Should I have breast op?

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When I was 27 (I’m now 36), I was diagnosed with breast cancer and had surgery, chemo and radiotherapy. The breast that had radiotherapy did get slightly smaller and more pert than the healthy breast, but not too noticeable.
However, over the years, not only did my breast continue to shrink and tighten, but after a few years of breastfeeding with my good breast (the other breast did not produce milk), I was left with two completely different boobs. One much smaller, smaller nipple, more pert. The other, not only bigger but much more droopy. This means that I have had to wear fillets over my smaller breast so that they look the same size.
I am now being considered for surgery, where they will basically reduce the bigger breast (and the nipple) so they match. As proceedure, I am seeing a pscychologist who will not let me go ahead until I am absolutely sure I want to have it done. And I’m not 100% sure at the moment. But I’m wondering if I ever will be about something like this?

Advantages: The main adv is not having to mess about with these stupid fillets which make me feel very conscious. I can go swimming and wear what I like and not have to worry about them falling out.
I am single, so it would be something less to worry about if I did ever meet someone (as at the moment my breasts are quite unappealing!).
I am not reminded of the time I had cancer and can put it all behind me.

Disadvantages: Nipple sensation can be either greatly reduced (or completely numbed) or very over sensitised. I am a bit concerned about this because when I was pregnant I had the worst time with over sensitised nipples, to the point it would make me cry with pain. However, sometimes there is no change to the feeling of the nipple and not normally severe.
The surgeon can not achieve exact symmetry. I guess there is always a risk that I won’t like the end result.
I will end up being about 2 sizes smaller (from DD to C). I’ve always been used to having biggish boobs so C would seem really small for me.

Has anyone had this type of surgery before? What would you do?

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Interesting, and a big decision. Personally, for me, sensation is all. I have one breast and to lose that, and the sensation - well, out of the question for me - hence, in my case, reconstruction is a problem because I am told I would need an implant which would make me like you, asymmetrical, one droopy and one pert - and I would not have anything done to my actual breast for fear of losing or damaging the sensation. So I see your dilemma. I had not heard that the reduction could result in oversensitized nipple, I had only heard that in approx 25% (that’s what I heard, but don’t know the source of that statistic) of cases the sensation is either lessened or completely numb. And oversensitized is as much of a problem isn’t it, if they mean you could have pain through damage to the nerves.

But I know that for some people it’s the business with the prosthesis that is the nuisance for them, and to get rid of that would be a bonus for them. Since symmetry cannot be guaranteed, you might end up still using a fillet which would kind of defeat the object - perhaps the surgeon could give some indication of how likely that is? - it is all such a step in the dark isn’t it, that is what I find so scary about the whole thing. You have to end up better off than you are now to warrant going through the surgery, and yet it is so hard to assess your chances of being better off. There is also scarring to consider, though with a reduction most of that does seem to be relatively concealed, and does heal reasonably well, but it is not invisible, so it is worth thinking about.

My concern over the psychologist is: how would that person know if you are absolutely sure? I read an article in BCC newsletter by a woman who was made to see a psychologist before proceeding with breast surgery and the psychologist was satisfied that the woman knew what she was doing (how could the psychologist be? how can one person know that another knows what is going to happen in the future since nobody does; not only does the person not know how they will feel in the reality, but another person is even more in the dark about how somebody else will feel in the future, however well they know them, or know about people in general) - and the woman was in fact devastated. Changes to one’s body are pretty fundamental, and no-one should underestimate how deeply they affect a person, even a change for the better can take a lot of getting used to. That being said, many people undergo cosmetic surgery, or breast reconstruction and associated surgery, and are very happy with the result. So you are absolutely right to be cautious, and gather information. I’m sure you will get many other replies sharing experiences to help in your decision.
Very best wishes,
s

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Thank you so much for your very interesting comments snowwhite.

It’s good to hear things from another point of view. It’s interesting how sensation seems to mean more to you. I think I was so focused on not wanting an over sensitised nipple that the risk of the nipple going numb seemed less important. Basically, you are going to end up in more or less the same situation as me but it seems you would rather be asymmetrical then have any surgery on your breast. I can understand that. It’s kind of strange, but I do feel a bit sad about having surgery done to my non cancer breast. This is the breast that caused me no problems, breastfed my child and now it feels a bit unfair in a way to make it go through surgery - if that makes any sense.

I think I am at increased risk of having nipple sensation changes because they are actually going to reduce the nipple as well, as the nipple on my radiated breast is much smaller.

