Single mastectomy with or without reconstruction? I need to decide and need help.

Hello you lovely lot

I have finished 6 cycles of TCHP and have surgery planned for 11 June. I had the consultation with my surgeon yesterday where we talked about a single mastectomy and the option of reconstruction and I am at a bit of a loss (or crossroads) to be honest.

If I decide to have a reconstruction it would be an implant - I am small-breasted and slim so there isn’t really another option. But I need to have three weeks/15 days of radiotherapy following the mastectomy and this treatment can make the implant fail. I was told that it’s a little more than a 50:50 chance of success and that this surgery has only actually been offered for three to four years so there isn’t much history to go on. My instinct is not to put my body through something I don’t need to. But I have no idea, if I just go for the mastectomy, if I can live with one breast. I think I can but I just don’t know. I don’t think I want to take the chance on the reconstruction when it is high risk and has a good chance of failing. But will I regret not giving it a go? Because of the radiotherapy and the tightening of the skin I wouldn’t be able to have reconstruction in the future. So essentially it’s now or never.

My mind is a bit all over the place. I guess I am reaching out to see if any of you have been in a similar situation and if you’ve got any words of wisdom. Has anyone had an implant with radiotherapy that has been successful or not successful? Has anyone had a mastectomy and was surprised at how easy it was to accept the breast loss? Any help, tips, thoughts are really appreciated as I make my decision. 

Much love


Hi @BeanieBoo  - I’m happy to share my experience with you and chat in case that helps at all.

I had my treatment about 5 years ago - chemo, single mastectomy and implant, then radiotherapy. Like you, I’m small breasted and slim and so I also only had the option of an implant. My surgeon was initially reluctant to do an implant recon before radiotherapy, but then he decided it would be ok if he did a “pre-pectoral implant”, sitting in something called a Braxon sling. Basically the mesh thing sits on top of the muscle, rather than underneath it, and holds the implant in place. I know it’s a relatively new operation - but you could google “pre-pectoral implant” on safe/reputable sites and that might give you an idea. The sling is supposed to help protect the implant from the radiotherapy - I was given a much lower failure rate for this than 50:50, but I do know from reading other posts on here that surgeons are reluctant to do implants before radiotherapy. Touch wood all is ok with mine. Mine doesn’t match my real one perfectly, but I’m happy with it and glad I went with that option.

That’s a short summary - but please feel free to ask as many questions as you like if I can help at all. It’s a difficult decision so important that you gather as much info as you can.

Sending hugs, Evie xx

I had a single sided mastectomy in August 2020. I didn’t have any reconstruction and absolutely don’t regret it. I don’t use any kind of prosthesis either. Friends have said that it is not noticeable.


I had a single mastectomy 13 days ago and lymph node clearance. Surprisingly no pain from the mastectomy just discomfort from lymph node removal. Key is to do your exercises. I have been given a softie to put in my bra, the option to not have anything in my bra isn’t really there being a d cup it does notice. I will be fitted with a prosthesis in a few weeks. At the moment and from the moment I was told I was having a mastectomy I said I wasn’t going to have reconstruction. My surgeon has urged me to think about it as I’m still young (46). I did want a double mastectomy but I wasn’t allowed as I have no family history x