I am not sure I understand the question. Are you asking whether to have both removed at the same time, or one at a time?

I had one mastectomy on the first but my surgeon promised to do the other one if I handled it well (I have other health issues). We have a legal right to symmetry, yes, but my other breast also felt funny. Sure enough it was full of cysts and had atypical dysplasia so was glad I did it.

I did not have any reconstruction so my surgeries were easy and I like "going flat." But that's me.