I really am sick to death of using these fillets, but I am actually going for my first proper prothesis fitting next week so maybe there will be an improvement there. I just feel, that by continuing to use fillets, and I don’t mean in any way to offend anyone who is happy using them, that things are…well, abnormal. I suppose I just want to forget the whole breast cancer episode and not have still deal with any after effects.

I did ask the surgeon how likely it is that the surgery would make my breasts symmetrical but he was a bit vague. I got the impression that most of the time they get it right but I guess he didn’t want to make any promises. That’s why I was hoping to come across others who have had this surgery already.

I was surprised to learn there would be quite a bit of scarring - around the nipple, a line down to the bottom of the breast, and a line underneath. I already have a scar where I had a lumpectomy and axillary nodes removed, I’m not that bothered by scars to be honest.

It really is a risk, there are no guarantees and even I can not know how I will react. I completely agree with you about the psychologist, I mean, sure they are trained to deal with this sort of thing but as human beings we are complex, I don’t think we can always be predictable, so many issues are involved here…how can anyone know for sure how someone will react. The example you gave of the woman who was devastated by her surgery results…do you remember why?

On one hand, I am being very cautious about this but sometimes, when I think about it, I am aware that women are having plastic surgery done all the time, without any psychological assessment. In that sense, maybe this is as bigger deal as I make it to be? Maybe I will have it done and it will just be simple and I will feel fine about it. But I get the feeling the psychologist would not even consider giving me the go ahead unless I tell her I’m 100% certain about this, but I don’t think I ever will be because I know the element of risk is always there.

I guess what I can do is to give myself plenty of time to come to a decision and maybe one day it will be clear to me.

Thanks so much for your comments, it’s really helpful to talk about it.

Regards, tinkywinks x

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Hello tinkywinks

I’ve just read through yours and snowhites posts with great interest.

I can’t really be very useful to you as I have a recent Mx with LD flap recon which is still ‘a work in progress’. My surgeon ( a woman) seemed very keen at the time of my surgery that a) my bra size was something that it wasn’t and b) I should have a reduction of my other breast and a ‘lift’. Now that I have had the surgery I know why!

My bra size was 34D. You cannot get that volume of tissue in a LD recon without implant, and she didn’t want to put an implant in at this point due to impending rads. Hence she desparately wanted me to be a C cup!

I refused surgery to the other breast because (and I did have to use these words to her as any euphamism I tried didn’t get through) 'my breasts play an important part in my sex life for both my OH & I ’ - he likes them, I like the sensations…

I currently have a recon breast cup size B and other one as it was. Like you, I use a fillet, a good bra and often cotton wool to push what I have into the right place to give me cleavage. The plan remains for me to have an implant in the recon one. If I can get a lift without reduction, I may go for that, but I do tend to think ‘if it ain’t broke…’

My priority is to be well, then after that to have matching breasts when dressed, and if I can loose the fillet, great!

And I agree absolutely with you both on the psychologist issue - how can they know?? Why is it important to ‘know’ that you are 100% sure… in my experience, things change whatever - look at how we dealt with things pre BC!!!

I had over sensitive nipple stuff when I was pregnant with my first baby ( I have 3) - my understanding was that it is a change in the nipple due to rapid growth and blood supply fluctuations. It ws never a problem with feeding and I’ve not suffered since - but I do empathise with you’re no wanting to risk that!!

Wishing you the best decision for you…

Love Td xx

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Hi Td,

Thanks very much for your post and for sharing your story. It’s always useful to discuss these things.

It’s commendable that you were willing to put your sex life needs first, that you value your relationship with your partner. I do wonder if I had a partner if that would influence my decision in any way.

A reduction and lift is exactly what the plastic surgeon wants to do with my good breast. It definitely needs a lift anyway as it’s quite saggy from breastfeeding. I don’t know about you, but I am so fed up with fiddling about with fillets! However, I am going for my first ever proper prothesis fitting this week so maybe that will help.

Exactly my thoughts about the psychologist. I mean if anyone had told me pre BC, how would I cope with it, I would have said not very well at all, considering I am prone to stress and anxiety. But I found strength I never knew I had and ended up coping brilliantly, and even inspiring friends and family.

My nipple was never a problem with feeding either, it was only during my pregnancy. I feel sick even thinking about it…it literally felt like thousand piranha’s had their teeth clamped on my nipple…horrible!

Thanks for your support xx