Megan: I Chose Not To Have Reconstruction

SHARE volunteer Megan Rutherford describes her decision not to have breast reconstruction after a mastectomy. 

I was lucky. Because I had my bilateral mastectomy after chemotherapy, I had ample time to consider my options, a luxury many breast cancer patients don't have. My breast surgeon encouraged me to consult a plastic surgeon about reconstruction. I was given a good deal of useful information: brochures, photographs, a lecture and slide show. But I also wanted to know about the alternative—no reconstruction. I wanted to know what it looked like, how it felt, what it was like to wear breast forms, whether it was conspicuous to go without them, what clothing options were available—everything!

So I called Share, and a "peer match" was made for me with a woman who had had a unilateral mastectomy without reconstruction. She told me she had become completely accustomed to having one breast. She wore a breast form to work and went without it at home. Although she couldn't tell me what it would be like to have both breasts removed, as I planned to do, she said she felt comfortable running errands without her form. She wore a button-down shirt with a well-placed pocket or threw on a jacket or a scarf, and no one noticed the imbalance.

After speaking with her, I, too, chose to forgo reconstruction. I'm physically active, with a yoga practice that's important to me, so avoiding extra surgery and getting back on the mat fast was a big factor in my decision. (In fact, six months later, I took a month off of work and completed a yoga teacher-training course.)

For me it was the right decision. I was in the hospital for about 24 hours. I never took the prescription pain killers I was sent home with. The two drains were a nuisance, but they were removed a week later. I had a little fluid accumulation and an itchy rash, which worried me at the time, but both resolved on their own.

I'm very emotional, so I was surprised by how little distress I felt about losing my breasts. They had been small to begin with, and the difference between an A cup and a flat chest is not that great. I had told my surgeon I wanted a "10-year-old boy look." And that's what I got. I had worried that having no nipples would make me look like an alien. It doesn't. And my scars have faded to scratch marks.

As for my partner, he was relieved that I chose the least-complicated option. I had been concerned about my teenage daughter's reaction, but my lack of breasts didn't faze her. In fact, a year after the surgery, she stumbled on some before-and-after snapshots I had taken. After examining them closely, she said, "Mom, you looked really weird with boobs!"

My surgeon gives me yearly prescriptions for silicon breast forms and mastectomy bras, but I didn't wear a bra before my mastectomy and rarely wear one now. It's not just about comfort. It's about my sense of self: What you see is what you get. That said, I do make an effort to deflect attention from my flatness. I wear busy patterns; layers; loose tops; scarves; and dark colors, which obscure the absence of shadow below my nonexistent bosom.

I know that for many women, resuming their former silhouette helps them regain a sense of normalcy. But for me, the sight of my unreconstructed chest in the mirror is somehow reassuring. Sure, my breasts are gone, but they were—literally and figuratively—superficial. My body works perfectly well without them. And when you're 60, looking like a 10-year-old ain't bad.

Looking for more information about breast reconstruction after a mastectomy? Click here.

Author

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Megan


  • Ann Fonfa

    I had three lumpectomies, a left mastectomy, and 1 yr later a right. I never planned on reconstruction. Like all of us, many reasons. I had D breasts before, very sensitive and that could never be duplicated.

    I choose my tops without low necklines (why wasn't that a popular look when I had something to show:) and without darts.

    Over time I got very used to and pleased not to wear a bra. I wore more form fitting tops and stopped wearing vests or scarfs. Scars got a lot less noticeable, although never gone. Its been many years and I don't regret this path taken. 'Perky (smaller) boobs on my 66 yr old body might be odder.

  • Cindy

    I have just been diagnosed with her2 positive breast cancer. Right breast. I was told I will need chemo, surgery, radiation and herciptan. I have a lymph node that is positive. My oncologist appt is Monday and so my journey begins.

  • Jane Browne

    Hi, I am not that good at writing about myself, but, here goes. I had a right mastectomy in 2012 and then two years later cancer showed up in the milk ducts of my right breast. I was not given a choice the breast had to go. Fortunately for me I did not have to undergo chemo or radiation treatment which was a blessing. Still I am without breasts and big breasts at that. I do feel self conscious about not having boobs but have read quite a lot about reconstruction and my surgeon felt that he would only do one at a time and the thought of two operations put me right off. I am feeling much better about being flat – what a relief really – no more chaffing or digging in of bra straps. I do worry a little about clothing – mostly that the neckline is not too low. I am now 65 years old and ready to retire so no boobs is not a problem. I think!!!

