Life After a Preventative Mastectomy: Bailey’s Story of Strength and Self-Acceptance
We chatted with Bailey Vail, a pelvic floor physical therapist, mom of two, and all-around mountain badass, about her decision to undergo a preventative mastectomy, and what life looks like on the other side. From navigating early screening and difficult choices to finding strength, humor, and self-acceptance in her new body, Bailey’s story is a powerful reminder that confidence doesn’t come from how we look, but from the choices we make to live fully, fearlessly, and on our own terms. Here's our conversation with Bailey:
Sarah “Mellow!” Berkeley: Please give us a bit of background on who you are.
Bailey Vail: My name is Bailey Vail. I am a Pelvic Floor Physical therapist. I practiced in outpatient ortho before. I am a mom of 2 boys, 8 and 4. I grew up in San Diego, then moved to the mountains of Colorado, then to Idaho, then back to the mountains of Colorado.
Our family is very active with skiing, snowmobiling, snowshoeing, wakeboarding, dirtbiking, horse riding, fishing, and organized sports for the boys! We live on 20 acres and have a lot of chores to do around the house with chickens, logging, plowing, and general maintenance.
SB: When did you first have concerns about breast cancer, and how did you know something was wrong?
BV: I have had this in the back of my mind when my maternal grandmother was diagnosed with breast cancer. So, when I turned 35, I talked to my GYN about my risks and asked her when I should start screening, and she recommended that I start the screening process earlier (at 35 instead of 40).
SB: What were your options, and why did you decide to have a mastectomy?
BV: It was an interesting process. So, my GYN ordered my first mammogram in January when I was 35, and it was just not a priority for me, I guess, so I didn't end up getting my first mammogram until I was 36.
Once they have your mammogram results, they put all your data into a risk calculator, which shows that I was a 28.5% risk. I believe the general population is 13%. So after that came back we decided to do genetic testing. I was negative for BARACA. So that was nice. However, the 28.5% risk put me into an intense screening protocol where you need to have an MRI and a mammogram alternating every 6 months.
I stayed on that track for about a year, and it was very stressful. They would find something on an MRI, then call me back, and need to do an ultrasound, and then do a biopsy if possible. If they couldn't get a biopsy, I had to schedule an MRI-guided biopsy over an hour away, and it was very stressful to wonder for a month if maybe I had cancer. Then the biopsy was not very pleasant either.
During this time, it was when I asked my GYN, “When do people consider preventative treatment?” and she said NOW! So I scheduled with a breast surgeon in Denver to go over my options. My options then were to continue the early screening protocol until I died (keep in mind the MRI is $1,300 for me, even with my insurance), take medications that kill all my estrogen and put me into early menopause and feel like crap, or do the mastectomy. (I feel like there was another option, but it was also bad.)
Ultimately, the reason I wanted to investigate this was because I didn't want cancer. I wasn't worried about dying from cancer. Being in early screening, they were very confident that if I ever did get it, it would be caught early and it would be very treatable.
However, I didn't want all that smoke and stress of dealing with a cancer diagnosis, the brain fuck that happens every time you get a sore neck or have some funky symptoms that make you wonder if the cancer came back. I didn't want the nerve damage and all the things that come along with cancer treatment. That is why I decided to go with the mastectomy because it was the only option that minimized my risk for GETTING breast cancer.
SB: Can you tell us about your decision not to do reconstruction? Did you feel any internal or external pressure to do reconstruction?
BV: This was kinda hard, actually. There were a series of things that led to the decision not to do reconstruction.
1. If you decide to get an aesthetic flat closure (no reconstruction), you can decide to get boobs later on—and insurance will pay for it. It would be a lot of work, though: one surgery for spacers, another for the implants, and probably a couple more to make sure the implants look right.
2. I met with a reconstruction doctor who was really good at this technique called the Goldilocks technique, where they basically tuck your bottom breast skin flap under your top flap. It makes something really small (depending on body type and breast size before surgery), but at least you have something there. All women’s clothing is really designed to have some amount of something on your chest, so it helps clothes fit a little better.
