I was dx TNBC and BRCA2+ in left breast and was told high rate of recurrence in the other breast, so decided bilateral mastectomy. I was 69 when surgery was going to be performed and had been married for about 40 years - saw no need to have implants or any additional surgeries - so I went flat. I did decide to get the prothesis - which are covered by my insurance. I only wear the prothesis when I want shaping. I also knitted myself some "knockers" which provide shaping without the added weight - great for the summer months. I think if I had been younger when I received the dx my decision might have been different regarding the implants - but I probably would still have had the bilateral performed due to the high recurrence rate in the second breast.

My only "issue" would be my definition and the surgeon's definition of flat. My chest is not as flat as I would have liked - when I went for prothesis and bra fitting, the assistant asked when I was having my implant surgery. I have some, not a lot, but some excess skin and some areas that cave-in more than others. Maybe it would have been different if I'd taken in a picture (so surgeon would be able to comment whether it was possible), could also be that I had gained some weight over my treatment journey and my expectations were unrealistic because of the weight gain. But would I change the bilateral and going flat - nope, the decision still would have been the same.

Best of luck when, if you must make the decision.