Double or single mastectomy?

I preferred having no breasts to having one, and like going flat. The second, non-cancer breast had some atypical hyperplasia, as it turned out.

I was diagnosed with TNBC Dec 2019. Only one breast was involved, with benign lump in the other. I had a dear friend who chose to do a single mastectomy, only to go back years later to remove the other with reconstruction following. Her experience directly affected my choices. I opted for a double mastectomy with a DIEP flap reconstruction. I am so thankful I chose this direction (for many reasons). I am in my late 50’s. Hope this helps.

@toomanyquestions, @windyshores
I wound up having both breasts removed and going flat and haven't once regretted doing this. Having one side larger than the other would require adjustments in bras so I would look even. I use front-closing bras now that are soft...I call them my "training bras." Now I can also go braless if I want to...ah, freedom!

My experience would recommend that you absolutely do the double. I've never had a second thought about it. A friend of mine had only one side removed and she is deeply regretting it. Legally, insurance MUST cover both even if one is prophylactic (sp?). I also went flat--the idea of inserting something foreign in my body just for looks alone felt alien to who I am. I have not had regrets about either decision. It does mean some wardrobe adjustments, for sure--probably more for you than for me since I was a smaller bust size than you've shared. But that adjustment comes with the freeing knowledge that there's not another mastectomy lurking in my future. There's a private FaceBook group called Flatties Unite, and some other online resources I consulted at the time of my decision in October of 2021 that helped me know I was not alone (or weird!) in choosing as I did. One of my lopsided breast cancer survivor friends said that NO ONE in her medical interactions before surgery ever mentioned the possibility of a biateral and she's now having great regrets over dealing with the lopsided situation. But I know others who have never mentioned regrets about their lumpectomies or singles even after having to have further surgeries. I guess no matter what you choose, you have some kind of a price to pay, whether those are mental (self-conception and wardrobe adjustments), or physical (continuing surgeries for reconstruction and other hassles or complications)!

I opted for double without much thoughts. Wanted the peace of mind. Just turned 46, I am awaiting reconstruction. I think whether you decide to go flat or reconstruct, it would be easier to have both looking the same and the big plus is ensuring you did your best to eliminate the chance of having cancer in the other breast.

You can do one and then do the other. You don't have to do both at once. The second one is still covered because you have legal right to symmetry. It's an option. I did it that way because I have an autoimmune condition and docs wanted to see how I did with one.

Thank you so much. This is so helpful. How long after the first mastectomy did you have the second one. How did the recovery for each surgery go? Were they similar?

I just had unilateral mastectomy on November 14th. Barely any pain. No narcotics. My husband did the drains. Negative 6 sentinel nodes. I chose one as I didn't know how invasive the surgery was. Thinking of removing the second next year.

@toomanyquestions I think it was Feb. and June but not sure. Might have been April for the second one. Recovery was similar for both, not that difficult.

I had a paravertebral block both times but the first time they still gave me dilaudid and I vomited a lot. Second time I was very vocal about NOT giving me pain meds and I felt fine after surgery.

Looking back.....The better decision for me would have been a bilateral back in 2007. All these many years of 2-3 hours mammos every 6 months + 10 years of Arimidex have injured me more Physically and Mentally. No matter, what IF I had to do it all over I would consult a plastic surgeon to be involved During any surgery. Since this is a recurrence I will not have reconstruction, Me and anesthesia are not worth having girl bumps. I Love the comments from flat chested, my question to them is how many years before all the swelling, fluid is truly gone and you are no longer lumpy and numb?