Thank you so much for your reply. You sound so positive and it’s just what I need right now! Your husband sounds amazing and mine is too. I have ruled out implants and I’m scared of the pain/ healing/ recovery time/ risks of reconstructive surgery. I think some counselling would be good- it’s such a big decision x
2 Likes
I was diagnosed with DCIS back in 2020. The original plan was a lumpectomy but further testing revealed more areas of DCIS. This meant a mastectomy was the only option.
After talking through the options with the surgeon and my husband I opted to go flat on one side. I chose not to even be measured for a prosthetic. I am only a B cup so it isn’t very noticeable. The main problem has been finding suitable bras.
I wish you well in making your decision
Thank you so much! I will continue to reach out for support to make an informed decision. I’m sure once I’ve made a decision it will feel easier. Wishing you well in your hunt for a great bra! x
I had a double mastectomy and decided to have an implant, as doing a DIEP was too risky in my case. I opted for a two stage procedure and currently waiting to get my temporary expander to be replaced with an implant.
I’m 36 and I wanted to go back to “normal” for me, to be honest. I’ve never been big chested (size B), but I’ve grown to love them and wanted my boobs back. My sister had a boob job done (for aesthetic reasons only) and is very happy with the results so I wasn’t too scared of the implants.
When I was making a decision, I realised that it is a very personal thing and only I can know what would make me happy. Listen to yourself and what option feels right for you, that’s all I have to say.
Thanks so much for your reply. I just wondered how uncomfortable you have found the expander? Good luck with the next phase x
I didn’t find expanders uncomfortable at all! I was quite swollen straight after surgery and having them only half full at the start was a blessing, as my skin wasn’t under too much pressure. They do feel differently when I touch them (they feel like thick plastic bags under my skin haha) so I hope it will get better with implants.
That’s reassuring. All the best x
I was in a similar position last year at the same age diagnosed with Grade 2 IDC ER+ PR+, HER2-. My treatment plan was initially to have a lumpectomy but after an MRI, this changed to a Mastectomy and I was given various reconstruction options to choose from. For me I knew I didn’t want a silicon implant due to a previous skin allergy when I wore a wrist brace which had silicon in it.
As I was slim my breast surgeon wasn’t able to clearly tell me if any of the body fat based reconstruction options would be viable for me, without being seen by the plastic surgeon (for which there was a long wait on the NHS). So I decided to get a second opinion privately, I saw another breast surgeon who referred me to see a plastic surgeon who spent an hour and a half explaining what options were viable after examining me & showing me photo’s of reconstructions she had done previously to help visualise. She explained that even though I was slim, body fat based reconstruction was possible with a combination of fat from my abdomen (DIEP) & thigh/buttock area (PAP), but would most likely involve one or two smaller surgeries for fat grafting after the first main surgery; I was a C/D cup. She also said that if I didn’t want to choose the immediate body fat reconstruction option (longer surgery & recovery time), she could do a nipple sparing expander surgery with a silicon implant (shorter surgery & quicker recovery time) which could be replaced with body fat/changed later if I didn’t get on with it due to allergic reaction (she mentioned this would be rare, but explained that there was such a thing called implant sickness symptoms) or needed radiotherapy.
That appointment with the plastic surgeon is what gave me the clarity I needed to make the decision that was right for me at the time (she went through various risk factors, DIEP failure rates and a lot of other information). The reconstruction options were just too involved for me, and I couldn’t see myself having multiple surgeries in the future in order to match the reconstructed breast to the other; At that particular time in my treatment journey I wanted to get on with surgery and understand what my oncology treatment plan was going to be. So I decided to go with a mastectomy without reconstruction (flat on one side) and leave delayed reconstruction as an option for the future seeing how I felt after.
I am now 21 months on from that decision and can say I have no regrets. I’m still working through finding the best fit bras and the most suitable prosthetic for various clothes I wear, which are practical lifestyle changes I’ve had to adjust to so it is a process. But other than that I can say I am happy with the choice I made and haven’t really thought of delayed reconstruction since then (but it’s still there as an option if I should want it, even though it wouldn’t be aesthetically the same as if I had had it done as an immediate reconstruction). Hoping some of the above information helps you make the decision that’s right for you.
Wishing you well in the next steps ahead… xx
Just responding to your comment about difficulty finding the right bra’s, as I’ve faced this as well. So far the closest brand that has worked for me is amoena, but they don’t have every style I’d like to get for certain tops I used to wear before. So my search continues.
Sharing in case this helps. xx
2 Likes
Hi! Thank you for taking the time to reply so comprehensively. It sounds like you have had great care and were given all the information you needed at the time to make a decision. I’m so pleased you had no regrets. I’m rubbish at making decisions and this seems a big one. I’ve been offered some counselling so I hope that will help x
Thanks for the suggestion to look at Amoena bras.
The problem with all post surgery bras is that they assume you want to wear some kind of breast form so they include pockets and some kind of shaping. Whereas I am quite happy being totally flat. I wear a bra made out of stretchy jersey type fabric and the unused cup doesn’t bunch too much under my clothing.
I have found one company that does one cup, one flat bras. Nice for a glamorous night out. https://www.unobra.co.uk/ Unobra was set up by someone after having a mastectomy, who wanted something a little more attractive than most of the current offerings.
2 Likes
Hi @saz1
Sorry to hear that you are having to make this decision. I also had to make the choice earlier this year after failed lumpectomies in my right breast.
