Confused re types of reconstruction...

I am having a left mastectomy at the beginning of Nov and want it to include a reconstruction. My consultant is talking about a muscle transfer from my back or a bag to be inflated and then an implant. Where can I get info and or photo’s as I am confused and don’t understand the medical terminology. Will ring helpline but wondered if anyone had any advice or stories to share…
Thanks : )

hi there. i had a left mast and LD flap recon in july and had expander implant to give good breast size and volume.the booklet on recon from thi website is helpful.I was able to see some photos of post op scars that my breast care nurse had at the clinic. always ask if you dont understand and get someone to make notes and answers to questions as i found i didnt remember all that was said I had a few weeks to decide on which type of recon to have but so often it depends on any other treatment you may or may not need and also what your consultant recommends.i wasnt keen on the thought of implants but didnt want a mega long anaesthetic to have the tummy flap option or the huge scar but a slightly quicker recovery time.hoping to have a bit of an uplift on right side to be more symetrical and prob nipple in the future but need to have the expander swapped for permanent implant before that happens. I was lucky not to need any chemo or rads so it was relatively straight forward. nearly 3 months on and the breast is settling down well i have tried to drive a couple of times and back to work nexxt week. my cons gave me some of the pros and cons of each option and this helped. everyone has a different expectation andwant a certain type of breast but do keep your options open and be guided and not forced into a decision before you are ready.good luck.hope this has helped.

There is quite a useful thread on here - see link

and on that thread there was info about a reconstruction site which has a lot of info on it about the various options. I’ll post the link as a PM or it may be removed
Yesterday I went to an info session organised by bcc which was so useful, they organise them around the country so that may be helpful -
m x

Hi Marniecat,
I personally did not want any skin, fat or muscle taken from another part of my body as I felt having a mastectomy was enough!
Therefore, I opted for a tissue expander (or bag as you call it) then an implant. The tissue expander is an inflatable implant which they put in under the skin and then inject saline into over the following weeks/months to stretch your skin enough to take an implant. At least with this method you dont have to have major surgery to move a flap of skin along with fat and or muscle to the breast area to recreate a new one! and having read the comments from people who have had an LD (use of back muscle) I know for me, I have made the right choice as there seems to be a lot of people unhappy with their LD op.
If you Google tissue expander or LD reconstruction you should come up with something - if you Google these terms under ‘images’ you will get some good photos which will give you an idea on what to expect.

Any questions please fire away - and dont be rushed into something you dont fully understand or are not happy with - I waited 12 months for recon so I could look into all of my options and be happy with my choice.

Take care and keep posting - we are all here to help you get through this!



There is a good reconstruction booklet on this site (under publications) and also on the cancerbacup site (has photos). Another site I found useful was Nothing beats talking to someone whose had a recon though - is there a support group in your area or can your bcn put you in touch with anyone? The peer support service on this site is excellent (1 - 1 phone calls) - you just need to phone the helpline to request it and they try to find someone to match your age/dx etc.

My story is that I chose immediate implant recon with bilateral mx - reasons
* least complex surgery- though at least 2 ops are needed as the initial expander implants are eventually replaced with permanent silicone ones.
* Chances of a good end result for smaller breast sizes (I was 34B).
* Chance of a good match for bilateral
* If it went wrong potential to have a tissue recon later

I’m 4 months post op now and living with the expanders - pretty uncomfortable but cosmetically ok. I see the surgeon in January to talk about the 2nd op.

Best wishes

We also have a very good surgery album on bcpals where members have contributed their own before and after photographs of varying types of reconstructions. These photos tell it like it really is. Some sites tend to show only the best of the bunch LOL. If you aren’t sure of the www then pm me.


I tried to access the bcpals site, but it says you need a password??

Hi Marniecat,

I had a skin conserving left mastectomy 2 weeks ago with an immediate LD recon. I opted for immediate recon as I felt I would cope better with something rather than nothing. The expander option wasn’t mentioned to me and I wasn’t aware of it to ask. I had the choice between LD and tummy and went for LD mainly because

  1. I would have to be referred to another consultant to discuss and wanted to get the op over and done with and the cancer gone
  2. I didn’t want a long anaesthetic and hospital stay (I think its 10-12 hours plus 10 days hospital with tummy as opposed to 5+ hours and 1 week with LD)
  3. I felt recovery from LD would be quicker as I wouldn’t struggle quite so much without a bit of back muscle as I would without tummy muscle
  4. Using my own tissue/muscle would give a more natural feel than implant alone

My only real concern was getting fit again enough to do my job (I am a police officer and worried I may not be able to wrestle the baddies to the floor without my back muscle but was told people have gone back to sports/horseriding/other physical jobs after LD recon and am lucky enough to have access to an intensive rehabilitation centre with the police)

2 weeks on much as I am having to adjust to my new boob I am happy with the recon decision I made. I still get a bit of back ache from where I guess my other muscles are working harder to make up for it. The back scar is along my bra line so wont be visible under a bra or to me unless I look over my shoulder. The skin conserving bit is brill cos apart from the small bit of my back where my nipple used to be the rest of my boob looks like my old one.