  • sheila

    I also elected no recon surgery. I'm only 3 weeks out so not sure how it'll eventually look but the extra surgery, infection risks, follow ups etc were simply not worth it. I'm 45 and had I been 20 maybe but very confident in my decision not to have it. I had a wonderful chest prior, 36C, I enjoyed out time together but time to move on. More to life than our boobies :- )

  • teresa

    I'm undecided which way to go. I have stage 1 breast cancer of right breast. My first instict is no reconstruction, but feel
    conflicted. I'll know how much it spread by end of week, but I am told probably a lumpectomy &
    radiation. I do not want radiation. Therefore, might opt for a masectomy.
    I am told radiation has no effect on heart. My heart Is only at a 25 percent ejection fraction. I also have a defibrillator. Suggestions?
    Teresa

  • Sue

    I am 67 and had a unilateral mastectomy. I am a DD cup and am so off balance. I've had open heart surgery and some unusual anemia problems. I am afraid to go through another surgery. I have heard about the pain and breathing problems with implants. I have a breast form and look fine but hate putting it on wear puff that I made for my nightgown. I know I should be grateful stage one cancer chose mastectomy no radiation or chemo. I know I am blessed but uncomfortable with this body.

  • Shannon Swartz

    I need to have a mastectomy on my left side…..I just don't know what to do with any of it. I am a 38dd. I certainly want smaller….way smaller ones, if any at all. Not sure about a mastectomy on right side. My oncologist encourages me to save what I can. That breast is healthy. I don't want to obsess over it in the future either. I am 66, and very active. I have swam the English Channel in 3 different relays….I need my life back….but I think going flat is going to make me look very unporpotioned. I only seem to know women who went with reconstruction, and it sounds dreadful, but then I could have small breasts…..I need to read more stories of others choices, and how it has worked for them

    Thank you

  • Caroline

    My friend had a single mastectomy 5 years ago.
    She was diagnosed with IBC. Unfortunately radiation left a sunken appearance above where her right breast had been. This sunken appearance could be disguised IF we could find her the proper tops, blouses.
    She has opted against reconstructive surgery.

    My question is, is there any clothing, (tops especially) flattering, fun, feminine out there & if so where can we purchase them.

    Thank you!
    Caroline

  • Julie

    Five years ago I had a double mastectomy as well, stage 3 cancer and I did reconstruction after chemo and surgery with silicone implants. I too am contemplating taking them out and putting saline implants or nothing. I too have shortness of breath, numbness and I miss sleeping on my side or stomach.

  • Glad they are gone

    I had immediate reconstruction after my surgery, and almost immediately I lost the use of both my hands due to severe carpal tunnel like symptoms. No grip strength and severe pain. Also, my implants ITCHED. and burned. I have very sensitive skin to start with, and they were unbearably painful. Following my surgeons advice to let them heal, after a year or so I could not take it any more, and had them removed. Also removed were my nipple tattoos. I just wanted simple. Almost right away the itching stopped, even as I was coming out of surgery to have them out. My hands are "recovering" although not completely. In terms of the mastectomy, I feel great. No problem whatever being flat. I was super large to start with and I am really enjoying the freedom of not having to fool around with bras and such. Only problem really is that i am 4 foot eleven and it's challenging to find small shirts that don't have action figures on them. other than that, best thing I did! I have healed fine, and only two little small 1 cm bumps where the stitches closed, and those are shrinking fine. I was told if needed they can be removed in an office procedure as I am healed. As of right now, I don't have any prosthetic for my breasts, as i have too many braces and such on other parts of my body for other reasons. I have more sensation now than i did, even when i had excessively large breasts, as my breasts were very heavy and painful. the implant surgery left me numb. Although the surgeon did a great cosmetic job, I would rather have my hands, and no pain. Also, felt really good to sleep on my belly again!

  • Shulamite

    I had reconstruction after a double mastectomy. Now I'm starting to regret the implants. Why? In part, the new "breasts" are partially numb. In larger part, the implants seem to constrict my breathing. I run a lot and have lost in speed at least 1 minute/ mile post operation. I am lucky of course to have my life and health back so this may seem like a small complaint. Still, I am starting to think that it would be worth being flat, and maybe even worth feeling "cut up," if I could only get my full lungs back. Has anyone else had a similar experience? Thank you.

