My Decision to go Flat After Previous Breast Reconstruction


I remember the day that I got that dreaded phone call…the one I’d been waiting for all day. The one where all the doctor on the other end had to say “Karin, are you driving?” and I knew without another word, that my biopsy was positive and I had breast cancer.

Every breast cancer patient remembers this day in their world, just as most of us remember where we were on 911 when the second plane hit the Twin Towers, that shortly thereafter they collapsed and the world realized we were under attack.

The scale is different , yes…and please do not misunderstand my intention here. I am merely stating that in this moment, I realized that my body was under attack, by cancer.

What you may or may not know, is in this moment…all you know for sure is that you have breast cancer. You don’t know the stage or severity until later on…and the wait for this information seems endless.

What the doctor did say to me, was that they thought it was fairly early on and to stay off the internet!!

I was incredibly grateful for this instruction. You may not know this about me, but I am constantly researching and studying, both for myself and my clients and so my natural inclination was to start researching. BUT, I didn’t have enough information yet…there are too many variables within this umbrella of breast cancer to even begin researching without going down a rabbit hole and I knew this would not serve me mentally at all.

So, I resisted and should you or a friend or loved one ever find themselves in this situation, I urge you to do the same.

Did I secretly wonder if I was going to die? Yes.

  • Even though logically, I knew it was early… 
  • Even though logically, I knew there were so many women who have survived this disease… 
  • Even though logically, I knew that the breast cancer that had taken the life of my sister-in-law was a different kind to mine.

Did I ever express this fear? No…I carried the heavy burden, because logically I knew it didn’t make sense.

Part of the reason that I now specialize in working with breast cancer survivors, is so that they don’t need to carry those heavy emotional burdens alone.

I cannot express the importance of discovering a community of women, like you, who have been through a similar experience in life and how valuable that is. It's also why I host the Healthy Living After Breast Cancer Facebook that you don't need to look any further for that group of amazing women.


So, how did I get from that point to today?

I’ll share a quick timeline, but I’ll go into more detail at a later date…because today I want to share how I came to my decision to explant.


July 19, 2018 – Breast Cancer Diagnosis, closely followed by BRCA2 diagnosis

August 2018 – Skin & Nipple Sparing Double Mastectomy with delayed reconstruction

October 2018 – Complete Hysterectomy plus started Letrozole – estrogen blocking medication (for next 5 years)

December 2018 – Beginning of breast reconstruction, Step. 1 – tissue expanders

March 2019 – Step. 2 Reconstruction – exchange from expanders to implants

July 2019 – Step 3. Revised reconstruction – replace one implant plus fat grafting to fill concavity above breasts.


As I write this a year later, July 2020 and after having been diagnosed with Grade 4 Capsular Contracture, I found myself with a decision to make.

Capsular contracture is a breast reconstruction or augmentation complication that develops when internal scar tissue forms a tight or constricting capsule around a breast implant, contracting it until it becomes misshapen and hard.


It is also the body’s immune system response to a foreign object. And as the body is fighting this foreign object, it can lead to the body not being able to fight in other areas…which can lead to a compromised immune system, chronic inflammation and pain in other areas too.

Over the past 6 months my body has built a hard shell around my left breast implant.

In my case, the Grade 4 capsular contracture refers to the pain to touch the breast, move my arms and also above the implant in my chest.

Basically, it does not feel good!! In fact, my whole body is in pain.

You may be wondering what can be done for this fairly common complication, and does it have to lead to implant removal?

The answer to that is no, it does not need to lead to removal…I’ll explain why that’s my decision shortly.

There are other options and my amazing plastic surgeon, Dr. Suzette Miranda was extremely diligent in making sure that I knew all of my options.

There were both surgical options and medication options to try, and the truth of the matter is, I looked really good. My boobs, other than the hard misshapen shell of my left one, looked really natural and I was very fortunate, as I know many women do not get results like this, after reconstruction.

BUT, there is one huge determining factor, and that was the promise that I made to myself when I discovered that I had this disease…


I will do everything in my power to not get this disease again, and not only that, I will also help any other woman who has the desire to do the same!


What you may not know about me, is that I’m a woman of my word, and if I make a promise, I do everything in my power to fulfill that promise.

And so, with that in mind, this is what I realized, and what my hubby Mike and I discussed at length because I felt like this wasn’t just my decision to make…this was something that we needed to do together.

I just need to share that I am incredibly lucky, that Mike is so supportive and as he kept reminding me, the important thing to him, was that I was here and healthy.

Did we discuss if it would affect our sex life? You betcha…after all, this whole experience can affect your self-confidence, body image and so many ways that we think of ourselves and define ourselves as a woman and how can that naturally not spill over into how it affects your sex life?

Trust me, it’s complicated and from the outside looking in…you may not know these internal struggles that your mum, wife, girlfriend, sister or friend might be experiencing. Just know that this journey is hard and one that may require lots of patience, understanding and grace as we work our way through these challenging emotions.

On paper, the logical decision was easy…my body viewed these implants as foreign bodies and so needed to be taken out. 

If my body was using its immune system to fight these, what was left over to fight cancer cells? PLUS, I also know that chronic inflammation alone, is known to be the root cause of ALL serious diseases including cancer. 

Sounds like an easy decision, right? 


What this logical thought process does not take into consideration, is this emotional part of the equation that I've been talking about. And this is a HUGE consideration and not one to be taken lightly. 

On the outside looking in, you could see the 20 external scars I currently have on my body, but what you don’t see are the emotional scars…some healed, and some still healing. Let’s just say it’s a process and it takes time. 

Imagining my body without breasts, trying to prepare myself for the upcoming surgery in just a couple of weeks. I find myself remembering how I felt as a 13 year old, tall, skinny, flat chested, acne covered, shy, awkward, hair that had just been cut short because it had been burnt by a perm. 

I was so often mistaken for a boy…which didn’t help my already non-existent self-esteem! 

I remember feeling so ugly and always wanting to just hide. 

I think about this little girl, and it feels like an entire lifetime ago, I wish that I could whisper in her ear and tell her how beautiful she is and how smart she is and that she is always good enough, no matter what others might say or think. 

What I know to be true, is that my journey, my bumpy journey, full of major trauma and pain, loss and grief has brought me to this point in time.


Where I can honestly say, that I love the woman that I am…


And that woman is not defined by how she looks, she is comfortable in her skin, no matter what size, shape, boob or no boobs…because they do not define me, my relationships, how I choose to serve others with what I do everyday or the morals and values by which I choose to live my life.

Knowing this, doesn’t make this an easy decision, but it sure does help and to know that Mike and I are making this choice based on our desire for me to be healthy and to be here for many years to come to share together, to serve other breast cancer survivors too…gives me true purpose.

The choices that we make for ourselves after that breast cancer diagnosis are personal and individual. Honestly, unless you are walking in my shoes, living my life, paying my bills…I ask that you not judge and I will always respect your right to make the decisions for yourself that you believe are the best ones for you too.

Know that you are not alone, know that I’m here to help support you and there’s a tribe of amazing women waiting to welcome you with open arms should you choose to come and hang out with us in my Facebook Community: Healthy Living After Breast Cancer.

Or maybe you're reading this and thinking of a friend or loved one, in which case I ask that you share this post with them.

I know that this journey is personal, and should you want to have a cup of tea and a quick chat…It's always an honor to get to know you better. 


What're you waiting for, it's free, so you have nothing to lose and a whole lot of support to gain? 

xoxo Karin

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