However, when I went to see the plastic surgeon who did that procedure, she asked me what my goals were. I told her my only goal was to not get cancer. She rolled her eyes at me and said, “I mean aesthetic goals.” I told her that wasn’t on my radar, and she looked me up and down, trying to analyze what type of person I was, and said, “You’d look super awesome with a sporty little A-cup. Super feminine and really sexy.” I was instantly out.
3. If I went with reconstruction, the plastic surgeon would become the doctor I did all my follow-ups with—and I really loved my breast surgeon, so I didn’t want that either.
4. Adding reconstruction to the surgery adds time. My surgery took three hours without it and would have been even longer if I’d had reconstruction.
5. Almost every reconstruction requires one or two more surgeries as “revisions.” Implants aren’t designed as stand-alone implants—there’s supposed to be some amount of fat there to soften the edges. So, they usually have to go back in, suck fat from elsewhere, and stick it around the implant. And surgery sucks! Less is definitely better than more when it comes to surgery.
As I got closer to surgery time, I became more stressed about my decision. My boobs were something I was kind of proud of before having kids. They were a big part of how the world saw and judged me. I’m not a super girly girl—I’m bad at fashion, I’m bad at doing my hair, and I don’t know how to do any makeup other than mascara. So, I felt like my boobs were a huge part of what made sure people knew I was a lady.
I also already had intimacy issues from trying to accept my new body after childbirth, so this wasn’t going to make that journey any easier. I realized that my boobs participated in how I interacted with the world—when I cuddled my kids, when I hugged people, when I worked on people for my job. This was going to dramatically change how people saw me and felt me. I mourned them before they were gone and worried about how people would react to me.
The best part is that my husband was sooooooo supportive of getting rid of them and keeping them gone forever. He said he was a butt guy anyway—and that was still “prime.”
My mom really didn’t want me to do it. She was worried it was excessive and that I had no reason to do it. But when I had a scare and they found something on imaging, she changed her mind.
SB: How do you feel differently in your body now?
BV: It was an interesting journey. I originally did not feel as sexy. However, someone hit on me one time and I was like OMG WOW! HUGE BOOST! I can see being “desirable” even without boobs!
But that was mixed with this other feeling of just being SUPER empowered. I really realized that we care A LOT more about what we look like than people even notice. I was very sure I was going to have to explain not having boobs to everyone I met. I had this intense desire when I met people to be like, “Hi, I'm Bailey, and I had a mastectomy in April,” to explain why I didn't have boobs.
Then, slowly over time, I realized literally no one noticed! People that I knew pretty well but didn't know I was having the surgery wouldn't say anything, then after talking a while and I would tell them they were literally mind blown.
No, no one notices. At all. Which felt very freeing!
Now I can wear cute tank tops without having to worry about bra straps. I can wear backless shirts and dresses. I feel really fast and agile because there is nothing bouncing around on my chest weighing me down! After birthing 2 humans and having this surgery…. I am SO impressed with what our bodies can do.
SB: What was the hardest part of the whole process? And what helped you get through it?
BV: The hardest part was feeling like I needed to convince people that the decision I was making was the right decision. Like I mentioned above, my mom.
Even my best friend was not super supportive. Looking back, the 2 main things that made this decision easy were the support of my husband, the unconditional love of my 2 kids, and MENTAL HEALTH THERAPY!
My therapist really helped me reframe everything. Being an adult is hard. A lot of times, we have to pick between 2 shitty options. She kept reminding me that you get to choose your hard. So this is the hard I chose.
The worst, worst part was the drains that had to be in place for a week after surgery. I got lucky. A lot of times, the drains need to be in place for 2 weeks, but mine were only in for 6 days! They are drains that collect the excess fluid. They need to be stripped and emptied, and measured 2 times per day. I couldn't do them, so my husband had to. They were very inconvenient. Really uncomfortable. Really disgusting. And made wearing clothes really hard. Getting clothing designed to accommodate the drains helped A LOT. And my husband's support was incredibly valuable.
