If you haven’t thought it yet, at some point in your breast cancer journey you’re likely to come across the thought, “Isn’t it enough that I’m alive?” Yes. You’re alive! Absolutely, that’s more than enough to celebrate. Every single day you will have new hugs, new conversations, and new treasured moments that make being alive absolutely enough. BUT… it’s also okay to have dreams beyond survival. That’s why we’re having this conversation about breast reconstruction after mastectomy. What you dream of in the days and years that spread out beyond a breast cancer diagnosis is up to you. What do you hope for? What do you long for? And does your shape matter to you in the midst of those dreams?

4 Questions that Matter

Let’s look at some appropriate questions to begin to ask yourself right now:

How will I feel in front of the mirror every day with or without breast reconstruction?
How will I feel with my partner with or without breast reconstruction?
How will my activities, such as exercise, impact my choice of breast reconstruction?
How important are my breasts to my sense of femininity?

Your answers to these questions may change over time, and that’s one reason why delayed breast reconstruction exists. However, you should begin asking yourself these questions as soon as possible, since some of the best reconstructive options exist only at the time of mastectomy.

Option 1: Going Flat

Some women, no matter how they enjoyed their natural breasts in the past, do not feel any great desire for breast reconstruction after mastectomy. These women may be very physically active women and don’t relish pausing life for more surgeries or the potential complications. Or they may have reached a stage in their life where the way they look without their clothing isn’t so important to them anymore. Perhaps they choose a custom prosthetic, which gives them the look they want non-surgically when out and about.

Others take breast cancer as an opportunity to take a stance in society. These women relish the opportunity to prove to the world that women are more than their breasts. Going flat may become a point of pride for women making this point.

The fact is that some women go flat, love it, and have no regrets. When they answer the questions mentioned above, in each case they come to the conclusion, “I’d be okay without my breast(s).” If you find yourself answering the same way, then maybe breast reconstruction isn’t for you. You alone can know how to answer these questions.

Option 2: Breast Reconstruction After Mastectomy

Other women, however, feel differently. The thought of looking in the mirror without their breasts may fill them with a tremendous sense of loss. Or maybe it’s thinking about the intimate times they’ve spent with their partner enjoying the shape of their breasts. Or just the feeling that their breasts have always been a display and symbol of their femininity.

Some women discuss how their breasts represent the mother they’ve been and the thought of not seeing that shape is unthinkable. Others talk about wanting to date again and not wanting to take off a prosthetic just as things are heating up. Still other women merely defiantly state that they’re not letting cancer run off with any body part that’s rightfully theirs.

These are deeply personal feelings, which one can neither “logic away” nor defend. They simply are. And not one of these feelings are selfish, superficial, or foolish. They may be more than enough reason for many women to choose breast reconstruction.

What Breast Reconstruction Is and Isn’t

Breast reconstruction is a chance to take ownership of your body and determine how you wish to present yourself (rather than letting cancer determine that for you). It can be deeply empowering, but it can also be hard. It’s surgery, after all. It can go perfectly, or there can be complications. That’s why it’s important to understand what it will or will not do for you.

Reconstruction does not make breast cancer better or worse. It does not make it harder to find future cancer recurrences, but it doesn’t make it easier either. It does not “erase” your past cancer, and you will still find yourself thinking about breast cancer and your risk for recurrence years later. That will be a feeling you will have to learn to make peace with.

Breast reconstruction after mastectomy is not a “free boob job.” It will not simply augment your old breasts, because your old breasts are gone. No matter what happens, you will likely find a need to mourn those former breasts, with all their touch sensitivity, and their unique texture and feeling. Most of the time, women will hold very little sensation in their reconstructed breasts, but that can vary woman to woman.

However, breast reconstruction can give you new breasts—new breasts with different textures and feelings. The results can be stunning, and you may find yourself able to confidently take off your shirt, enjoying the view of your new breasts. Alternatively, no matter how much you appreciate your new breasts, mastectomy scars may still remind you of a loss. These are all normal feelings, and feelings to consider before you begin your breast reconstruction journey.

Back to Our Guiding Questions

How will I feel in front of the mirror every day with or without breast reconstruction?
How will I feel with my partner with or without breast reconstruction?
How will my activities, such as exercise, impact my choice of breast reconstruction?
How important are my breasts to my sense of femininity?

No one can answer these questions for you, but you can read the stories of other women who’ve made their own breast reconstruction choices. Perhaps you will see a bit of yourself in them. Then make your choice and be proud of it. If breast reconstruction after mastectomy is on the table for you, start by exploring Breast Reconstruction 101 or skip to your Breast Reconstruction Options. Make sure you also take the time to understand what life Going Flat might look like.