Bilateral mastectomy with LD reconstruction

Dear Ladies,
I really need your experiences.
I have had 3 neo-adjuvand (before the op) chemo’s so far and it is working-my tumor is shrinking, however, as I am a BRCA1 mutation carrier I was srtongly advised to have a bilateral mastectomy with immediate reconstruction after I had 6 chemos.
I am 36 and never even had stitches in my lofe, needless to say that thoughts of operation are haunting me and give me nightmares. However what I really need to decide is what type of reconstruction to go for.
The surgeon I was assigned is extremely good at LD flap reconstructions and everybody advises me to go for this type, as apparently the implants only in my case (full mastectomy that is) have more aftermath problems, like encapsulation etc. If it is the case, then I would really prefer to have an LD reconstruction, but using the muscle only, no implant at all. Has anybody had the implants only or an LD flap only, but no implants? What is your experience. I am 38 B/C, but would like to go back to A/B as I was before breastfeeding my son 4 years ago.
Thank you in advance for your advice.

Hi, Dahlia,
It is my choice to have both done at once-instead of one by one-just want it over and done with in one go. Might even request for them to do an ovarectomy all in the same surgery -they need to see whether my body would coop. Met a lady who had bilateral mastectomy with LD reconstruction last May and she told e she feels great-showed me a full range of movent and said she can climb ladders when needed. Bumped into my assigned surgeon in the corridor (he is a country-wide famous breast reconstruction surgeon, who specialises in LD reconstruction, was on TV in 2004 performing recostruction) and asked whether he would be prepared not to use an implant-he said he only does it without the implants in 15-20% of the time and he would need to look at me to answer the question. So I guess I just ned to relax a bit and concentrate on getting through chemo (only half way through, and they normally allow you to eet the surgeon to talk about the op after chemo 5). I don’t feel I have a need to ask for the second opinion as I was lucky to get a very good team looking after me. Now I am a bit paranoid about statistics of breast-cancer re-occurences, espessially the hereditary ones. Althoogh I am very curious, I am afraid to research it-as I don’t want to get depressed and think the worst-I would much rather hope for the best.

Thank you for your support.
Take care

Hi Irina,

I think your surgeon is the same as mine - Mr B at Manchester??! If so, then write down all your queries and discuss with him the next time you see him and ask him for his guidance. He is a lovely, caring doctor, a first-class surgeon and will happily answer all your qus. I placed all my faith in him and he hasn’t let me down yet - he’s been brilliant. I am 36 too - I was 35 at dx last summer and he glanced at me and decided I didn’t have enough fat/muscle elsewhere to do flap surgery so it was implants for me. I’ve had chemo and just about to finish rads which may cause problems with having implants but we’ll see. I needed the rads because I didn’t have clear margins.

I was glad not to have flap surgery because of the longer recovery period but there’s plenty of ladies who would disagree and have been v happy with results. Ask to see pictures if you haven’t already. The BCN has a file of completed surgeries. You can also see step-by-step pics at the bcpals website once you’ve posted there 20 times.

Good luck with the decision-making!


Hi, Nicola,
My surgeon sounds very similar to your, but he can not be, as I am from Surrey. I saw the pictures of his LD reconstructions as well as a couple of ladies who had it done-and it all looks quite good. I have not seen any implant only on a live person yet, only on the picture.
Until I actually talk to my surgeon during pre-op consultation after my fifth chemo I have decided to have an LD flaps if he can do it without the implants (I want to go down in size and don’t mind small boobs) and if I can not avoid the implants, then I will strongly consider implants only, But he (surgeon) might talk me out of implants only, so just have to wait and see.
Good luck with the rads and have a good Easter!