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Single or Double Mastectomy

Rhonda Mohr
Posts: 7
Joined: Mar 2012

Hello. I am a new member recently diagnosed with DCIS in the right breast. It is in more than one location so I have to have a mastectomy. I just saw the plastic surgeon and we discussed reconstruction. I am not eligible to have reconstruction because I am very overweight. I will need to lose at least 70 pounds to be eligible for the surgery. If I can lose the weight it will take me at least a year and then I have to go through more surgery for the reconstruction. I have VERY large breasts. If I have one mastectomy the breast form I will need will be heavy, sweaty and uncomfortable. I think. Plus I'm not sure how happy I am going to be with one huge saggy breast and one total flat side of my chest. Now I am thinking of having both breasts removed so I can wear smaller (D cup) breast forms. I will me much more comfortable as I try to lose weight and hope for reconstruction. I am 56 years old, am not vain, but I am human. Any advice or comments for me?

jessiesmom1's picture
Posts: 874
Joined: Jun 2010

Hi Rhonda, and welcome to the Boards. Two years ago I was 52 when I was diagnosed with cancer in my right breast -Stage IIa, grade 3. I too was overweight and wore a very full DD cup bra. Before my mastectomy surgery I met with a plastic surgeon to discuss my options. He never suggested that I have a double mastectomy nor did my general surgeon or oncologist. It never even occurred to me to have a double since there was no real medical reason for me to do so. Being overweight makes any surgery a bit more challenging but we decided to have a tissue expander put in at the time of the mastectomy and have it exchanged for an implant after I was through with all treatment. I had the right mastectomy then had 16 rounds of chemo. No radiation. No hormone treatments as I am triple negative.

I was indeed lopsided after the surgery but it wasn't particularly uncomfortable. I wore loose fitting shirts and unless someone stared right at my chest they probably didn't notice too much (or so I would like to think). I needed only 1 saline fill of the expander and then I had the exchange surgery. At the same time I had a reduction/lift on the left side. That side looked very good. It was so strange to be so much smaller but I was pleased. I was not pleased about how the reconstructed side looked and eventually had it re-done by a different surgeon. I consulted 3 other surgeons before having the revision-reconstruction done. None suggested that I shouldn't have had it done because of my weight. It now looks much better. I am now a C cup. The "girls" are firm and as perky as they were when I was 17. My 19 year old daughter is jealous.

I certainly don't look like I did prior to the reconstruction but I can wear most types of clothes that I want to wear and buy bras off the rack. I just wanted to look more female and less like a cancer patient. Who needs that lopsided reminder every day? I have plenty of other reminders. I have found that there is a substantial difference between the skill levels of plastic surgeons. Just because one surgeon is unwilling or unable to do a procedure does not mean another surgeon won't have the skills to do something. I think you should consult another plastic surgeon to determine what your reconstruction options might be. If the consensus of opinion is that you should have a double mastectomy then so be it. If you are not a reconstruction candidate then you will live with that, too. Just be completely informed.

Let us know what you decide to do. Good luck.


teresa41's picture
Posts: 468
Joined: Jun 2009

i had a lumpectomy on my left side in 2009 a year later i was diagnosed with breast cancer on the right side i had a masectomy i was big busted a E i made the choice to have a masectomy on the left side to i was lopsided and i didnt want one big boob hanging i was glad i did it. i was also told by a plastic surgeon that i was to over weight for reconstruction she told me i needed to drop 50 pounds. i just had the latissimus dorsi reconstruction in jan and i never lost the weight i found another surgeon that did the surgery it was 5 hours and i did just fine . i would check around with other plastic surgeons they are all different.

wishing you the best


Posts: 3660
Joined: Aug 2009

I was not eligible for recon at time of surgery because I'm IBC. It was a year before it was an option according to all my Drs. Honestly, I'm glad I didn't have to think about it as I had issues with seroma and bad rad burns. I was 63 when DX'd and had a single mod. rad. mast.

I have thought about recon and have had 2 different appts scheduled but last winter something came up (don't remember now what) so I canceled that one and had one scheduled for this winter but developed cataracts so had to take care of that surgery. I'm not going to use any part of my spring/summer/early fall for elective surgery so I might look into recon next winter if nothing else comes up. As while he will support me if I want recon, Hubby of 36 yrs would rather I not have unnecessary surgery.

I don't have any problems with my pros being heavy feeling, sweaty or uncomfortable at all. Actually I basically never think about it. I'm a 36 D.

