Should I Have Breast Reconstruction or Not?

Several readers helped us by sharing how and why they chose reconstruction or not – read their stories

‘Should I have breast reconstruction or not?” is a question that has many factors influencing the final decision, and each woman must evaluate those factors for herself.


Sometimes it helps to hear from other women about why they made the choice to get breast reconstruction or not, and how they feel down the road.


Some of our friends have shared their breast surgery stories, which could help you to decide whether to get breast reconstruction or not.


Breast Reconstruction or Not: Mastectomy on One Side with Reconstruction

Choosing whether to have breast reconstruction or not can be complicated for a woman who has only one breast removed. Both of the friends we spoke with for this part of the article have had problems with their reconstruction. Not all women have problems with their reconstruction, but their stories do highlight some of the potential difficulties.


Rebecca G. from New York


Rebecca had reconstruction at the time of her mastectomy. She did her homework prior to deciding whether to have breast reconstruction or not:


“I spoke to two plastic surgeons. I attended a reconstruction group at SHARE (a resource centre in New York for breast and ovarian cancer) and another support sponsored by JALBCA (Judges and Lawyers Breast Cancer Action).”


However, the procedure was more uncomfortable than she had expected. “The tissue expander felt like a weight in my chest. It was really uncomfortable physically and emotionally. There was a point when I wondered if doing the reconstruction at the same time as the mastectomy was really such a good idea.”


Rebecca has had to adjust to the results after she pondered on having breast reconstruction or not:


“I am not great with scars. I could not look at the reconstructed breast for a long time. Everyone tells me it’s a great job. I think it is okay.


“One difficulty that often comes up is that the natural breast does not match the reconstructed breast. “If you gain weight,” Rebecca explains, “the saline implant can be a problem. When I gain weight, my natural breast gets bigger and the reconstructed breast does not. Everyone thought that would help me maintain my weight. They were all wrong.


When choosing whether to have breast reconstruction or not, there could be important post-procedure decisions as well. Rebecca explains her decision to have a lift on the other side a couple of years later:


“Apparently they can put a person on the moon but they can’t create a sagging 47-year-old breast — only perky 17-year-old breasts. My plastic surgeon suggested that I have the other breast lifted to match. My breasts had always been pendulous. I remember the plastic surgeon saying that I could have great cleavage after the reconstruction. I had always wanted cleavage, but my breasts were too far apart.


Breast Reconstruction or Not: Rebecca’s Surgery Results

But the results of the lift were disappointing. “It was much more painful than I expected. There was a chance that I would lose feeling in that breast as well. I don’t know why I let the plastic surgeon talk me into this. I let him cut into a perfectly healthy breast. It didn’t look like my breast anymore. I guess I thought that after the lift I’d be ‘normal’, whatever that means. Instead, I felt like I had lost both breasts.


However, after making the decision to have breast reconstruction or not, Rebecca has found one benefit: “On the plus side, it’s nice to run out to the store and not have to wear a bra.”

Breast Reconstruction or Not: Mastectomy on One Side with No Reconstruction


Rose O. from California


Rose had a mastectomy in Sept of 1994, which started her thinking about whether to have breast reconstruction or not.


“The question of getting breast reconstruction (or not) didn’t come up in any of my doctor visits. I didn’t know I could have reconstruction at the same time as the mastectomy, so I assumed that the question of reconstruction would come later.”


After considering breast reconstruction, she decided not to go back for the surgery. Rose says her biggest problem is balance. She describes her recent thoughts about that: “I have never wished I’d chosen reconstruction, but I don’t like how unbalanced my body is. My remaining breast is large, so it can be a problem at times.


“My plastic surgeon mentioned recently that I might consider breast reconstruction to give my body more balance. I told him I was not interested in having more surgery. He responded that he wasn’t trying to talk me into it, he just wanted me to think about it. I got some literature on reconstruction, but after reading it I’ve decided breast reconstruction is not for me, I would rather have the other breast removed.”


Rose feels comfortable being a one-breasted: “I think that my husband’s total acceptance of me whether I have one breast or two has been very important in my comfort with the changes in my body. After seven years of having one breast, it just became who I am. I like to say I have battle scars, but I won the war against breast cancer.” 


Breast Reconstruction or Not: Bilateral Mastectomies with No Reconstruction


Lynne D. from Canada


Lynne had a lumpectomy initially and then, when the pathology report came back showing that she needed further surgery, it was time to decide whether to have breast reconstruction or not. She chose not to have reconstruction.


“Basically, I considered having breasts — which in our society are viewed as more sexually attractive. I could wear lower cut clothing, regular bathing suits, and regular bras, without the fear of my bra riding up.


“But I did not want any more unnecessary surgery. Saline implants involve not only the initial surgery, but very likely more surgery down the road if there is hardening, scar tissue, or leakage. The reconstructed breasts would not look the same as my natural breasts. Flap reconstruction involves much more surgery than that, and I was not willing to consider the pain, the risks of infection, nor the scarring. (Although I did think the tram flap tummy tuck might be a nice option.) I felt reconstruction of any type would make detection much more difficult.”


Breast Reconstruction or Not: Bilateral Mastectomies with Reconstruction


Pamela S. from California


Pamela had prophylactic bilateral subcutaneous mastectomies over a decade ago. A subcutaneous mastectomy is a skin-sparing surgery where the nipple is left intact and as much of the skin as possible is preserved.


“As a woman in my thirties with no evidence of disease, the only option to me (other than doing nothing) was subcutaneous mastectomy, with the simultaneous placement of a prosthetic under the major pectoralis muscle.


“While I was mulling over whether to get breast reconstruction or not, I got multiple second opinions and researched my options in depth. My plastic surgeon shared his expertise and showed me the results of other patients who had had the procedure. My husband, who is an orthopedic surgeon, was very helpful in the clinical aspects of decision-making and supportive in the emotional aspects.”


More than ten years later, Pamela says: “My concern at the time of my surgery was the cosmetic result. It turns out, I had a very good result. Unless I share my experience, no one would ever know I’ve had mastectomies with reconstruction.”


Making the Decision to Have Breast Reconstruction or Not

As you can see, there are lots of practical and emotional reasons for choosing or not choosing reconstruction. It’s a deeply personal decision. The only “right” choice is one that feels right to you in your particular circumstances.


We’re Here to Help You Decide

If you choose not to have breast reconstruction at all, Amoena breast forms are  a great solution for you. If you go the other way but find that after reconstruction, if you still need a little help with balance and symmetry, Amoena is here.