23/02/2018 2:29 PM IST | Updated 23/02/2018 5:22 PM IST

Mastectomy Always Means Reconstruction, Right? Wrong, Actually

"I’ve discovered that I don’t need breasts to feel like a woman."

Sue Lacey Photography

I was diagnosed with breast cancer in January 2016 at the age of 54, and was quickly told that I needed a left mastectomy.

Why is it assumed that all women will want to have reconstruction? One reason could be that the medical professionals think that we all want to look exactly like we did before our surgeries, and that our breasts define us as women.

After being told that I was going to have my left breast cut off, I was shown some gruesome after and after photos. I think they were actually called before and after, but I like to think of them as after mastectomy – numb, flat chested with no nipples – and after reconstruction – numb, breast shaped chest with no nipples.

My extremely kind and caring breast care nurse assumed that I would want to undergo breast reconstruction because that’s what everyone does, and I agreed that that is what I would do... because I knew no different and was not given any information to let me know that there was another option – no reconstruction.

It turned out that the only reconstruction option open to me was the DIEP flap procedure, or tummy tuck as it was sold to me. I was so lucky as I would definitely go down a jeans size after the 8-hour operation, which would leave me with a hip to hip scar and a “breast” fashioned out of my own fat from my stomach.

I would have to have delayed reconstruction because I was expected to have radiotherapy and they couldn’t do surgery until a year after my last session. So, I would be living as a uniboober for at least 18 months – this would be interesting for someone whose remaining breast was a GG cup. As it turns out, the enforced delay was a gift.

Fast forward to a few days later. Doubts had been growing in my mind about whether I really wanted to undergo such a long procedure and recovery. I thought that reconstruction was the only option. Why wouldn’t I? I hadn’t been given any other choice.

I want to advocate for the right of woman to be given all of the options after a mastectomy, including the option to remain flat. And I want to increase the visibility of women who choose to live flat


I remember having one of those light bulb moments after Googling “does anyone not have breast reconstruction after mastectomy”. I found the Flat Friends website, and felt that I had found some kindred spirits. There were women out there who had chosen not to have reconstruction and were living happily as uniboobers or completely flat.

This was a revelation to me and I knew that this was the route I would go down. The more I Googled, the more I saw photos of flat and semi flat women. These photos were far less shocking to me than the after photos that I’d been showed in clinic. It was wonderful to interact with women who felt the same as me and to know that I wasn’t a freak for wanting to live without a replacement breast.

March 17th 2016 – the date of my left mastectomy. My surgeon had rejected my idea of a bilateral mastectomy, so I woke up after the operation as a uniboober... and I hated it. I hated that I’d had my breast removed, and I hated that I was now so lopsided and would still have to wear a bra with a fake breast in the other cup. Once my scar had healed, I got used to my large silicone breast and wore it every day. It was so funny to take my bra off with my breast attached to it at the end of the day – it certainly made a thud as it hit the floor!

Still, I couldn’t get the thought of a contralateral prophylactic mastectomy (CPM) out of my mind, and I mentioned it to my surgeon at every check-up. He was clearly loth to remove a healthy breast but once I started to use the symmetry argument, he became more open to the idea.

At my annual check-up, I asked him whether he thought it fair that I should have to go through the rest of my life so lopsided. I think he realised that I was serious and rational. He agreed that he would perform the CPM but that I had to talk to a phycologist first to make sure that I wasn’t mad. This seemed a small price to pay, but I did, and do, wonder why women who opt for reconstruction don’t have to see a shrink too?

November 9th 2017 – the date of my second mastectomy. What I haven’t mentioned is that I’m terrified of having operations, and I’d already been forced to have two. My decision to have an elective operation is one of the bravest things I’ve ever done. It turned out to be one of the best things that I’ve ever done! Having lost one breast to cancer, I had decided to face my fear and have the other one removed – I found that to be very empowering.

I’m so happy with my new shape – I feel as though I have the body that I always should have had. I feel confident, brave and strong. This is not to say that there are no down sides. There definitely are... I’m numb under both of my arms and over most of my chest, I have excess folds of skin under both my arms and I have strange aches and pains and sometimes flashes of pain. But these are nothing compared with the joy of never having to wear a bra again if I don’t want to and, if I do, to be able to choose the size I’d like to wear. I’m thinking a C cup!

I’m trying to embrace my new life after cancer. I feel that I have made the best of a pretty bad situation and taken control of how I want to live. I want to advocate for the right of woman to be given all of the options after a mastectomy, including the option to remain flat. And I want to increase the visibility of women who choose to live flat. I’ve discovered that I don’t need breasts to feel like a woman. I think that I look pretty darned great topless – a little different to the norm, but great nonetheless.

For more on Juliet, visit her blog here