The question below is answered by Dr. Richard M. Kline, Jr(opens in a new tab)., of The Center for Natural Breast Reconstruction(opens in a new tab).I am scheduled for reconstruction(opens in a new tab) on the 29th. I feel as though I shouldn't go through with it because, for one, I am 58 years old and secondly because I am scared that I will not be pleased. Thirdly, I heard that it is very painful and is worse than the bilateral mastectomy(opens in a new tab) I had. I am so confused as to what to do. Firstly, if you are scared, and feel strongly that you shouldn’t do it, then DON’T—END OF DISCUSSION! We’re talking about a quality-of-life surgery, not life-saving surgery. Attitude about the outcome is far too important to risk going into it feeling like you shouldn’t. Having said that, unless you have a serious medical condition making the surgery dangerous, diabetes, or inadequate donor sites (I assume we’re talking about DIEP (opens in a new tab)or GAP flaps(opens in a new tab)), statistics suggest it might not be as bad as you fear. Age is of no consequence—some of our happiest DIEP patients (and best healers) have been in their 70s. Satisfaction with the final outcome is critically dependent upon realistic expectations, which can only be arrived at through careful preoperative discussion with your surgeon, and ideally, also through discussion with other patients. Perforator flap surgery IS more painful than mastectomy, but pain is a relative thing. A few patients say it is terrible, most say it was about what they expected, and a few say they had almost no pain, even the day after surgery. I can think of one patient out of hundreds who suggested she might not have gone through it if she knew how bad the recovery would be. Best of luck to you, and please feel free to ask any more questions(opens in a new tab).—Dr. Richard M. Kline, Jr.