I think you're absolutely right about the decisions we make; I belong to a support group where we talk about our values and deal with the impact that breast cancer has had on our self-esteem. In our group, others -- society, family, friends, husbands and lovers wield quite a bit of influence. There are 33 of us -- two of us are double amputees.
Of the remaining 31, 17 had reconstructive surgery and of those 17, 14 say that if they had it to do again, they wouldn't -- 13 have confessed that they had the surgery more for their husbands/significant others than themselves; the other says she didn't feel like a woman until she had the surgery but regrets it just the same.
The other fourteen opted for prostheses and say they're fine with their decisions to wear them. Interesting enough the two of us who have no breasts wanted no parts of the surgery. We wear our prostheses only when our clothes dictate the need for them. We've recently decided that we will be modifying some of our duds so that we will need them even less -- especially in the summer..
Sadly I lost a very good friend to breast cancer recently because she refused to have surgery, stating that if she lost her breast, it would be like losing her femininity. Friends and family could not convince her that she was worth far more than the sum of two breasts. I walked in her honor during the Race for the Cure.
BTW: I've been single for 21 years, and my fiancé met me with no breasts. He recently confessed that before me, he had been a real "breast" man, but became aware early on that he didn't miss them. We met at the hospital where we were undergoing treatment -- he for prostate cancer and I for my breast.cancer.
I wear eyeglasses, have a partial dental plate, two prostheses, and was wearing different styles of scarves on my bald head when we were becoming acquainted -- would've gone bald, but it was winter, and I couldn't stand it. When we made the decision to become intimate, to break the ice I simply asked, "Would you rather sleep on the night stand with all of the goodies or in the bed with me?" It's our personal joke, and we still laugh about it occasionally.
After that it was on, and now into our 13th year, it's all good. I guess it just depends on the individual(s).