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It Went as Well as It Could: Double Mastectomy and SGAP Flap Reconstruction

Real Talk

July 08, 2024

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Illustration by Brittany England

Illustration by Brittany England

by Anonymous, as told to Crystal Hoshaw

•••••

Medically Reviewed by:

Elizabeth Berger, MD, MS

•••••

by Anonymous, as told to Crystal Hoshaw

•••••

Medically Reviewed by:

Elizabeth Berger, MD, MS

•••••

I honestly look the same as before, with the exception of minimal scars. These techniques allow women to feel as much like their previous selves as possible following diagnosis. 

  • Procedures: nipple-sparing, skin-sparing double mastectomy, superior gluteal artery perforator (SGAP) flap reconstruction
  • Reconstruction immediately postmastectomy: yes
  • Year of procedures: 2022
  • Age: 44 years old
  • Ethnicity: white

This article contains graphic, intimate images of a postsurgery body. The photos have been generously shared by a breast cancer survivor so that others can benefit from uncensored visual information that may help them make important surgical decisions for themselves.

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My diagnosis journey

In January 2022, I had a mammogram. Luckily, the mammogram caught the breast cancer.

The biopsy came back in February as invasive ductal carcinoma (IDC), stage 1. The doctors called it node-negative, meaning the lymph nodes weren’t cancerous, so it was minimal.

I had a family history, so it wasn’t a complete shock, and we caught it early. I had a big event in March, so the medical staff said I could wait to do surgery because it wasn’t an immediate threat.

Even so, you don’t have all the facts initially, and it’s very nerve-wracking. It’s easy to start spinning out until you get more information. My mom has a friend who is a surgeon and does a lot of reconstruction, so they talked me through different scenarios.

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Making a decision

It was my choice to have a double mastectomy. It was just a no-brainer because I wanted to make any future risk as low as possible.

I was almost a D with dense breasts, and a lumpectomy would’ve been hard to rebuild and look like myself. Plus, I’d have to have mammograms every 6 months and worry.

I chose reconstruction from my own tissue because I wasn’t keen on the implants. My doctor told me they could feel cold inside the chest, and I liked the idea of my own tissue and the warmth of it — not something foreign in me.

Surgeries at the breast center

In May 2022, I got a mastectomy and SGAP flap surgery. They took tissue from my back because I didn’t have enough in my stomach to rebuild at the same size.

The mastectomy and SGAP procedures took 8 to 10 hours total and were really stressful for my family. The breast surgical oncologist did the mastectomy first. Then, the plastic surgery team flipped me over to take tissue from the back.

The surgery teams put a Doppler ultrasound monitor on me to make sure there was enough blood flow to the tissue being used for reconstruction.

The surgeries went really well. I did my procedures at the Center for Restorative Breast Surgery, which is a great place to heal. I spent 3 nights there recovering, then another 4 to 6 weeks at home. I’m lucky I live nearby, so I didn’t have to get on an airplane afterward.

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Recovering at home

Recovery is painful, but it’s doable. I do think I have a high tolerance for pain.

I had 12-year-old twins at the time, so they were old enough to be somewhat independent. I’m a business owner, so I have flexibility in my work, and I was able to time it right so I could rest and recuperate.

I did have drains in the breast and the hip: fun, fun. That was a learning experience. I had never seen anything like that. I had those for 2 weeks, and then they took them out. I slept downstairs during that time, and my husband helped me empty the drains. He works from home, so he was always there to assist.

In November, I had a second optional surgery to even things out and “perfect.” It’s a lift, basically.

While I didn’t have any other side effects, I did end up with a frozen shoulder. It’s very common in middle-aged women, especially after breast surgery. Your arm and shoulder tighten up, and you can’t lift it. It’s pretty painful and is definitely something you have to work through. I ended up getting physical therapy for it.

Overall, the surgery went as well as it could.

My doctors were an awesome team who worked together often. I definitely feel very lucky because so many things can happen. I’m very glad it went as well as it did.

I honestly look the same as before, with the exception of minimal scars, which are the same as those who opt for a breast augmentation or lift.

Now, my follow-up is Tamoxifen for 5 years during premenopause, and my medical team sees me every 6 months for checkups.

closeup image of breast reconstruction results after SGAP procedure and 1 to 3 months of healing

Why sharing is important to me

I’m naturally very modest and private. However, my sister sent me the What It Looks Like project.

Breast cancer can happen to anyone, and it’s becoming so prevalent. I want to do what I can to make sure people are getting their annual mammograms.

I also want people to know that a mastectomy doesn’t mean you’ll be disfigured. Nowadays, they can really make you look like yourself. These techniques allow women to feel as much like their previous selves as possible following diagnosis.

I think people hear the negative side of things, and I want to put the positive out there. I really encourage people to get their mammograms. Get MRIs if you have dense breasts, and don’t skip them.

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What I want people to know

I want others to know how important self-care is, especially as a woman. We have to make sure we’re looking after ourselves because we’re all looking after kids and life. We need to make sure we don’t skip our appointments because it can make such a big difference.

I encourage people to go to all of their annual appointments, pap smears and all.

What cancer taught me

There were times when I was Googling and spinning out, wondering if it’s not going to go how I hope it’s gonna go.

It’s a shock. You always know it can happen to you, but you don’t expect it to. It changes you, and you realize what’s important.

Family and friends are important, but material things aren’t. Relationships are really what matter because you don’t know how long you have.

I also try not to live in fear now, I think I’ve gotten to a point where I don’t. Faith over fear.

Bezzy BC and Young Survival Coalition are partnering to create What It Looks Like, a series showcasing photographs of different breast reconstruction choices on bodies of all shapes, sizes, and colors.

We’re spotlighting breast cancer survivors’ reconstruction decisions and stories so that other women facing mastectomy surgery can see and hear about many different real-life outcomes.

If you’re a survivor who’d like to share your reconstruction (or flat closure) images and story, we’d love to hear from you. Just have your photos ready and fill out this submission form.

Images and stories will be anonymously published on BezzyBC.com.

Medically reviewed on July 08, 2024

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About the author

Anonymous, as told to Crystal Hoshaw

Crystal Hoshaw is a mother, writer, and longtime yoga practitioner, and currently the Editor for the Bezzy Breast Cancer and Migraine communities. Crystal shares mindful strategies for self-care through yoga classes and online courses at Embody Ayurveda. You can find her on Instagram.

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