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The Choice to Go Flat After Mastectomy

07 Sep, 2016

From Full Reconstruction to Flat: The Decision to Explant Eight Years Later

Guest Post by Samantha Paige

Photos by Lisa Field

I missed half of my senior year of college for a thyroidectomy and radiation after a sudden thyroid cancer diagnosis weeks after my 21st birthday. I spent the following decade in and out of hospitals for follow-up testing, chronic migraines and PTSD-related anxiety, depression and panic attacks. At some point during that period, I tested BRCA1+ and was then overwhelmed by the ongoing MRIs and mammograms, thereafter imposed, because of my genetic mutation, prior cancer and my mom’s own (gratefully successful) bout with breast cancer in her early thirties. Eight years ago, I elected to have a preventive double mastectomy shortly after my daughter was born. In light of my new role as mother, I desired to mitigate as much risk as possible, as my nerves could not handle the constant pressures, fears and testing around another looming cancer diagnosis.

I had contemplated the prophylactic decision for years and, in discussing what that would look like, reconstruction with silicone implants was the only option I remembered being presented with any great support or detail. I recall asking questions about using body fat instead of silicone, but did not push the discussion too far when met with replies about my lack of ample body fat. I also recall someone very close to me at the time encouraging the implants, so as to “look normal” for my daughter and to “go as big as possible” (the infamous “reconstruction is a boob job” view). I ended up with arguably perfect, gorgeous and quite large reconstructed breasts, but was never comfortable in my body.



Almost exactly eight years to the day, this past January, I had explant surgery. I had not been feeling well for years and hoped the explant would help, which it did. Equally importantly, I did not feel whole, sexy or connected to my implanted chest. It always felt foreign to me. The most important aspect of my decision to remove my implants was not a gallant act of bravery, nor a rejection of boobs, foobs or anything in between. It was an act of self-love and self-honoring. It was a moment of truth. I have spent the last five years of my life making consistent (within myself) the inconsistencies of decisions made along the way. I left my marriage, closed my business, ended a cycle of betrayal and edited so many other internal and external areas of my life that had contributed to my lack of physical and emotional wellbeing. I have taken the time to assess what was no longer working and lived the consequences of much heartache and liberation in the process.



My implants were another place within myself, literally and figuratively, where I knew I had said "yes" when I should have said "no." I have no regrets. I had not yet honed, or cleared enough of the interfering noise to hear, my own opinions about my emotions, my life and my body, or how to stand up for those truths. So, in removing my implants I was making another "last cut," or significant decision that brought me closer to my truth, as I call them in my book and photo documentary, Last Cut. After twenty years of intense health challenges, the lens of my memoir highlights the power of finding clarity around what is most true for each of us and how we live that. So even when we are overwhelmed, scared and often rushed, it is incredibly important to ask the questions, be informed, do our homework, take our time (when possible) to digest and react, own our own bodies and make our decisions based on our own voice and not the (often negative) internal and external ones that chime in.



I spent eight years completely ignoring the upper edges of my torso. I detached and disassociated because, even though I had an exquisitely perfect set of foobs, I did not feel like myself. I did not feel sexy. I did not feel any sensation. I could not make them move. I could not sleep well. I could not lie on my stomach, and I was often sick and lacking in energy. I would exercise and feel worse. It was an uphill battle, and I did not even appreciate how I looked. Yet, I didn't put two and two together until a friend brought her own decision to remove her implants to my attention. My implants and post-mastectomy chest served me well for a while, but the day I opted to say goodbye to them was one of the most powerful and beautiful days in my life. I entered the familiar OR with confidence, calm and grace, because I was making a decision that was consistent with my personal, and very internal, needs and desires.

I know I made the right decision for me. I am healthier. I feel sensation across my chest once again. I feel sexier (especially in my gorgeous AnaOno bras). I am renewed and connected to my body. I am whole. I am proud. I am consistent. I feel true. I can now look my nine-year-old daughter in the eye and talk about body positivity and self-love with confidence, because I feel it within myself. I can move through the world without wanting to hide, as I have reclaimed my personal power and a confidence in myself that was lost, not only with the mastectomy, but also through thyroid cancer, a hysterectomy and other previous health challenges. I chose what was right for me and that is incredibly empowering.