I didn’t have enough muscle/fat/tissue for the whole boob (I was a 32DD) so have a small implant as well. My new boob is like my other boob would be had I had a boob job and I am hopeful that once it settles down from the hard thing it is at the moment and my other one has a bit of work on it to bring it up so to speak I will have pretty good boobs, better than before.

So apart from the bonding issues which I would have had however I had my recon done I am happy with the choice of it being an LD recon.

Hope that helps, x

Thanks everyone!! I am following up suggestions for more info : )
I don’t really understand why my surgeon is so set on a LD flap, I have 34B boobs so not huge by anyone’s imagination! and am very slim. I had thought LD flaps were for larger ladies. She said an implant would sit too high and possibly go hard. I possibly face having the other boob off in the future - has anyone gone on to a second LD recon?

Ostrich, well done for doing well, watch out baddies!! What was op like? Unfortunately I read a newpaper article last week where a lady said it was horrific and incredibly painful - I know everyone’s experience is different so I am not dwelling on it but I has shaken me rather.

My op due Nov 6 so am beginning to get very worried.


Narnia, whats the bcpals site?

Struggling to find photo’s anywhere, chemo must be affecting my brain!

Hi Marniecat.

I found my consultant was set on me having ld reconstruction as well.I got told that having expander reconstruction was a faster recovery time so that was option i took as my baby was just 5 months old when i had my surgery last month and i didnt want to have longer period that i couldnt cuddle him.I am now managing to cuddle him.probably get a row but hes so of my family history i had both done at same time to avoid the possibility of having to go through it all again.I too was a 34b and very slim and apart from a build up of fluid on one side which will drain gradually all is looking great.scarring is really good.I made mistake of reading magazine stories that caused me to have panic attacks before surgery.But all is well.

thoughts are with you.wish you all the best.


In same postion as you with rhs mastectomy due in November…with exception that my surgeon won’t do recon immediately as I need radiotherapy. I want both off and reconstructed to minimise risk and so they match up , but have been told I will need ‘psycological assessment’ by plastic surgeon before this will be considered, and wait for 6-12 months!

Do you have any information about pros and cons of LD or Abdominal fat reconstructed boobs? I feel that the surgeons tell us what they want, rather than what we need or expect from our bodies and them. Will be asking to see before and after pictures of their surgery and have been told that they will put me in touch with other patients to ask their opinions.

I had surgery to replace crutia ligaments in my leg with reconstructed ham-strings…it worked very well, and I believe that using our own body tissue for reconstruction is better if we can, it should reduce risk of rejection, and having to possibly replace implants.

Hi Ladies,

The op was okay, think I was down for about 6 hours in total including in recovery, I had a patient controlled morphine pump for 2 days so the pain was ok, the drains weren’t as bad as I thought (I really dont do well with blood and ucky stuff) the only thing I found was sleeping! Couldn’t sleep on my back (scar and drains going from my side into my back under the skin) or my side (right because I was afraid I wouldn’t be able to get back up if I got stuck and afraid I would pull drains out which were on my left and left because that was the side they operated on so drains etc). Managed to sleep semi sitting up on my back but the first week or so they were long nights!! Am now sleeping better at a 45 degree angle between back and right side and managing a whole nights sleep! Everyone says my boob looks fantastic (and many have seen it over the last 3 weeks) and although I am still getting used to it I can appreciate that its pretty fab and natural looking (apart from the bit of back where my nipple was) and better (firmer, more pert) than before. I am beginning to imagine that perhaps a year from now when I have my nipple reconstructed and my other boob titivated (LOL) I might have a pretty fab pair of boobs.

I am only a size 10 and was a 32DD (though described by my surgeon as droopy (cheek)) and they had to use a small implant as I didn’t have enough muscle/tissue for the recon alone so I don’t think LDs are only for larger women.

Am still having a few issues due to a secondary bleed under the skin and the blood and fluid oozing out through a scab and slight inflamation on a bit of my back scar and a bit of back ache and numbness on that side but I have to say overall I am pleased I went for it. Mind you no-one talked to me about an implant only recon and I am not sure had I known what decision I would have made.

I do know now that I am glad I didn’t choose the tummy method as the surgery is longer, I believe recovery takes longer having used your tummy muscles and, most of all for me uck - they re-site your belly button by making a new hole and poking it through (to save your belly button ending up in your public line apparently).

In the end for me I went with the first thing I was offered just to get on with getting rid of the cancer and starting further treatment (I would have needed to be referred to another surgeon for the tummy one). I think you will find pros and cons of all if you look through the site so I don’t think there is a better one.

Good luck with your choices/ops etc.

Hugs to all, x