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The Voice of People With Breast Cancer

helping you understand your surgical options


Living Flat or Asymmetrical (No Reconstruction)

After a mastectomy, you may choose to not replace the breast that was removed (living asymmetrical) and after a double mastectomy, you may decide not to replace both breasts and instead decide to “live flat”. After breast surgery, deciding whether or not to have reconstruction is a personal choice and it is important to know that choosing to live flat or asymmetrical is as valid an option as choosing to have breast reconstruction. Below we provide some considerations when deciding whether to live flat or asymmetrical.

Considerations for Living Flat or Asymmetrical

  • General Considerations

    There are many reasons and things to consider when decided to opt out of reconstruction. Some reasons to live flat or asymmetrical include, but are not limited to:

    • The freedom of living flat
    • Reconstruction may not be important to you
    • The idea of a long surgery and recovery and the associated pain from reconstruction may be overwhelming
    • You find wearing a prosthetic uncomfortable
    • The cost of a prosthetic – view community programs that can help with the cost.
    • You may be concerned that the reconstructed breast(s) will not feel natural
    • Reconstruction may not be an option due to other health reasons/concerns
  • Day-to-Day Considerations

    You may have concerns about how living flat or asymmetrical may affect intimacy. Here are some things you may need to adapt or try, following having no reconstruction:

    • The loss of feeling in your nipple(s) may make other areas of your body more sensitive
    • Sensual touching may need to be adapted. It’s important to be vocal and to speak with your partner to find what works best
    • There are some versions of lingerie that can be worn with breast forms. However, if you are not comfortable wearing breast prostheses, you do not have to.  Ultimately, wear what makes you feel the most comfortable and sexy

    Living flat or asymmetrical may also impact your everyday and overall aesthetic. BreastFree gives the following tips on dressing in a way to draw attention away from your chest area:

    • Fabrics with busy, irregular, not-too-small patterns
    • Dark colors, especially black
    • Crisp shirts with strategically placed pockets
    • Off-center closures or other asymmetrical features
    • Overshirts, jackets, and sweaters can be layered over closer-fitting garments
    • Scarves and shawls can be draped to cover part or all of your chest.
    • Earrings and hair ornaments draw people's attention upward
  • Questions to Ask Your Surgeon

    If you are considering or have decided to opt out of reconstruction, it’s important to make this clear to your surgeon. While discussing your options, here are some questions/topics to speak to your surgeon about to ensure that you are both on the same page:

    • How will the contour of my chest look after mastectomy? Can an uneven contour be fixed with fat grafting?
    • Will my chest wall have a generally equal appearance?
    • Where will the scars be after my surgery? Will they lay flat on my chest?
    • How many times have you done a mastectomy/double mastectomy with no reconstruction?
    • What results can I expect to have? Do you have pictures that I can use as examples?
    • Will I have any feeling or sensation in my chest area?
    • If you have large breasts, you may want to speak to your surgeon about any health concerns that may come with living asymmetrical
  • Options After No Reconstruction
    • After choosing to not have breast reconstruction, there are still various options available to you:

    • Breast prostheses – can be used whenever you choose to, or not at all
    • Decorative tattoos
    • Silicone nipples

I love being able to go flat, to lie on my stomach at night, to jog without bouncing, no hot boobs in the summer. I don't mind the scars, because to me it's like looking at an old, interesting gnarled and knotted tree. It shows life and strength and survival. Honestly, being flat is better than the original issue!”

- Anonymous

To be honest, I have never regretted not having done reconstruction or just having one breast removed. I love not having to wear a bra!!!! No under boob sweat when you exercise, and I pretty much wear tank tops year-round. I have various prosthesis forms that I could wear if I wanted to but honestly never do. When I try to wear them now, it feels very foreign to me having breasts. I was lucky enough to get a chest tattoo done a few years ago through the Project Pink’d organization with a fantastic artist named Sam R on Vancouver Island. She did an amazing job creating my tattoo from my original idea. 

- Alison