Double recon which way to go?????

hi, just looking for a little bit of advice really as I always tend to find myself in a wierd position. Ive had all my treatment about a year ago and looking at options now, didnt get very far so been to Newcastle which is around 2.5 hours away to discuss options and was blown away by given options.

I have had a right masectomy and had chemo and rads incluidng to the armpit and due to having BRCA1 gene opting for left masectomy, so the options seem to be a no no to tissue expanders due to rads

LD flap, could do both at same time after an expander in one side to stretch skin, and either put in implants or use my back fat (have plenty) and this seems the lesser of the pain side of things as Im such a wimp, however the draw back would be the fact that I already have 26% lymphoedema and this is a high risk for making it work, also might cause problems re rads.

Tram/Diep, this is an option which terrifies my but then also like the idea of not having implants but said around 10 hours due to reduction along with skin sparing masectomy on other side, Ive heard that can be problematic and can fail and in fact is really hard recovery. Have to get my blood pressure under control and loose 2 stone before would consider and this would also entail expander in first

Anyone any advice, Im totally stuck with what to do but Im so large at moment prothesis drives me scatty and as having to have 2nd masectomy seems silly not to try recon at same time.

Thanks all from a scaredy cat!! x

Hi Lisaf,

Hmmm a tricky choice…I really wish I could offer you some advice on this, but I don’t think I can. I am in a different position to you in that I am due to have a single mastectomy with immediate reconstruction (LD flap).

All I would like to say is why not ask to speak to someone who has had similar experience through breastcancer care peer support system? Just call the helpline 0808 800 6000 and they may be able to put you in touch with someone. I did this, because I didn’t know (and am still not 100% sure) whether to have recon at same time or not. A really nice lady called me back and was happy to chat about her experience and ask any of my questions).

I think you just need to ask for as much as advice as you can, from all sorts of places, including of course the professional medical people.

The tricky bit (I am finding) is that at the end of the day only I can decide, and I just need to make a choice and go with it …easier said than done, I know.

I totally sympathise with you about being a ‘scaredy cat’ - I am just the same!

Whatever you decide, please try not to be afraid. Wishing you all the best :slight_smile:

Thanks for that, good luck with your decision.

Im going to meet with some people who have had both options and do some more reading, like you say only me that can make the decision.

Again good luck and thanks

Hi Lisa,
I can only tell you about my positive experience having a single tram flap. I had delayed reconstruction a year ago using a free tram flap. I was in theatre from around 0830 until 1530 when I woke up in recovery. I had to stay in bed for 3 days under a warm air blanket to keep my new boob nice and warm. I had regular analgesia via a pump and could press for extra. I was in hospital for 7 days. My tummy is now like a teenagers it was quite wobbly after 2 kids! I went on holiday to Turkey 6 weeks after. Breast cancer knocked my confidence but having the op has made me so much happier in myself. I was completely aware of the potential complications and did all I could to minimize then such as deep breaths and coughs, wiggling my legs and feet around, drinking plenty for the urinary catheter. When I was allowed out of bed i forced myself to go for little walks, getting a little faster and going a little further each time.

Hope you are happy whatever you decide and I wish you luck.
Best wishes

Thanks for that Chris, glad it turned out well for you. I do think I am vearing towards that option and will find out what I can do to minimize risk.

Thanks again


I hope you opt for TRAM or DIEP.

Please don’t consider having LD if it is both sides. I have it on one side (been done twice thanks to incompetence and neglect) and it is crippling 2 years on. I had a revision and am still in pain and didn’t get a good result - it was absolutely NOT worth it and does NOT feel part of me at all. Implants are awful if you are slim …

Good luck.

Hi Lisa

As well as the support and information you are receiving from the other users you may fine it helpful to read the BCC booklet on reconstruction. It covers a wide range of information on the procedure, from suitability for reconstruction and how to find a surgeon through to the possible side affects and the recovery period after surgery. If you would like a copy just follow this link:-

I hope you find this helpful.

Kind regards
Sam (BCC Facilitator)

Thanks sam I have the book from the plastic nurse and Dahlia thanks for your thoughts, im defo not slim but i am not convinced about having implants in as i would know they are there all the time if you get my meaning.


Hi Lisaf

I’ve only had a one-sided recon, but I was thrilled with the results from my TRAM op.

The downside (apart from the long and rather painful recovery time) is that I’m pretty sure it triggered my lymphoedema and I know you’re worried about yours getting worse, too.

My physio said the last thing I needed was another ‘excavation’ in my axilla with from a PS surgeon with his ‘knife and fork’! Altho’ I feel that was a little unfair as the recon itself…well, I couldn’t have wished for anything better. But there was a marked lack of interest when my arm swelled afterwards.

However, recons with lymph node transplants are starting to be done in Europe to cure/avert problems with lymphoedema. Is is worth hanging on until the NHS catches up?

Good luck with your decision.