The Right Decision, Twice
How two very different decisions both turned out to be right
A few days ago I underwent surgery to remove my breast implants and receive an aesthetic flat closure. It brought into focus something I've been sitting with for years: how two very different decisions can both be the right one.
When I was diagnosed with breast cancer at 38, reconstruction felt like the obvious choice. My focus was on getting through treatment, reducing my risk of recurrence, and finding some sense of normalcy on the other side of a life-changing diagnosis. Reconstruction offered that. It gave me something familiar to hold onto during a time when very little felt familiar. Over the next several years, I went through the many stages of breast reconstruction: tissue expanders, implants, fat grafting, revisions, more fat grafting, implant downsizing, and all the appointments and decisions that came with them. And for a long time, it felt right.
What sometimes gets lost in these conversations is this: there is often an assumption that choosing to remove a reconstruction means regretting it, but that wasn't my experience. Reconstruction served an important purpose in my healing. It helped me navigate the aftermath of cancer and gave me the time and space to understand what I wanted for my body.
Over time, though, my priorities shifted. The person I was at 38 isn't the same person I am at 42. I grew tired of knowing there would likely always be another decision waiting around the corner. More surgeries. More revisions. I missed my original breasts. Despite my best efforts, I never really felt connected to my implants, and I was having body image issues. I also longed for a direct connection to my chest wall — fewer layers between me and my body, not more, in case there was ever a recurrence.
The question gradually changed from "How do I improve my reconstruction?" to "Do I want reconstruction at all?"
The answer wasn't immediate. I spent years considering different options. I looked into flap procedures. I explored implant revisions. I researched alternatives. I changed my mind more than once. When I finally decided to pursue aesthetic flat closure, the decision felt less dramatic than I expected. It felt settled.
Reading the operative report gave me a new appreciation for everything my body has been through. The surgery was significantly more complex than a standard aesthetic flat closure — years of reconstruction, multiple rounds of fat grafting, and multiple surgeries had left extremely dense scar tissue throughout. The en bloc capsulectomy, partial mastectomy, adjacent tissue transfer, and internal mammary artery perforator flaps each required more time, precision, and care than anticipated. I'm incredibly grateful for my surgeon, Dr. Champaneria, who navigated all of it with exceptional skill.
As uncomfortable as recovery can be at times, I feel surprisingly at peace with where I've landed. Not because reconstruction was wrong, and not because aesthetic flat closure is better. They're simply different decisions made at different points in my life.
Looking back, I don't see a mistake that needed correcting. I see a woman who made the best decision she could with the information, priorities, and circumstances she had at the time — and then, years later, made another one.
One thing I like about getting older is that I've become better at listening to myself. Less concerned with what I think I should want, and more interested in what actually feels right.
Reconstruction was the right decision for me in 2021. Explantation was the right decision for me in 2026.
For me, both can be true.