No Breast Reconstruction: Why Going Flat May Be Your Only Choice | I'm Taking Charge

No Breast Reconstruction: Why Going Flat May Be Your Only Choice

No Breast Reconstruction: Why Going Flat May Be Your Only Choice

It’s likely that you’ve already heard about breast reconstruction. Our blog does discuss it quite a bit, after all. You may have even talked to your cancer team about it. But what if they say “no breast reconstruction for you”? When so many other women can get breast reconstruction, why are you unable to? Unfortunately, reconstruction isn’t an option for everyone. And in this article, we will help you understand why that may be.

A Quick Primer on Breast Reconstruction

no breast reconstruction


First, let’s start with a quick explanation of what breast reconstruction is. The procedure reconstructs the breast you lost during a mastectomy. It uses a breast implant or tissue from other areas of the body. The latter procedure is also known as autologous reconstruction.


You can also choose between delayed and immediate reconstruction. Delayed breast reconstruction occurs after you’ve received a mastectomy. It is most often done within six to 12 months of your mastectomy. But you can also receive delayed reconstruction several years after your initial mastectomy.


Meanwhile, surgeons perform immediate reconstruction at the same time as your mastectomy. Plastic surgeons first remove the cancerous tissue in your breast. Then, they insert either an implant, tissue from part of the body, or a tissue expander.

Making a Choice About Reconstruction

no breast reconstruction


The first choice you need to make about breast reconstruction is whether you want it. This may seem simple enough, but it can be difficult. You can talk to friends, family, and professionals about your decision. But at the end of the day, your choice is your own.


You need to be happy with your decision.


If you do decide to get reconstruction, you have to decide which type you want. Depending on your situation, your options are limited. These limitations are due to your health insurance or your health.


Fortunately, there are plenty of tools to help you make this decision. Lots of studies have looked into the success rates and happiness of various types of breast reconstruction. And there’s even an app to help you choose the best breast reconstruction option for you.

Factors Affecting Breast Reconstruction Candidacy

With so many reconstruction options, how is it possible that you aren’t a candidate? Well, there are several things that affect your candidacy. These include overall health, body size, and smoking history, among other things.

Overall Health

no breast cancer

All forms of breast reconstruction need some sort of surgery. For this reason, there is an inherent level of risk involved. If you are not healthy enough to handle surgery, you may not be a candidate for breast reconstruction.


Various autoimmune diseases and diabetes increase the risk that your wounds won’t heal. Or that they may become infected. Further, clotting disorders increase your risk of postoperative bleeding.


Either way, health concerns that increase your risk of complications after surgery can keep you from being a good candidate.


Many studies have linked smoking to increased problems following breast reconstruction. These issues result from nicotine’s effect on the blood vessels.


When exposed to nicotine, the blood vessels in the body constrict. This limits blood flow to the breast skin and other tissues. And lower blood flow increases the risk of infection and healing problems.

It’s important to note that nicotine is in chewing tobacco and some non-smoking patches and gum. So, even if you are trying to quit, you may not be a good candidate for breast reconstruction.


But there are other medications to help you quit smoking. And, once you have stopped smoking, breast reconstruction may become an option again.

Breast Cancer Treatment

no breast reconstruction

It may seem unfair, but your breast cancer treatment may prevent you from getting breast reconstruction.


Treatment is always the first priority when you have breast cancer. Yet certain types of treatment can limit your breast reconstruction options.


In some cases, these treatments may delay your ability to get breast reconstruction. This occurs because of how your wound reacts to certain treatments. Meanwhile, some treatments remove various types of reconstruction from your list of options.


Breast cancer treatment does not usually cut reconstruction as a choice completely, though.

Body Mass Index

no breast reconstruction

Most of us already know what body mass index, or BMI, refers to. It’s a measurement relating weight to height. Those with a BMI higher than 25 are overweight. And those with BMIs under 18.5 are underweight.


BMI isn’t the best guide for measuring weight in relation to height. This is because muscle is heavier than fat. So if you have a large amount of muscle, your BMI may be higher.


Still, it serves as a guide for women looking into breast reconstruction.


Women with a low BMI often cannot undergo autologous reconstruction. This is because they often lack the extra tissue needed in other areas of the body.


Those with a BMI over 30 may not get the aesthetic results they want after reconstruction. They are also more likely to have healing problems or experience fat necrosis.

Surgical History

Finally, you may not be a good candidate for reconstruction if you’ve had certain surgeries in the past.


Liposuction and tummy tucks often prevent women from undergoing TRAM, SIEA, or DIEP flap procedures. All these procedures use tissue from the abdomen. Other procedures can be limited if you’ve had chest surgery before. Or if you had a thigh lift or vascular bypass surgery in the thighs.


Fortunately, these are all individual. Women with a surgical history are not always prevented from undergoing breast reconstruction.


So, No Breast Reconstruction. What Now?

This is when you can benefit from the support of other women who are going flat. We’ve chosen to focus on the topic of going flat this month, and are happy to offer the thoughts of several women who have gone flat: Rebecca Pine and Clover Lewis. If you’re already thinking about prosthetics, you might appreciate our very popular post about the Knitted Knockers breast prosthetics.


Dealing with breast cancer, mastectomy, or breast reconstruction? Join our conversation on Facebook, or check out our Pinterest and Instagram sites. Take care!



One Comment

  1. Avatar
    Adrienne January 30, 2018 at 7:22 pm - Reply

    I have to say that, I have heard more and more women testifying that “going flat” after mastectomy has been quite a freeing experience!

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About the Author:

Jessica Henslee
Jessica is a powerful breast cancer fact-finder. When our team puts a question before her, she can turn up the answer. As such, she has been the engine behind many of our most informative articles—providing women with the answers they need to the questions they’re asking.If you were to meet Jessica in her day-to-day life, you’d probably notice her wearing black and listening to music. She says if you want to get her something special, she’ll take a fancy cheese platter over flowers any day! She also has a special love for corn flakes and oatmeal raisin cookies.