Heatherbelle's picture
Posts: 1227
Joined: Jun 2010

Hi Rhonda,
When i was diagnosed in 2010, i had a tumor in my right breast. I was 34. I also consulted a plastic surgeon before deciding on what surgery to have, and i ultimately decided to have a double. I decided to go with a double for two reasons, 1- peace of mind that it wont eventually come back in the other breast, and 2- cosmetically it would just look better having both removed and reconstructed. I'm close to 2 years post surgery, and I couldnt be happier with my results. I have silicone implants, but i believe you can achieve a bigger size if you go with saline implants. The largest size you can get with silicone is 800cc, which are pretty big around, but they dont have the "projection" like you would think, because i have no breast tissue , just implants. I know it's a hard decision, best of luck to you L(

Rhonda Mohr
Posts: 7
Joined: Mar 2012

Thanks for your helpful comments ladies. I've decided on a bilateral both for preventative and cosmetic reasons. I was diagnosed on March 1st but because of a very large hemotoma (blood clot and full bruising of the breast) I have to wait until April 3rd for surgery. Now my mind is just spinning on domesday senarios...are my ovaries in danger? Is the pain in my shoulder really bone cancer (I know...silly!). Any hints on how to just survive the weeks until you know more details from surgery and pathology?

Heatherbelle's picture
Posts: 1227
Joined: Jun 2010

xanax. Im sure your doctor would prescribe you something for the waiting anxiety to help get you through it.
And its completely normal to fear every little ache and pain, most of us do, and that's something that will abide a little more and more, the more time goes by. I also had about a month wait from diagnosis until surgery, due to scheduling difficulties (had to get my breast surgeon and my plastic surgeon to sync their schedules so they could both be there at the same time).
Take it one day at a time, and fill your days with fun things that you enjoy, and come here to the boards, ask all your questions, read through the posts, and find comfort :)

butterflylvr's picture
Posts: 944
Joined: Apr 2011

I too was overweight and big busted. I had IDC my left breast only but opted to remove them both for the exact same reasons Heather mentioned above. My plastic surgeon didn't hesitate with immediate reconstruction. If your Plastic surgeon is telling you to lose the weight before surgery seek a second opinion. Keep in mind implants only cover a certain circumference of the chest wall. My implants are currently in place but I need a little bitl of fat grafting around near the armpit area and they should be fine. I went from a DD before cancer to a C cup implant size. I love my small girls...

Best of luck as you continue your journey to getting well,

Posts: 1
Joined: Mar 2012

I understand exactly how you feel. I was diagnosed in 2009 and waited 4 weeks for my surgical team. It was an eternity, but well worth the wait. I had Paget's of the nipple areola and DCIS (also Paget's). I discovered it myself realizing something simply wasn't right.I opted for BMX primarily for peace of mind. I knew I would always be waiting for it to recur in the other breast. Additionally I was small breasted and 61 years old. I just decided not to live waiting for the cancer to recur or for a more common variety of BC. The BMX was the best choice for me. I had simultaneous reconstruction with silicone implants. I could not be more pleased. I stayed pretty much the size I was before. Recovery was pretty quick. Though the cancer was high grade, it was early stage, non hormone receptive with no lymph nodes involved. I am now nearly 2.5 years post surgery and have had no problems. I am grateful we have options today.

Kylez's picture
Posts: 3765
Joined: May 2009

I had a lumpectomy with rads Rhonda, but, want to wish you good luck with your surgery next week. Nothing is silly about wondering about every new ache and pain. We all go through it Rhonda. If it bothers you for longer than a week or two, be sure and let your oncologist know of anything new.

Good luck,


DianeBC's picture
Posts: 3886
Joined: Jun 2009

Good luck Rhonda and keep posting to let us know how your surgery went and how you are doing.

Hugs, Diane

icefishinglady's picture
Posts: 15
Joined: Mar 2012

I had the same decision to make - bilateral/unilateral? I chose the bilateral, ultimately, and I'm glad that I did. I had LCIS, which was not discovered 'til the final path report.

As far as surviving the wait, I think personally that the waiting is the most difficult part of this to deal with. Seems I was always waiting for this result, that result, this appointment, etc. Then the final few days before surgery - very difficult.

You WILL make it through. I got a prescription for a mild tranquilizer, personally, and though I rarely actually took the things, just having them there "in case" was good.

I need to lose about 30 pounds. A medication I was on caused a LOT of weight gain in a short period of time. Unfortunately, being only two weeks post-op, the exercise part of the equation is difficult, but I am definitely eating better and trying to do what I can. LOTS of fiber, really helps. Keep your metabolism going on high by moving, eating something for breakfast. Walk. Get support from others trying to do the same thing (I'm here!). It really helps.

I did get the tissue expanders and will have implants. Right now I'm just hoping to get the drains out! :-)

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