I was diagnosed in January with invasive ductal breast cancer in 3 areas of right breast and a spot in lymph gland; grade 2, hormone receptive, HER2neg. Due to the focal areas, they want to perform a mastectomy and I have had a bit of a standoff which I posted about here, as I am only willing to consider with immediate reconstruction. The plastic surgeons were refusing for months to even see me due to my hypertension for which I am on medication, but also my age (66) due to the long hospital stay and risk of COVID-19. The guidelines in my region have now been relaxed on age so they have told me I can have immediate recon, although my hypertension remains an issue as does the fact that I was a smoker until 2009 - they told me my blood vessels will still be damaged.
Does anyone have any ideas which would suit me best - implants are not an option, and they seem to be steering a bit towards either DIEP or LD/back flap. I don’t know really, as I am concerned about cosmetic appearance and also the risk of failure is a big deal as I cannot cope with waking up flat which they said I would be if the blood supply didn’t work, they mentioned 5% risk factor. They know I was unwilling to have the mastectomy without immediate recon so they realise it’s crucial but can’t guarantee. The blood vessels risk seems to be more associated with DIEP, but any advice would be appreciated; I have to see the nurse later this week about my decision if any.