SB: Anything positive or funny about the process?
BV: I really, really, really like to prank people now. Like my boss’s husband is kind of a jokester, so I will come out from around the corner and “flash” him, and he freaks out, but then remembers there is nothing there to cover his eyes from.
Positive… I have been getting connected with several women who are facing a similar surgery. However, most of them HAVE cancer. The fact that they are looking to me for information, guidance, affirmation… It's just mind-blowing to me. They are the real warriors, and I could not be more honored to be a small part of their journey.
Another thing I keep hearing from women is “I could have never done that, I feel like you have to be a bad ass to do that, and I am not a bad ass.” And I keep telling them, you just become it, I guess, after you do it. Because I do not consider myself a badass. I am just a mom! So that has been pretty empowering as well. Everyone is capable of becoming a badass!
SB: Do you feel anything different about your gender identity post-surgery?
BV: I think I actually feel more positive and secure than ever before. Because I learned that my boobs DO NOT make me ANYTHING except for a person with breast tissue. I am who I am! So, maybe I don't feel more feminine, but I also don’t care because I am just Bailey. There is a lot more that makes me who I am than my boobs.
As a physical therapist, what recommendations do you have for women recovering from or preparing for a mastectomy? OMG YES!!!!!!!!!!!!!!!!!!!!! If you have a surgery scheduled, you NEED to get in to see a pelvic floor physical therapist who has a whole body approach BEFORE surgery. They will help make sure you have good mobility of your spine, good activation of your core, good strength to support transitions from sitting to standing without using your arms, and good breathing patterns. Using these strategies AS SOON as I woke up from surgery REALLY helped my recovery.
Then, I recommend getting back in following surgery really quickly. I came to see one of my co-workers, I think, 4 days after. And she helped make sure the fluid (swelling, edema) was moving, made sure my fascia was moving. The thing that was the most sore following surgery was my upper back (thoracic spine) and my upper traps. I was in weekly for the first 8 weeks following surgery, and then I would recommend continuing weekly to continue to work on scar mobilization and returning to strengthening! I also ended up with some cording, which is a lymphatic problem. So I needed to come in several times to get that worked on so it wouldn’t make forever problems like lymphedema.
SB: What do you want other women to know about breast cancer awareness, our prevention options, mastectomy, or anything else related? Anything you wish you’d known earlier?
BV: I think the thing that I would like everyone to know is… advocate for yourselves.
I really “got myself into this” by asking questions, making sure to follow through with what the doctor was recommending, and feeling confident. I shopped around for health care providers that fit with me. I didn't look for people who just told me what I wanted to hear, but people who understood me, listened to me, and TAUGHT me about all my options.
Then I was able to make a truly informed decision about what worked best for my goals and my lifestyle. One provider that I tried to schedule with has a policy that you wouldn't meet the doc/surgeon until you schedule your pre-op appointment. That didn't make ANY sense to me at all. So I ended up canceling that appointment. It's ok to travel for the care you deserve. We live in a medically rural community, so I ended up traveling 1.5 hours to find a provider that I liked. It was worth every second of driving.
Please take all of your screenings seriously. Don’t put it off. It’s important.
Your boobs are not you, and you are not your boobs. DON’T BE AFRAID TO GET RID OF THEM! No one notices anyway.
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Huge thanks to Bailey for sharing her story with so much honesty, strength, and humor. Talking about mastectomy, body image, and self-advocacy isn’t easy—but it’s conversations like these that help other women feel seen, informed, and a little less alone. We’re so grateful for her vulnerability and for reminding us all that confidence, courage, and identity go far deeper than appearance. 💛
At Symbiosis, we’re here to keep that conversation going—to create gear, community, and space for every woman to feel strong, supported, and seen, no matter where her path leads.
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If you’d like to help young women access preventative care that insurance doesn’t always cover, check out Tits Deep, they’re doing important work.