  • Babs

    Ten years ago I had a bilateral mastectomy and reconstruction. I decided on saline implants. I was relatively satisfied, however, over the course of the years I began to feel discomfort around the implants. Now, ten years later the discomfort level is very high. I went to the plastic surgeon who stated that I had symptoms of capsular contraction which is basically a capsule or scar tissue develops around the implants because they are a foreign body. At this point I am considering going flat. To resolve the above issue the implants have to be removed anyway and I am not sure if I should bother with them again at 60 years old. Even with the implants I do not feel as though I have breasts anyway, they are just mounds. I think I may have just made up my mind,

  • Mindy

    Hi, I had a right breast mastectomy 10 days ago, and have chosen to forgo reconstruction. My preference is having as little surgery as possible. The mastectomy surgery went really well, and I have not needed any prescription pain meds. I wear the "sports-bra like" compression bra when I go out. I have no plans to wear a "spacer" for the missing breast. I am a "plus size" short woman, and have my remaining "D" sized left breast. I view my missing breast as an inconvenience, not a disability! In a way, I find my decision empowering. I am still me……and, to me, that is all that matters.

    I hope that the more we talk about the "go flat" option, the more women will consider it……and not feel pressured to have reconstruction. Less pain, less complications! that's how you get back to feeling "normal"…….not what you look like on the outside!!!!

  • Anonymous

    Two Time Survivor – Reconstruction 1st Go-Round, NONE 2nd Time Around.

    My PCP felt a lump in my left breast in Nov. of 1998. After several mammograms & ultrasounds done monthly, that failed to show any irregular tissue, my PCP insisted a biopsy be performed in spite of reluctance of the breast cancer team. Four "random" tissue samples proved cancer positive & I was diagnosed with breast cancer in June of 1999. With no confidence in the surgeon who repeatedly sent me home with advice to return for mammo in one year, I switched to a new breast surgeon who recommended a mastectomy after going through a round of chemo. I chose to have a free flap reconstruction done at time of mastectomy. Lymph node biopsy resulted in removal of all lymph nodes under my left arm & additional chemo & radiation. The post surgery chemo & radiation destroyed the reconstruction & after five revisions, and rejection of the saline implant, I was back to flat – right where I would have been had I originally foregone reconstruction. I became accustomed to wearing a prosthesis & nicknamed myself "uni-boob".

    June of this year (2013) marked my 14th year as a survivor. In July I was diagnosed with a "new" cancer in my right breast. Within a month I had a mastectomy – NO reconstruction. Didn't even consider it. So, I am now flat chested on the left side & concave on the right side, quite a change from the 34DD chest I used to have. Trying to look on the bright side of things, I decided I would get boobs more normal for my 5'5"/130 lb. frame. After appealing my Medicaire Insurance supplement's ruling that I am only eligible for one prosthesis now & a replacement for my left one in June 2014 (only eligible for prostheses replacements every 2 years), the decision was reversed & I was told I would be eligible for 2 now. In the meantime, the mastectomy fitter did not have a bra or prostheses in the size I require & I am awaiting the order to come in. In the meantime, I have grown accustomed to my flat chest, the comfort of going braless and have decided that I will wear bra & prostheses ONLY when garment necessitates OR I feel like it!

    When asked about reconstruction, I say that if I had it to do over again, I would possibly try reconstruction with saline implants (not knowing my body would reject them) or more likely – chosen NO reconstruction! There is something liberating about a bilateral mastectomy & having the option of being "myself" or wearing fake boobies. I never liked thinking I was noticed because of my big boobs, and now I don't have to worry about that. Camoughflaging a flat chest is easier & more fun than trying to fit big boobs into small sized tops & blouses!

    I hope this helps those debating their options when confronted with a breast cancer diagnosis.
    Gail

  • Terri

    Love this forum. I never even conSIDered having reconstruction after my DM. I couldn't figure out why someone would want to put bumps on the front of their body…but that's just me…) I've love having no breasts from the moment they were gone!!! I am 61 and I've never felt so free!!!!! My husband and I both think my chest is beautiful. When we hug he says, " I love that our hearts are closer."

    (I am enjoying making really fun clothes for the warm weather that I could never have worn before.)

  • Barb

    Megan: I too have agonized over whether or not to have reconstruction. I am a small A cup and would prefer to go braless due to comfort at this point. I like that I can choose to wear my bra and form or go without.
    I hear about so many women getting reconstruction to help them regain some normalacy. I kind of feel like an oddity because I am not so sure I want to go that route.
    Your story helps me to feel a bit better about how I am thinking.
    Thank you for sharing

  • Beneta

    I had a matectomy on my left side, then treatment..ihad very large breasts 18E they both were very heavy..i absolutly hated having one boob so a year down the track i had the right one removed..i didnt want recontructive surgery and i just love being flat..no more heavyness or pain, ive actually lost weight, am alot fitter and feel more a woman now than ever..i know this is not for everyone..but its been fantastic for me..

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