LD vs Pedicled Tram?

Hi everyone,


I’m new to this site and new to this whole breast cancer malarky actually. I was diagnosed 2 weeks ago with DCIS in my left breast and need to have a mastectomy. I want a reconstruction at the same time and last week had my first surgery to remove sentinel lymph nodes. While I await the results of that (expected anytime now) I need to decide in the next day or so which type of reconstruction surgery to go for, so we can get the ball rolling and the appropriate stuff arranged and booked in.

My breast care nurse explained the options available to me but I’m struggling to decide which is the best one for me. I wanted a DIEP (as this won’t be disturbing any muscles, thus avoiding muscle weakness) but unfortunately I can’t have one as my BMI is too high. So I’m back to square one.


My surgeon seems to be favouring the LD flap (and I’d go for one with lipofilling and no implant, as I am onlly a B cup) but I am concerned about the side effects I’ve heard about, particulary the pain and muscle weakness in the back and shoulder (I’m not sporty, but the only proper exercise I do regulary and enjoy is swimming). I’ve seen a lot of threads on here relating to very negative experiences relating to the LD procedure but I’m trying to weigh up the options and understand if the impact of this is better or worse than the TRAM (Pedicled), which is my other option. (although because of my BMI I’m at a greater risk of scar and fat necrosis problems with that, so understandably I’m not keen on those risks).


I’ve read lots of leaflets etc but I get the impression that they skate over the pitfalls, and I’d like to understand from real people what to potentally expect and what issues are commonly experience, so I can make a more informed decision.

Any info and experience sharing would be gratefully recieved!

Many thanks! x


Hi Smodge and welcome to the forum  though none of us would willingly choose to be on this site. I had LD 4 years ago and would recommend it. I have no weakness whatsoever and continue to go swimming. I was very happy with the result but unfortunately developed capsular contraction of the implant but if you are not having an implant that won’t be an issue for you. If I had to make that choice again I would still choose the LD. I did also have the tram in the end as the implant had to come out and I am still in the process of reconstruction and awaiting lipofilling. It is a very long road when complications arise so if you can go for the lesser invasive op with the lesser risk that is the choice I would make and did make initially. It is the hardest thing making decisions though I know x