Tuesday, February 26, 2019

Flat and Fabulous

I've been asked a few times whether or not I'll have reconstruction done, so I thought I'd address that here.

The majority of reconstructive surgery for breast cancer patients undergoing a mastectomy/lumpectomy is done at the time of the initial surgery. Because of the location of my affected lymph nodes (including one in my sternum), my RadOnc wanted me completely flat for radiation, which meant delayed reconstruction, if any. The failure rate for implants after radiation is very, very high, so my best option for reconstructive surgery is/was DIEP flap.

DIEP flap surgery, which could happen after my skin was completely healed from radiation (minimum of 9 months), is very, very invasive. Feel free to google it, but it basically involves a hip-to-hip incision, the removal of skin & tissue from your abdomen to form new breast shapes, and then the reconnection of all of the blood vessels in that tissue to the vessels in your chest to keep that tissue alive. It's a minimum of 2 surgeries, and the 1st surgery has a 6 week recovery time.

I could change my mind at any point in my life and decide to undergo that surgery, but right now I'm as happy as I can be flat. Here are my reasons:

1) I don't want to put my body through another surgery & recovery. It's a long surgery and a long recovery, and my body has been through a lot already.

2) My kids (ages 9 & 11) have seen me go through enough. I don't want to add an elective surgery on top of that. Right now I'm starting to get my energy back and they're enjoying me looking/feeling/acting more like my "old" self. I don't want to take that away from them.

3) If I went through a surgery, it would just be for aesthetic reasons. It's a lot to go through for lumps of tissue. No matter what, I'll never have my former body back. The new "breasts" might look great, but they won't be the same and I won't have feeling in them. Would that really be worth it? My husband is happy with me just as I am.

4) If I end up with mets at some point, will I have wanted to have wasted all that time in surgery & recovery? Will the new "breasts" be in the way/make any new scans more difficult? Will it be easier to notice a possible recurrence if I just stay flat?

5) I'm actually enjoying being flat, in a lot of ways. I still have to get used to how I look when I see myself in a mirror, and shopping is trickier - things fit differently than they did on my 32DDs - but being flat has advantages. No boob sweat! No adjusting bra straps all the time. No extra layer in the hot Houston weather. Button-ups don't gape over my breasts anymore. And I have an excuse to buy cute new shirts.

So I'm 99% sure I won't want to ever do reconstruction.

The decision is personal for everyone, but I've been happy flat so far. (My bilateral mastectomy was 7/20/18.) If you are going through this process yourself and have questions, feel free to comment or email me and I'll get in touch.

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Anonymous said...

I’ve been thinking about this for the past 16 years, since my mom was diagnosed. I’m nearly, now, the age she was then, as we are 19years apart. I came to the same conclusion you have. Better to be healthy, better not to have more surgery, and they are just lumps, even if they look great (and they don’t always.). Thanks for posting about this very personal decision!

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