Implant or DIEP?

Hi everyone, 

 

I had 2 excisions for high grade DCIS in Jan and Feb and was devasted 2 weeks ago to find out that I still have margins and now need a full mastectomy. 

 

I have read the books and looked at the photos, but was counting on a reconstruction support meeting tonight to meet ladies who have been through this to get some real insight into which way I decide to go - no recon, delayed recon or immediate recon, and which type (implant or DIEP flap). Arrived at the meeting venue to be told it was cancelled. Absolutely gutted. I have appt with my surgeon tomorrow and a list of questions as long as my arm. She has been away and it was someone else who broke the news so I was left for 2 weeks with a booklet to read to make a decision after she’s answered any questions I have tomorrow.

 

Can anyone please give me any advice on which recon might be best for me? I am 50, about 5’6” and not big breasted (large B or small C cup), weight about 9 stone. I was leaning towards implant as not sure I’m up for the more invasive DIEP, but change my mind daily at the moment. Can anyone tell me why/how they chose one over the other and if it was the right choice for them in the end and why? I work full time and although I need to be back to work as soon as I can, I also want to do what’s best for me. I have been in emotional turmoil since November and don’t even have invasive cancer so feel a bit like a fraud which actually doesn’t help.

 

Thank you x

Hi KMG

First of all a big hug to you as you go through all this and have to try to make decisions. So sorry to read that you now have to have a mastectomy. But please do not think that you are a “fraud” in any way, you are absolutely not. This is a place where we can all share concerns/questions and experiences, no matter what diagnosis.

I wanted to share my experience briefly before you meet your surgeon tomorrow in case that helps you at all. I am the same age as you, same cup size, a tiny bit shorter and a tiny bit lighter, so our experiences may be similar. I had a mastectomy in May 2017 and an immediate recon with an implant. I had chemo and radiotherapy too. I didn’t have enough fat for a tissue recon but I wanted an implant because of the shorter surgery and quicker recovery. I believe tissue recons look more natural than implants, but I’m happy enough with mine. It doesn’t match the other one, but I’m glad to have something. I use a prosthesis on my real boob to even things up a bit and in clothes you can’t tell there is any difference. Almost 2 years on I would still say I made the right decision for me. It is a very personal decision though and many ladies choose to stay flat, there are plenty of support groups for people who choose that option.

My implant is called a “pre-pectoral” implant, which means it sits on top of the muscle rather than underneath it. This is a relatively new surgery, implants always used to go under the muscle. Mine sits in a sort of sling thing, called Braxon (I believe). If you do go down the implant route it is worth asking your surgeon about this option as again I think it gives a slightly quicker recovery time.

I don’t know if you have to have radiotherapy too after surgery, but many surgeons warn of the risk of “capsular contracture” with an implant if you have to have radio and therefore won’t put in an implant.  This means a hardening of the scar tissue around the implant. However, I think the Braxon sling helps to cut the risk of this contracture.

I said I’d be brief but this has turned into a bit of an essay, sorry, but hope it helps a little. I wish you all the best and am very happy to answer more questions on here or via private message if you prefer.

Hugs, Evie xx