Breast cancer: choosing no reconstruction

Nowadays breast cancer and all the topics that are related to it, like the feelings of shame regarding the effects on the body or the aesthetic choice about a reconstruction operation, are always more discussed. A recent article published by Breastcancer.org entitled “Going Flat”, for example, talks about the possibility for the women that survived this disease to not start the way of the beauty surgery.

Indeed while most women choose to have some type of reconstruction, some women don’t want to have additional surgery. Many women and doctors call this “going flat” or “living flat”. A 2014 study found that about 56% of women had reconstruction after mastectomy, which means that 44% didn’t have reconstruction. Women who choose not to reconstruct may do so for a number of reasons, like health issues, concerns about cost or concerns about losing muscle strength.

The decision to reconstruct or not is very personal. Some women who want no reconstruction say that they’ve felt pressured by their doctors or family members to have reconstruction. Studies from the American Society of Plastic Surgeons have found that more than 70% of women aren’t fully informed about their reconstructive options before mastectomy.

Recovering from a mastectomy with no reconstruction is generally easier than recovering from mastectomy with reconstruction. Generally, immediate reconstruction does lead to the most cosmetically pleasing results. If you choose delayed reconstruction — reconstruction 6 or 12 months or more after mastectomy — your recovery from mastectomy should be a bit easier. If you’re not having reconstruction after mastectomy there are some aesthetic issues to consider. Some women may end up with what are called “dog ears” under their arm. These are pockets of fat left behind after mastectomy. Also, if an incision ends abruptly, a “tab” of skin and/or fat may form a bulge at the end of the scar or under the incision. Most women prefer scars that lie flat, leaving their chest fairly smooth.

For a number of women, breasts are an important erogenous zone. They may be worried that the loss of the nipple and some of the feeling in the breast area may change sex life for the worse. They might worry that their partner will not able to prove attraction with only one or no breasts.

What do partners of breast cancer patients care most about? Studies show that the answer is simply this: Their loved one is alive and feeling well and the loss or alteration of a breast is almost meaningless in contrast. “I don’t care what they take from you as long as I can see your face” is a common sentiment. Most caring partners see their lovers as having many parts to love and as being more than the sum of those parts. Sex after mastectomy with no reconstruction can be just as fulfilling as it was before surgery.

Matteo Nunner

Graduated in Literature at the University of Eastern Piedmont, he's now studying anthropological and ethnological science at the University of Milano-Bicocca. Journalist and writer, he collaborated with many local newspapers and in the 2015 he published his first book "Qui non arriva la pioggia". In the 2017 published "Il peccato armeno, ovvero la binarietà del male".

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