Reconstruction dilemma for petite frame

Hi everyone,

I was diagnosed with BC recently on my left breast, HR+/HER2-, grade 2. I completed chemotherapy and am waiting to have my single mastectomy. The plan has always been implant reconstruction. However, my team is not 100% sure whether I will need radiation or not, I will have to be with the tissue expander. Now I am actually having second thoughts.

First of all, I am really petite. 33 yo, Asian, 5’2, around 102lbs. My breasts are really small. My tops are usually XXS. I own some Victoria Secret bras with underwire in 32A but there are always gaps between my breasts and the cups while the underband is super tight. I used to wear them everyday but they got so uncomfortable, especially the bridge area. It was so tight that the area where the ends of the underwires met the bridge left an indent onto my skin. I got so frustrated that I switched to a bralette for everyday use and only wear those underwire bras for special occassions that won’t last all day.

This leads to my fear of implant reconstruction. My plastic surgeon already said I am not a candidate for reconstruction with my own tissue and fat. I feel like I am going to have a really hard time with the tissue expander rubbing and poking from underneath my skin. And if I am to have radiation, I will have to live with it for at least a year. Then comes the actual implant, even if the smallest implant available in the market, there will probably be asymmetry after reconstruction. And I don’t know if I have the strength to go through revisions.

I am not good with surgeries, in fact, I am so afraid of needles, blood and pain that thinking about the mastectomy makes my limbs weak and I need to calm myself down or pass out. So the thought of having multiple surgeries is terrifying.

That is why I am seriously considering the aethetis flat closure now. But I also have to weigh in my future body acceptance with being flat one sided. My family members are against going flat right now. While I understand their concerns because I am unmarried and being flat one-sided may be a problem, I want to make my own decision in the end after weighing all the risks and benefits.

Have anyone gone through the same experience?

Thank you.