There may be many different reasons for this choice, and none of them are wrong. Choosing to have—or not have—breast reconstruction is your decision, and only you can know what’s right for you. Regardless of your choice to have breast reconstruction or not, we recommend that you learn about all of your options before making a decision.
For many women, breast reconstruction is part of their healing process after cancer surgery and helps make them feel whole again. There are many breast reconstruction options to choose from today. After going through the emotional and physical ordeal of breast cancer, additional, non-medically necessary surgery isn’t desirable for some women.
Women choose to go flat for a range of reasons, including:
Keep in mind that even if you don’t have immediate reconstruction (done at the same time as the mastectomy), you can have delayed reconstruction (done at a later date after the mastectomy). Breast reconstruction can be done 6-12 months after mastectomy, or even later. However, immediate reconstruction usually has the best cosmetic results.
If you choose not to have reconstruction but want to have the appearance of breasts when wearing clothes, you can use breast forms. Whether you’ve had a single or double mastectomy, you can find comfortable breast forms that fit inside bras and swimsuits. Breast forms are available in many different sizes, shapes, and materials. It is important to be fit by a certified mastectomy fitter to ensure a proper fitting form and help minimize any contour irregularities.
A growing number of women are having the area around their incision site—or their entire chest—tattooed after mastectomy. Much like breast reconstruction, a beautiful new tattoo can be an important part of emotional and psychological healing for many women.
It’s important to consult with a plastic surgeon to fully understand your options about breast reconstruction in your process of deciding the best direction for you. Even if you opt out of breast reconstruction, you might want to plan with your breast surgeon the best surgical approach, incision placement, appropriate closure, and removal of redundant/sagging skin for your best outcome.
If you’ve decided against breast reconstruction, it’s very important to discuss your decision with your surgeon so that you both are clear on your wishes and your desired outcome. Tell your surgeon why you want to go flat. Ask your surgeon:
During the mastectomy, some surgeons may leave extra skin at the incision site to make room for a new breast in case the patient changes her mind about reconstruction later. After surgery, the extra skin sags on the chest. If you don’t want extra skin left, make this very clear to your surgeon. If you want the sagging skin surgically corrected after the mastectomy, your insurance company very likely won’t pay for the procedure.