I had to decide at the time of surgery(age 69). I am small breasted and opted for no reconstruction. Im glad I did as I have prothesis which is quite comfortable or if I need otherwise I just wear slightly padded inserts and it works great.

If you are worried about your cognitive functions be sure to tell anesthesia that you don't want any Versed.

thank you all for your input

thank you I never even considered the effects of general anesthesia so thank you for your answer!!!

I decided against reconstruction because of having to be under anesthesia longer to do it. My memory was already bad (I'm 75), and I didn't want to risk losing more of my short-term memory. Luckily, my hubby was fine with my decision. (Of course, my poor memory affects him too as we live together!) Haha!