I was diagnosed with breast cancer 2 weeks ago and told I needed a mastectomy. I have an appointment on Friday to discuss it so I’m trying to info gather as much as I can. I’ve read about the different reconstructions and I just don’t think I want one. I don’t want to choose to have more surgeries, more complications, more time for recovery. Also nothing is going to bring my boob back, even a reconstruction is just a pretend one.
But what are the realities of being flat? Do you still feel attractive (to yourself or others!)? Do you regret being flat? Should I just accept the societal norm is having breasts?
I’m 38 so hopefully a long life to live yet, but maybe fear is holding me back?
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Hi @firefly2
I had a bi lateral lumpectomy so can’t comment on mastectomy and being flat. I have read many posts and found this website that may help.
I’m sure many people will come on here and help.
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I had mastectomy at the end of August this year with flat closure. I do not intend to have reconstruction and am quite happy with my looks. I wear prothesis in my bra and it doesn’t show that something is missing. Actually, last weekend in the water park I wore a swimming suit (from before diagnosis) and just didn’t care that asymmetry was visible. My husband and my 8-year-old are also fine with how I look now (also naked :-)).
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Hi @firefly2, I had a left side mastectomy with flat closure in 2023 and have not regretted my decision. I was offered a lumpectomy but elected for mastectomy for many reasons…I didnt want to risk further surgeries if clear margins not obtained, I wanted to avoid radiotherapy, I preferred to have no breast rather than a deformed one. I wanted to be under the anaesthetic for the shortest possible time. I asked surgeon for a curved incision and to do slnb through the same incision. When the registrar came to see me before the op to mark me up he said ‘you are doing the right thing’. I didnt want an implant or reconstruction as either options did not appeal for various reasons. The nhs prosthesis i put in my full cup pocketed bra feels very similar to my remaining breast and is even hard to detect when stripped down to my undies. I even still have what looks like a little cleavage. I did look at the flat friends website before my op and spoke to 3 other ladies who had had mastectomy. I also showed surgeon pictures of what I wanted. The op was straightforward and I left for home the same day, only needing painkillers for a couple of days. I wish you well. Love Tulip x
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I had a mastectomy in 2020 and went flat. I don’t even use a prosthetic of any kind. The operation itself and recovery from surgery is much quicker than having any kind of implant.
My husband was fully supportive of my decision and it certainly hasn’t affected our relationship in any way.
A colleague at work, when hearing about my operation, asked which side had been removed as she couldn’t tell!
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Hi @Tulip29, I will be having a single mastectomy after my chemo and have opted to go flat. Would you feel ok explaining why you chose a curved scar please? I had no idea there were options! Many thanks x
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Never having seen a real live person with a mastectomy scar I looked at pictures on the Flat Friends site. I noticed that some looked more aesthetically pleasing than others. This led me to researching mastectomy incisions and reading that there were different types. The look of a straight line on a curved body seemed wrong to me. When I saw my surgeon pre op I asked if she could show me some examples of her work. She didnt have any - only a diagram of the incision that she would always do for mastectomy… Then I showed her my photos I had printed and said which one I liked best. It was then I made my request for a curve, and not to leave me with any dog ears. The surgeon said she had only ever been taught one type of incision for mastectomy which I found dissapointing, but she said she would do her best. When the dressing came off I could see that two incisions had been made. They were curved and meant to meet in the middle but they didnt quite do so! Still, it wasnt too bad. The surgeon was pleased, even proud, with her effort but It wasnt as good as I had hoped. She explained that it was difficult to do when the patient is lying flat. Still I was glad I made the request. My post op appearance was slightly compromised by a pre existing deformity of my rib cage where my right side is concave from the sternum and my left side convex with a lumpy rib. This was previously hidden by my breast but is now overcome by having a slightly larger prosthesis replacing my amputated breast which now makes bras fit properly for the first time in my life. I do feel very strongly that as much care should be taken with mastectomy flat closures as is given to reconstructions to give as pleasing result as possible and that breast surgeons should have more than one incision type in their repertoire/skillset. Some do some don’t. I hope my experience will encourage others to make their personal wishes known and ensure they are properly discussed before surgery. X
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Thank you so much for all that information @Tulip29, it’s really helpful x
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I love that you did this - i wish i had too. X
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Thanks so much for your replies. That’s a great idea to have a photo bank, I will give that a go. Didn’t occur to me either that they wouldn’t have training for it!
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Hi Firefly! I had a left side mastectomy and opted for a temporary expandable implant so I could have a delayed DIEP flap reconstruction (which I had 7 weeks ago). I am 43 so similar age.
I honestly truly wish I had just gone flat at time of mastectomy. I think the feelings I had about the expandable implant confidence wise would have been exactly the same if I had gone flat, yet I would have saved myself further recovery and complications etc.
However there is one thing I will say… I had had quite extensive damage from radiotherapy which can happen, and surgeon said the implant saved some of the chest wall from damage.
It’s such a hard decision - I do feel for you. There are always options later down the line to do a form of reconstruction or implant, or change what you have so don’t feel like it’s going to be permanent decision right now xx
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Thank you so much for your reply.
