Hi again @Emily W
Obviously choices for “self tissue” delayed recon very much depend on if, whether and where you have spare flesh that can be utilised. It’s a more major op, but quicker results than with an implant.
I didn’t have any option but a back or “Lat (Latissimus Dorsi muscle) Flap”, as am slender and was also only a 34B. But I opted for “implant” recon, as was always my wish, as opposed to self tissue. Reasons for that being:- no visible extra scars on body or breast, no extra “healing” time and risk of infection with the extra scars, and implant shapes are a lot more natural these days than the plonked on looking 1/2 spheres that were.
Down sides of it, are it being a lengthy process from start to finish (approx a year) from initial op to install an expander (two in my case), but a relatively minor op to your mast op, with a 3" insertion scar along “existing” mast scar. That’s followed by a series of “expansion” appointments to inject further saline to gradually stretch the skin and create a “pocket”. How many is dependent on what size you’re wanting, but also very much dependent on the thickness of the skin as to how many it can take. I already had a standard 100ml in at time of expander installation, to keep it in place. 2 months for the insertion scar to fully heal, and the skin to gradually stretch and settle down. Expansions - I have delicate skin so specifically asked for less saline at each appointmnt than they were suggesting. Plus to have the appointmnts spaced out more - 50 ml every 5 wks, rather than 100ml every 3-4wks to a 250mls size. You then have another op to remove expander and install the permanent silicone, followed by 3 mnths for that to “settle” develop a natural droop or drape. Then nipple reconstruction op, if desired, again couple of months healing time. Followed by the final icing on the cake or nipple!) with nipple tattooing, if desired, to create an dark surrounding areolar.
My masts were 2006/07. Didn’t get onto the delayed recon “horse” until 2014, due to a series of major life trauma’s. Went through all the expansion appntmnts, to the scheduled replacement of expander with perm silicon install op, but my surgeon cancelled it a week before, which threw me off the recon “horse” and still haven’t yet got back on it, again down to other major life stuff happening.
There are now further options to “implant” recon - to have implant “under” the Pectoral/chest muscle, or on “on top” of it. Plus another further option of a tissue matrix cradle, to prevent any possible “rippling”/shifting of the implant when raising your arms.
** Most surgeons have a portfolio of photos, to show different ops and results. Do make sure to ask to look at before deciding, Emily. It’s very helpful to actually see results **.
Much food for thought hey. Hopefully, others will come on soon, to talk about their “self tissue” recon experiences or implant. Good Luck with it all, darlin’ and no doubt see you on other threads once you’ve embarked on your chosen op.
Delly XX