Survivor Voices: What Factors Influenced Reconstruction

How do you make a decision?

Create a pros and cons list? Flip a coin? Call a friend? Trust your gut?

When it comes to deciding what to do following surgery for breast cancer, the stakes start to climb. Add additional factors, such as radiation-burned skin, a short window of time to make a decision, and/or insurance coverage, and the stress and anxiety can build.

So how does one make that decision? We asked Firefly participants to share the factors that went into their own reconstruction decisions. Here are their stories:

• “I am (very young and) active and have a long life ahead of me. I wanted to feel and look as normal as possible, and move past my cancer as best as I could. For me, that meant reconstruction with expanders. (My) plastic surgeon explained the entire process and I had met some ladies who were on the other side of the reconstruction process so I felt I was well-prepared for that choice. I have had an amazing outcome and am so happy with my decision.”
• “I had a double mastectomy and couldn’t have immediate reconstruction because I had radiation post-surgery, followed by 2 years of on-and-off lymphodema.  Just recently—three years from my mastectomy—I am exploring reconstruction options.  It’s not body image, but clothes do not fit right.  The prosthesis isn’t comfortable, nor are the bras that hold them.  I’d have a way faster get-ready time, feel better in my clothes and be able to free myself from that aspect of recovery.”
• “I elected to not have reconstruction after my bilateral mastectomy. Prior to cancer, whenever I thought about breast augmentation or reduction, I knew it was not for me. I wanted whoever I was to be “OK“ and not feel that I wasn’t OK without some form of surgery. So when I found I had cancer, I knew reconstruction was not for me. Flat is what would be “me” and I needed that to be OK.”
• “I chose reconstruction with expanders because my children were under the age of 4 years (that magical age when our memories start) and I knew that they wouldn’t remember all that happened during that terrible year following my diagnosis. I wanted to look normal to them and then be able to choose at what point I shared that awful part of my life with them. Being extremely small-chested, I chose implants that are much bigger and I feel very good about my choice—I feel more feminine and attractive than had I chosen to stay the same size.”
• “I wanted reconstruction to put my body back to whole as much as possible. I did a lot of research online, talked to surgeons, got multiple perspectives from other breast cancer survivors and the Firefly Sisterhood match I was paired with. I took over two months to decide what to do and what would be best for me. My reconstruction choice was for me first and foremost, for my husband (I joke that every time I swap out the implants I will go bigger to keep him around), and to keep my professional work appearance and to still look nice in my current clothing. I just wanted to be the same size, same everything, after all of this was done.”
• “After a long year from diagnosis to lumpectomy to chemotherapy and radiation, I thought I was finally done. Not so.  More lumps appeared on my mammogram, and the whole mental anguish returned but far more intense. So I requested a mastectomy which we did with reconstruction at the same time. I decided on the smallest implants at the suggestion of my friend who warned that without them, I would forever look in the mirror or be dressing and be reminded of the cancer. I can say now that I like my breasts and they look very natural and make me still feel like a woman. As a “tough broad,” I didn’t think I was carrying a lot of fear and anxiety, but upon recovery, I notice that a huge weight was lifted from my shoulders.”
• “I was diagnosed with breast cancer while very young. I ultimately chose to pursue reconstruction for the sole reason that I wanted to feel as “normal” as I could after cancer. I wanted to feel like “me” again.  I knew that reconstruction was the one part of this journey that I had some control over. I just had my bilateral mastectomy 7 days ago along with phase 1 of my reconstruction. Even though I only have tissue expanders in at this point, I think waking up from surgery and having something that resembled the shape of my breasts there in their place helped with the shock of the whole situation.”

For more information and pictures of reconstruction options, view the FORCE (Facing Our Risk of Cancer Empowered) post-mastectomy photo gallery or their Breast Reconstruction Options webinar.

If you are facing a similar decision—trying to decide what to do following surgery for breast cancer—Firefly is here to help. We’ll match you with one or several Guides that match your options so that you can hear the many sides of the reconstructions story before making your own informed decision.

A huge thank you to the women who bravely shared their stories for this blog. Real stories involving real women making very real choices about their bodies. At Firefly, we are humbled by these personal narratives and share them with great reverence.

Written and compiled by Amy Tix, Firefly Staffer and breast cancer survivor, who felt the need to reconstruct so that her children (toddlers at the time) would see her as whole as they grew up, too young to remember their mom’s breast cancer experience.