen looking good in skimpy clothes. The plunging neckline is not my thing, and I wouldn’t be seen in a swimsuit long before this. I am not worried about cleavage.

I think what I am worried about is the physiological experience of having one side of me flat, the asymmetrical experience. I am sad about losing my breast, and I don’t know if having my stomach on my chest will be consolation, considering the physical price I have to risk and pay to have that.

I will speak to the PS tomorrow and think some more.

Grateful Yankee