I opted for a bi-lateral DIEP reconstruction which was a long surgery, I would say the recovery is long but you will be up and out of bed the next day and able to do most daily tasks within a 2 to 3 weeks. The only additional surgery I have had it nipple reconstruction but I know other ladies who have had multiple surgies to achieve better results.
I would recommend looking at the https://restore-bcr.co.uk/ or https://keepingabreast.org.uk/ for additional information.
I am very happy with the results of my surgery, and it was the right choice for me, and 6 months on, I am now just waiting for tattoos. I found making the choice very overwhelming, but for me, I was very surprised to find that body image was very important to me even though I am not what you would call a girly girl!
This is a very individual decision, as others on this chat who have opted to go flat or different routes have said, I am sure you will find the path that is right for you.
Any questions always happy to help, and all the best x
You are so welcome. To be honest, I actually felt quite overwhelmed at the stage you are in now. I know writing it all down after-the-fact, it sounds like it was straight-forward. But I was a bit of a wreck when I was trying make a decision before I got to my plastic surgery appointment, so try and be easy on yourself and know that it’s normal to feel the way you do. You’re doing great. I spoke with a health coach who helped me write down pro’s and con’s for the options viable for me, in order to help me figure out what was most important to me & therefore right for me… 
It is such an individualised personal decision, but once the decision/choice was made I felt like a great weight had been lifted off my shoulders and almost instant relief.
1 Like
Thank you so much for taking the time to reply. I’m glad it is all working out for you. I think I would consider DIEP if I had enough tissue. After seeing the plastic surgeon, I know I would be disappointed if I only got an A cup (rather than my normal C) after all that is involved. Wishing you all the best x
1 Like
Thank you for your kind words. I’m sure I will feel much better once I have made a decision. I have written a list of pros and cons and not having reconstruction looks the best option in black and white. What I’m struggling with is having the confidence to make a decision at a time when I feel an emotional wreck! Thank you for acknowledging that this is normal. I’m hoping that talking things through with a counsellor will help x
1 Like
Hi! Thank you for all your helpful comments and support. I have made the decision not to have reconstruction (at least not for now). I’m going to see my breast surgeon today to discuss. I’m feeling soooo much better now I have decided and finally have some head space to think about something else and enjoy Christmas 
. Merry Christmas everyone x
Has anybody’s surgeon refused expanders?
Mine seems very nice but also says HE will make the decision and that most oncologists don’t like expanders cos they have metal in them. I haven’t made up my mind what I want so had my heart set on an expander so I can make a decision post radiotherapy when hopefully my brain works a bit better (my chemo brain is awful).
He seems to be pushing for me to just get an implant (be it silicone or diep). I don’t think I want the latter as recovery sounds grim (I thought I could handle chemo but I was immediately signed off work and haven’t been back yet).
I’m pretty good at advocating for myself and I don’t need to make a decision til January but I’m just wondering if I should speak to someone else.
Has anyone else had a surgeon try to discourage them about expanders?
Hi @sez
I was in a similar situation as you (but on the other side - my surgeon only wanted to do expanders and nothing else haha!) and you are absolutely right about wanting more information is your damn good right. I ended up getting a second opinion and you can get it privately for £250 or so, if you want to speed up the process. For me, it was the money well invested.
I understand that expanders vs one stage is usually a personal preference of each surgeon and there is no right or wrong. It is for you to decide what you prefer. I must admit it is the first time that I hear that expanders cannot be used for radiotherapy (my oncologist explicitly said in her clinical letter that this IS the reason why we use expanders, it was unclear at the time of surgery whether I need it or not, so installing implants straight away would have been too risky and I didn’t want to go flat).
Some pros and cons of implants vs expanders that I’ve identified for me when making the decision.
Implants first:
- just one surgery, one and done
- if you are generally healthy, you should heal well and get on with life quickly
- may require some follow up surgery to improve the look
- slightly higher risk of failure
Expander
- Two surgeries (both quite major)
- Easier to fine tune later
- Slightly less risky re failure and when healing
My second opinion surgeon didn’t like expanders, as I thinks that the second surgery is unnecessary for a young and healthy woman who is likely to recover quickly and heal well. Basically, no reason to do it. After a long contemplation I went for expanders, as my surgeon promised to make my tits look really great and with a double mastectomy I take all benefits that I can get haha! I must admit he has delivered (and I was also able to go up in cup size)
1 Like
Thank you for replying. Maybe I need to speak to my oncologist if he’s putting words in her mouth.
He didn’t say they don’t like expanders cos they stop radiotherapy from working but said they ‘interfere’ with it.
My Macmillan nurse has told me of two other surgeons at another hospital I could talk to (I’ve sent her an email about this and hope to speak to her next week if she’s working).
I definitely don’t want to go bigger (DDs are more than enough for me right now, and I might try and lose some weight). I’m only one-sided mastectomy, I’m having ovarian cyst surgery too probably later next year so I really wanted to hold off til maybe 2026.
I think I still need to talk to some more people. Thank you for validating that it was odd he was saying it’s all his decision.
It is definitely not his decision, as you are the patient and you’ll get to live with the consequences of this decision. His job is to help you make the decision by answering your questions and providing additional information. This is the reality of it. It definitely helps talking to different people, at least it helped in my case. I am well aware that consultants often don’t like when patients challenge their views or ask for clarifications (like “interfere with radio - how exactly?”). However as I said it’s you who live with the consequences of this decision and not them and sometimes it’s worth reminding them of it.
1 Like