I was 50 and thought I did everything right. I got a second concurring opinion that I needed a right side mastectomy. I wanted some kind of reconstruction because I was going through a divorce and my self-esteem was very low. I assumed I would have an implant. However, I was put under extreme pressure by the plastic surgeon to have a tram-flap reconstruction, using my abdominal rectus muscle to create a new "living" breast. I was strongly opposed to losing any muscle at all. After all, women live a long time and need strong bones and muscles. Here's what happened. The mastectomy was over and the tram-flap completed. Both surgeons happened to take a few days off. So I had a team of residents and interns checking me out with a Doppler and asking ME if I thought every thing was okay. Is that ludicrous or what? Well, the tram-flap failed. It might have lived if a real doctor had been around that weekend. The tram-flap had to be removed a month later and an expander inserted. A month later two implants were inserted. Not one, but two, because my breasts were so small that I needed two implants to make a match. I didn't realize that one of these would implode 10 years later! When will the next one go? The surgeon had assured me the surgery would not affect my ability to teach ceramics: lift 50 lb. boxes of clay, 60 lb. kiln shelves and mix a ton of clay weekly. He also assured me I would be able to continue all of my physical activities: hiking, biking, swimming, etc. Instead I lost the ability to practice my profession. My physical stamina and abilities have also been severely restricted forever. My experience with cancer was very different from many other women, who have a large lump develop overnight. I had a very slow growing cancer. Shortly after my surgery I read that Swedish Hospital was "following" women with slow growing cancer, instead of taking any action. They say if a man lives long enough, he will die with prostate cancer, not from it. I wonder if lots of women have lived long lives and died with slow growing breast cancer and not from it. If I had it to do over again, I would do nothing at all surgically, unless the cancer began to grow rapidly. In retrospect, I would never recommend any reconstruction using muscle. I met a woman in my support group who gave up part of her back muscle for a new breast and she could not lift a can of soup off of a shelf. Knowing what I know now, I would have no reconstruction at all. Surviving cancer is the goal. Women are gorgeous creatures with or without breasts and as Elisabeth Dale often points out, there are many ways to have beautiful breasts or none at all and many alternatives to reconstruction.