Editor: Going flat after mastectomy is a decision that skews towards the older patient population. After age 60, close to four out of five women forgo reconstruction. Oftentimes, as with Sindee’s case, it’s because the risks of additional surgeries outweigh any cosmetic benefit, due to slower healing simply because of the woman’s age (Sindee was 60yo), and/or co-existing health conditions that affect surgical risk such as diabetes (as with Sindee) or heart conditions, which are more common in older women. The harm of flat denial being inflicted on these older women is especially great, because of the double bind that their remaining years are likely shorter than that of a younger patient, AND they are less able to pursue revision surgery.
My first surgeon, a woman at CINJ Rutgers New Brunswick NJ, kept pushing me to get a lumpectomy and reduction [Editor’s note: with a lumpectomy, it is often an option to surgically reduce the opposite breast to “match” to improve the cosmetic result]. I kept telling her no. Mastectomy and flat. NO revision. I was 60 and definitely not being swayed! She knew I was overwhelmed.
She mentioned twice about leaving the side fat flap. I said as long as I’m flat after. Triple negative [Editor: “triple negative” is a subtype of breast cancer that has fewer treatment options and the worst prognosis of all subtypes] was scary as hell! I awoke from surgery with dog ears and a full blob of skin under my very odd looking mastectomy. I changed surgeons for my prophylactic second mastectomy. But I had 25 radiation treatments so now I’m not able to even fix her mess.
[Editor: irradiated tissue is forever compromised from scarring, and can have problems healing after surgery – this is one reason why many women choose to go flat in one surgery, to avoid operating on irradiated tissue, and when that choice is taken away it changes the risk profile of revision surgery such that many women are forced to wait years to get their bad result “fixed.” And many women end up not getting a revision surgery at all due to the increased risk.]
My new surgeon made me flat as requested. So I’m pissed I have one mini maimed Boobette and one great flat one. My oncologist said just last week to wait a few years and hopefully, I’ll be able to get my left baby Boobette flatter. But more surgery is upsetting. I have type 2 Diabetes so always a bigger risk post op.