I’ve had my appointment today to discuss my surgical options and have told them I don’t want reconstruction. Thankfully the breast care nurse was there being awesomely supportive as actually the doctor didn’t really seem to view this as a realistic option!
I really hope this is the right way forward for me, and certainly in terms of gut feeling this is the one that makes me feel happiest.
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Oh the nurses are amazing aren’t they! They were such a great advocate for me too.
Your decision now doesn’t mean you can’t opt for reconstruction at a later date! It makes it a bit harder, but still doable.
It’s your body your choice x
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Another one who has had mastectomy and remained flat. I had full node clearance at the same time and just have one scar which is really neat - had a very good surgeon. I don’t regret my decision at all and know I won’t ever want reconstruction. If I was to have further surgery it would be to have the other side removed to match. My surgeon wants me to wait in case I change my mind about reconstruction….
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Hi there, I completely understand your questions and thoughts around this. I had a mastectomy 18 months ago and opted to stay flat. I wondered if later down the line I’d maybe reconsider this but I’ve been so pleased with going with my gut instinct at the time. I wear the nicest bras and prosthetics inside them and don’t feel I’ve lost my femininity at all. I love fitness so it almost feels better without them/ it. It’s such and individual choice but you’ll know inside what it should be for you. I also love to wear the same clothes I wore before and I consider myself to be fairly trendy for my age at 52. I did have small boobs before which I always like having so I’ve kept my prosthetics the same size. I still feel like ‘me’. I know some people do have issues with implants which was another reason I chose to stay flat along with not wanting further surgeries etc. I hope you have your answer already and feel confident in your choice. Xx
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It’s so nice to hear so many positive stories. The nurse had said to me I could think about it over the weekend if I wanted but I said I didn’t think I would change my mind! Once I felt fat closure was the right way for me it’s been such a relief to stop worrying about all the options.
Will just be worrying about the actual surgery next! Luckily have a holiday booked beforehand so hopefully that will be distracting!
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I didn’t have a choice as I have inflammatory breast cancer where the protocol is to have a mastectomy with no reconstruction allowed for at least a year. Before I knew this, I had thought I would want reconstruction but now I know more about it, I’m not sure I would want more surgery for the outcome you get. I’m happy at the moment using my softie, I still have to get a ‘proper’ prosthetic as I have been waiting for my skin to heal after radiotherapy. I’ve given myself a year to then think about it some more.
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I had mastectomy in July. I decided that reconstructive surgery was not for me. It takes a while to get used to your new look but you do. I look at it this way - I gave the surgeon my boob he took away my cancer! I don’t wear bra much anyway but if I’m going out I use the soft insert the give you. I could have a silicone one but not bothered to try it. I’m proud to be flat a
S it means I’m a survivor!
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Hi I had a left breast mastectomy with lymph node clearance. I had a Left flap reconstruction at the same time. Because of previous bowel surgery the plastic surgeon said he would use muscle from my back and this wouldn’t be a problem for me as I wasn’t a climber. He failed to mention that I would have a scar extending from my spine across half my back and under my arm, and a dog leg of flesh which got caught and pinched every radiotherapy session. I may not be a climber, but I did sail yachts, dance and sing. I also carried shopping and lifted boxes and moved furniture. I have got back to singing but none of the rest. I’ve got an old lady shopping trolley, and even find holding music in concerts difficult (I’ve not dropped any yet, but the conductor is watching!). Radiotherapy post surgery reduced my reconstruction breast so that I am now uneven and have a shrivelled breast. I went for a fitting at the hospital and the fitter said “You should have a breast form to put in your bra for that”. One of the worst comments I’d heard and coming from someone selling bras to vulnerable women - Dreadful! Fortunately i was fatigued so refrained from hitting her. Since then the tightness from the scar across my back has been constant and the GP keeps telling me to massage it. I have pointed out that I cannot reach it to do so, but now spread cream on a puppy training pad and roll around on that. I don’t have a puppy and the Poundland staff are thinking they should report me to the RSPCA as I’ve bought so many pads I must be running a puppy farm. My new breast feels tight and stiffer than post surgery. I’m assuming that is the effect of the radiotherapy. I’ve finally got a referral to the Breast Clinic and will seek to go flat. I regret having the flap surgery and feel if the plastic surgeon had not been so keen to tell me how good he was he would have had more time to discuss the procedure with me - and it’s downsides. I’m usually a pragmatic patient and do what my docs advise for the best. I’m not finding the positive in this course of action at the moment. 24 bowel and gynae operations in my past and I have no pain from any of them since the surgery, except with this flap one. I want my back back:)
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I had a mastectomy in December, a single one, I was in great sadness and in denial at the beginning cause my breasts was my pride. Beeing flat for me is very difficult and I will have to have a mastectomy to the other one in a couple of months. Being flat made me feel that l lost my identity. Having a prosthetic in the bra is ok but doesn’t suit me . I think it is all about how you feel about your breasts and if it is an important part of your body. Looking forward for the reconstruction, I could not see myself with out breasts .
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