Help, Failed implant recon / DIEP query re quality of tummy skin / experiences at Norfolk & Norwich

Sorry, apologies for length of post. A bit of a saga with my reconstruction, I will try to summarise.

June ‘20, I was diagnosed with IDC, had right side full mastectomy and immediate recon (NHS).
I definitely wanted reconstruction, preferred immediate recon, so looked at options with plastics consultant. DIEP was my preference (and he didn’t offer anything else) but after assessing my surgeon advised my tummy tissue wasn’t good enough (very stretched tummy due to full term twins and later large weight loss).
Disappointing but I’m a pragmatic person so accepted this. There may have been an element of them wanting a simpler op due to Covid but this wasn’t expressed to me at the time, has been mooted since.

Sept ‘20. Had surgery with immediate implant recon with implant. No mesh.
I had severe seroma following, multiple draining for this over many months. Once seroma had receded the implant had displaced and essentially the reconstruction failed.
Jan ‘22. Second surgery to replace implant and insert mesh sling.
No seroma, more painful after with the mesh insertion but healed well. I think I had realistic expectations of my aesthetic outcome, i.e. definitely not expecting perfection, but the breast mound sat very high so quite poor symmetry and 6 months later still lots of pain in the mesh area. Check with consultant at that 6 month point, he was happy with result and suggested it was a good aesthetic result, dismissed my query over how high it sat and he felt I had an acceptable level of discomfort but he hoped that might still improve. I went away ready to accept my new physical appearance and try to be positive and move on with life.
Aug’ 22 Just a month later the reconstruction developed severe inflammation and infection and has remained inflamed. Consultant wasn’t sure what was going on but said initially if it doesn’t settle it will have to come out, he couldn’t put a new implant in then but possibly could at a later stage. Or go flat as another option. No other forms of flap surgery suggested.
I’ve since had multiple courses of antibiotics including being admitted for IV last week and now still on an oral course.
Unfortunately the inflammation has led to a severe capsular contracture. The infection appears to be receding now but with the contracture it’s extremely painful and generally very uncomfortable which is permanent until removal.
My consultant wasn’t there when I was reviewed prior to discharge last week so saw another consultant from the team.
She said the implant had to come out, asked why I hadn’t had DIEP and (quickly) assessed my tummy, saying that in her opinion it would be fine for DIEP. She asked to see me in her clinic in a few weeks where she would discuss options.

Obviously I need to wait to hear what she says and have all the information and options laid out. I don’t feel so keen on other forms of flap surgery.
I do like my original surgeon, I know other people are happy with him, but I’m very keen to know if DIEP is a realistic option for me and could give me a good outcome so I’m happy to hear another surgeons opinion.

I’m just a bit wary now, after 2 failed ops.

If anyone can relate, has been through similar or has any advice I would welcome thoughts, and also any personal experiences with consultants at N&N (maybe via dm?)

Thank you

Hi DestinyIsAll 

I’m sorry you haven’t received a response yet. If you would like to talk things through with someone in the mean time, our friendly nurses are available to lend a listening ear on our confidential Helpline.

You can reach them on freephone 0808 800 6000 (Mon-Fri 9am-4pm; Sat 9am-1pm). Alternatively, you can get in touch with our Nurses in the Ask Our Nurses area of the Forum and they can respond to you online. We’re always here to support you.

Best wishes,


Hi. I’m going through something similar. I was diagnosed with IDC late 2018 and as it was multi focal I had to have a right sided mastectomy. At the time I wasn’t given any choices on which reconstruction and was told an expander implant was what was best for me. I was in such a state of shock at the diagnosis that I accepted everything that I was told - basically I put my full trust in the consultants.

Fast forward to today and to try and summarise what has happened since 2018 - the expander implant was horrible. It is like big blob on my chest, sits really high up and is uncomfortable and looks horrible and it is considerably smaller than my real left breast. I had reduction surgery on my left breast in March 2020, which didn’t make hardly any difference and because covid hit in I couldn’t have any more appointments.

Once appointments were starting up again last year, I contacted the hospital to get to see the consultant as I wasn’t happy with the implant or the reduction - as there was still a VAST discrepancy in size, I couldn’t have nipple reconstruction as the surgeon said he wouldn’t know where to place it as the breast were SO uneven.

When I seen the surgeon in November last year he was very dismissive of me and more or less said there was nothing he could do for me and maybe I should go flat. This really upset me as this was never an option as far as I was concerned and I ended up in tears. His solution was to say I needed counselling. I told him that the expander implant was never going to work, and I should have been offered an informed choice of which reconstruction to have. He got very defensive when I said this. I really think I was given an expander implant at the time because it was the cheapest, quickest and easiest option. I also think that due to my age they weren’t too bothered about my appearance and maybe thought I’d be the same (I’m 66 years old now, I was just 62 when I was diagnosed). I had quite large breast’s a D+ cup and I know now expander implants are better for smaller breasted women, which I wasn’t advised about at the time.

To cut a long a short I was referred to a psychologist who only seen me once and discharged me as she said there was absolutely nothing wrong with me mentally and it was my physical appearance that was the problem. I have now been referred to a plastic surgeon to discuss my options. I have an appointment for 2nd November. I don’t know what to expect as I have lost faith in these consultants - but at least this is someone new and it’s at a different hospital - so hopefully I won’t be dismissed as a nut job. 

Keep us updated with your progress.



Hi all, 

Bit of a saga!  I was diagnosed in March with IVC grade 2, ER+ (8/8), and intermediate DCIS in my left breast.  Lymph nodes thankfully clear but after WLE, no clear margins so decided on single mastectomy. I should be grateful I didn’t need chemo or radio therapy (just Tamoxifen at the moment). I am 56 and perimenopausal and as I had a coil in for 5 yrs which delayed menopause)

Plastics rejected me for a DIEP - apparently my BMI is too large and I need to lose weight.  So I had a silicone implant but due to very thin skin, I got an infection and fat necrosis so the surgeon then tried an expander implant.  This too has caused problems too as the port twisted but finally fully inflated 3 weeks ago.  After that, the skin was thinning again on the scar and the surgeon is worried.  She suggested perservering but was concerned a new silicone implant would fail as well,  so have made decision to go flat on the left side which the surgeon and I reckon best decision.  The surgeon is doing this next week.  Completely ruined Christmas plans but better flat than not!  So staying at home with a Pico (possibly a drain) and am a bit fed up! :slightly_smiling_face: .  I am concerned the skin will break down again, even without any implant! 

Sorry to vent!  I should post this to the “Awake” forum on the Macmillan site, rather than highjacking this thread but seemed best place to post.