I had a bilateral mastectomy with immediate reconstruction. I could not be happier with the outcome. The new "breasts" are small, only so much skin to go around. They fill out my clothes, and I never have to wear a bra again! Keep in mind they have no feeling, and they could not spare my nipples. I had 3D nipples tattooed in the plastic surgeons office. Took about 30 minutes, felt nothing and they are amazing. It has been 14 months and the scars are beginning to fade. I had implants not the flap procedure. There can be more complications with the flap procedure, although the thought of an insurance paid "tummy tuck" was tempting. The surgery is twice as hard since you have two areas to heal.
I have a work out friend who had a mastectomy with no reconstruction. She is fine with her decision, but does admit to wearing prosthetic, breasts when she is dressed up. Most of the time she goes without. She said they are a little heavy, and can get hot. Whatever you decide, good luck. You can always do reconstruction at a later time. My reasoning was if they are going to take them off, and the surgeons were already in there, and it was going to hurt no matter what, why not start the procedure. Why hurt twice!! You will have spacers for awhile, and will need a second surgery to replace the spacers, but the replacement surgery did not hurt. Remember you have no feeling. A slight ache, for about 24 hours. I hope this helps, and you have several women share their experience.