To reconstruct or not (small breasted)

Hi all

I had a diagnosis 2 weeks ago and was advised to have a mastectomy due to multiple cancers.

I am very small chested (can’t remember size - need to find out for own sanity) and have always been insecure about my chest BUT over time and ironically since diagnosis have realised that i like my chest.

Had thought id landed on immediate recon with implant due to fear of ops and time to do the tissue option, hadn’t even considered no reconstruction.

When i met with my surgeon yesterday we discussed single implant or both sides. It sounds like it is very difficult to get small implants for single sizes as implants were meant for larger breasts.

The suggestion was to have an expander first (4-12 months) and then double implants to ensure even. This concerned me as was expecting it all to be done there and then.

Am now thinking about no reconstruction and then dealing with that at later date.

Has anyone had experience of;

Single sided implant for very small breast 

Both sides done with an expander, how invasive, troublesome is this

Reconstruction at later date, how does tight skin deal with stretching against to accommodate new breast

I am so anxious about all of this in terms of surgical risk, implant risk (rejecting implant or rupture and psychological risk (insecurities without breast) that i just don’t know what to do.

On top of this, the clock is ticking and i want this cancer out. I have three children that i adore and every time i think of what to do i feel like i need to be a role model to them…

I will deal with surgery anxiety once ive taken this next step, can only cope with one area at a time.

Is anyone else in a similar boat?

Have you considered single sided mastectomy and no implant?  This is what I had and have no regrets.  I am happy to answer any questions.

@omil  - it’s a very touch decision, so you are doing exactly the right thing and asking others for their experiences.

I am also small breasted and I chose to have an implant when I had my right side mastectomy. Unfortunately it’s slightly larger than my original one, but I use a small insert in my bra on the left side to even them up. I’m happy with my decision and also happy to answer any more questions if that helps at all.

Very best wishes to you going forward. Hugs, Evie xx

Hi Omil:  I am so glad you have posed this question. I have just completed 2nd lumpectomy. Due to close margins, the Surgeon and Oncologist are saying a 3rd is needed and the potential of 4th OR, a mastectomy. Having viewed a video on mastectomy, very straightforward but left so many questions.  I am like you, smaller 5’4.5, 112 - 115#.  Not a lot of extra skin or tissue for grafting.  I have a couple of choices: 3rd surgery with potential for 4th and RT; of which they have said If that route I would not be a good candidate for reconstruction as the scar tissue of what is left would not be pliable. Or mastectomy, no RT, and reconstructive surgery on left with an implant on right to match.  All your concerns are mine also, rejection of the implant, time to complete reconstruction with the expanders,  number of checkups during the process, and healing.  IS IT WORTH IT?

I have also vacillated on 3rd surgery, forging RT and going for reconstruction.  I am 64, very fit, with no family history of breast cancer (everyone lives into their early 90’s) then it’s heart issues.  It would be helpful to hear from anyone that has forgone RT and/or persons that have had reconstruction and or NOT. I know from reading data stats, there are those that have chosen a different route, but have not found personal voice or posts from anyone.  Thank you for your post.  Big hug.  None of this is easy.  Very glad for board.