There are certainly many unknowns still to be confronted and explored, as I am only seven months into this chapter. As I explanted while single, I have no clue how it will feel to show this revised body to a new partner. I have no clue how I will be perceived or the questions I will be asked. I joke with my friends that, if I ever try online dating, I would not know what to write. Creative artist type with short dark hair, light green eyes, tattoos and no boobs (or thyroid or uterus or ovaries) loves to travel, read, cook, walk and visit farmers' and flea markets, speaks fluent Italian and Spanish, writes and loves to dance and drink coffee. Did you catch the no boobs? I have no clue how to do this next part, but staying true to myself seems the best way to attract the right partner or anything else I want in life. If I make decisions with truth and consistency, I feel whole and healthy.

I am sharing my story not to preach for or against implants or the decision to explant. This is simply my story. These are incredibly personal decisions. Each woman must look within to find direction and answers about her own body. I am sharing my story because I have learned the power of asking myself powerful questions as I face issues, big and small, seemingly in my control or not, in order to make empowered decisions that will create lasting internal wellness and harmony within my life. Being able to look myself in the eye after my explant surgery has been the greatest gift of post-cancer health. If I leave you with anything, I hope it is a desire to honor and love yourself enough to make whatever decision you know is right for you. I hope I inspire you ever so slightly to claim, live and write your own story.




Samantha Goldstone is an artist and mother with a passion for life. As a young adult cancer survivor and BRCA1 previvor, Samantha has learned to use life experiences as fuel. Her health challenges have been her greatest teachers. After 6 major surgeries and some lovely scars to show for it, she is happy to feel stronger and healthier than ever.

Samantha speaks fluent Italian and Spanish, loves to cook and takes every opportunity to travel and explore the world. She is constantly reading {real paper} books and has a strong proclivity for cookbooks. Making and appreciating art has been a love of hers since childhood. Samantha can often be found at her local farmers’ market and especially loves to visit food and antique markets and eat the local fare wherever she finds herself in her travels.

You can find out more information about Samantha and her documentary project on the web and across social media:


Instagram: @lastcut

Facebook: @lastcutproject

Twitter: @lastcutproject


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Barbara Savage

September 08, 2016

Thanks for having the courage to share your personal story. It is truly inspiring. You’re a beautiful radiant shining light! XO


September 08, 2016

Congrats on your decision. I had br cancer on R side when I was 42,
again on L side when I was 51. In 2012 I had it again, and had no choice (because of previous radiation) but to have a mastectomy. That’s when I chose to have both sides removed.
My sister and I both tested positive for Br C 1. she passed away at age 43 due to Br Cancer.
After I had made decision to have implant surgery, I found out that they cannot do proper exams with implants, particularly physical exams. For 4 yrs I have been flat. No regrets. Feel much safer

Nancy Tew

September 19, 2016

2 years ago on 8th Ocotber 2014 I had a mastectomy on my right side. I was just left with my skin,no tissues or nipple. From day one talking to doctors and plastic surgeons I requested that I do not have a reconstruction. I had read about problems and further surgeries and I didnt want that. being only 48 I was reassured that implants were the way to go. In the end expanders were suggested. I felt a bit happier. When I awoke from my op I was informed that they had put in an implant for me. In the past 2 years I have felt nothing but pain and sadness from what it doesnt feel like like as well as what it looks like. It is a cold brick which doesnt belong to me. In the past few months it has moved and last week I was told it had ruptured and was far too big and tight for my body. Itis 2 sizes bigger than my other breast. They have finally agreed to remove it! I am so happy for for once I am getting what I wanted from day 1. ok it will be flat one side but my normal side is only 34 B so not huge and I will be able to sleep at night and above all happy with myself. yous story is so uplifting and proves that we know what we want when it comes to breast cancer and everything else after it. thank you


October 05, 2016

Thank you for telling your story. It will help a lot of people. You look beautiful.


February 06, 2017

Oh Samantha, if you read this, thank you for this post. At the moment, I am sitting here 1 week post mastectomy. I was originally planning to have DIEP flap, but the day before (literally) changed the procedure to just have tissue expanders put in as a place holder. Reconstruction hasn’t felt right to me, and I realized I had blindly been following that path. I’m so relieved it was put on hold. You’ve helped me to articulate why I feel confident in saying I do not want to continue moving forward with recon. The doctors I’ve seen have been willing to talk about that, but it’s like I can hear in their voice that they disagree or just don’t understand. It’s also left me wondering why I had to start the conversation with them about going flat instead of it being presented as an option along with implants or my own tissue from the get go. I’d love to hear more about your journey if you’re ever interested in a penpal. Either way, thank you again.

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