"From the moment I was diagnosed, I was pretty certain of my surgery choice and reconstruction method. I felt it was best for me in my circumstances, and thus far, it certainly has been. I chose a bilateral mastectomy with immediate tissue expander placement. I had those exchanged for 'gummy' implants several months later. Here were my reasons:
"1. I was very small breasted. If you took the lump, you pretty much were taking the whole thing, so a lumpectomy was not much of an option. I also preferred to avoid radiation. I hope to avoid a recurrence, but if one does happen, I want as many treatment options available to me as possible to address it. This keeps radiation as an option for me should a recurrence happen.
"2. I was 44 and have a family history of breast cancer, so I wanted both to go. Even though there was not cancer in the other breast, I'd already had a biopsy on a suspicious lump a few years prior. I wanted to minimize my chance of a recurrence. Hence the bilateral mastectomy. I also did not want one tiny sagging breast, and one perky breast. I wanted a matched set that would age together.
"3. I am quite thin, so the flap surgeries were not an option for me. Even if they were, the muscles they have to cut in those procedures caused me worry. I am a firefighter/paramedic, and I need to be strong and flexible. I wanted to minimize my risk of range of motion issues.
"4. My plastic surgeon told me that these implants would be very durable and hold up well given my line of work. If anything happened or went wrong and there was a rupture, the implant could easily be replaced.
"5. I had nipple reconstruction and areola tattoos which look great. I also had fat grafting. The fat grafting is the only area I would not do, if I could choose it all again.
"I had my skin-sparing bilateral mastectomy in August 2013, my exchange in January 2014, nipple reconstruction and fat grafting in April 2014, and tattoos in September 2014. I am thrilled with the results. I am a runner and have found them very comfortable, even on long runs. I also have no problems with the implants under my airpack at work (a prosthesis would not have worked well, so implants were a better option). I look really good in both clothes and a bathing suit. I can wear a bra if I want or choose to skip wearing one. I would not do the fat grafting again. I developed lumps afterwards. Though they are not fat necrosis, biopsy results simply indicated inflammation. The presence of the lumps makes me nervous about being able to detect new lumps. I was told before the surgery that developing lumps was rare, but am told now that it is very common. It's been a long road, but I am thrilled with how everything looks. I went for a second opinion on the lumps and the place I went, who had never seen me before, said that I look like someone who has had a breast augmentation, and not like someone who had a mastectomy...which was a great compliment."
-- KBeee, implant reconstruction with nipple reconstruction