In a very emotional decision I opted to take both breasts to alleviate worry. Pathology showed it was the correct choice- the cancer side was found to have cancer spread throughout (not seen on mammograms or MRI) and unaffected side was found to have "cellular changes." So for me, going with my gut was the right decision. I had the option for a lumpectomy. And the decision is not easy. It's easy until you actually have to make the choice. Hugs to you!

Hi. I was 42 when diagnosed. Had a single mastectomy with immediate implant reconstruction. I was never offered or had any discussions on a double. My muscle is over the implant. I can still see rippling of the implant and when I tense the muscle the implant moves to the side. Not a lot but enough. I am considering a lift to the opposite one as they are not level and think that will help me mentally. One thing to think of is if you are using insurance to pay they have a time limit on symmetry of 18-24 months. I’m 5 years on so they have declined my claim. It’s only now I feel ready to go through more surgery which is a shame these time limits apply. So. Goth be worth checking any timescales. No one told me this at the time. Not that it would probably have made a difference at the time. Hope this helps.

I became a certified mastectomy fitter in 2007, and have seen many, many women over the years. I always told myself "if this ever happens to me, I'm just going to do a double". I was 43 when diagnosed, and stuck with what I have told myself for years. I did reconstruction with implants, but ultimately had to have one removed. I'm currently in radiation, but will definitely do reconstruction again once cleared. It is a very personal decision, and the only "right" answer is the one that YOU feel is right for you!

PS When talking to the plastic surgeon, ask about fat grafting. They lipo fat from somewhere else on your body (stomach, thighs) and use it around the implant to fill out it and create a more natural curve. I didn't have it done -- didn't know it was even an option until right before my second surgery (implant exchange), when my plastic surgeon said it wouldn't work because I didn't have enough fat, though now he says he could do the thighs. I'm pretty satisfied with my implants overall, but they just kind of pop out a little low down without enough upper cleavage. Fat grafting would have helped with that, as well as covering up rippling of the implants. When I talked to my plastic surgeon about fat grafting (too late, after the surgeries), he said it can take up to three tries to get it right, if fat is reabsorbed by the body. I'm taking a break from surgery, but I may get a second opinion from another plastic surgeon once/if COVID is over!
As I said, I was too overwhelmed by the cancer to do research on the cosmetic side, but if I had to do it over again, I'd ask more questions:
-- what are the advantages and disadvantages of placing the implants under or over the chest muscle? (mine are over the chest muscle, which can make ripples in the implant more prominent, but fat grafting would help)
-- are there choices in terms of how you position the implants -- higher or lower on the chest? closer together or farther apart?
-- are there choices in terms of the shape of the implants?
-- are there choices in terms of the texture of the implants (note that one type of silicone textured implants has been banned by the FDA!)
-- do you recommend fat grafting to fill out the implants? Will that likely need to be redone as fat is reabsorbed? How will that be affected by weight loss/weight gain?
-- what kind of imaging of the implants will I need going forward? Does placing the implants under or over the chest muscle affect that?
If you have time, you might want to talk to two plastic surgeons. I've heard of women doing that. Ask to see pictures of their outcomes.

Everything Melissa said is right on. I was stage 1A with a small tumor. I choose the bi-lateral and no recontruction. Just wanted peace of mind and to be done with surgeries. Best decision I made - I love being flat! I wear prosthetics and no one knows and in summer, it’s so much cooler with no bra.😊