I was in a similar position last year at the same age diagnosed with Grade 2 IDC ER+ PR+, HER2-. My treatment plan was initially to have a lumpectomy but after an MRI, this changed to a Mastectomy and I was given various reconstruction options to choose from. For me I knew I didn’t want a silicon implant due to a previous skin allergy when I wore a wrist brace which had silicon in it.
As I was slim my breast surgeon wasn’t able to clearly tell me if any of the body fat based reconstruction options would be viable for me, without being seen by the plastic surgeon (for which there was a long wait on the NHS). So I decided to get a second opinion privately, I saw another breast surgeon who referred me to see a plastic surgeon who spent an hour and a half explaining what options were viable after examining me & showing me photo’s of reconstructions she had done previously to help visualise. She explained that even though I was slim, body fat based reconstruction was possible with a combination of fat from my abdomen (DIEP) & thigh/buttock area (PAP), but would most likely involve one or two smaller surgeries for fat grafting after the first main surgery; I was a C/D cup. She also said that if I didn’t want to choose the immediate body fat reconstruction option (longer surgery & recovery time), she could do a nipple sparing expander surgery with a silicon implant (shorter surgery & quicker recovery time) which could be replaced with body fat/changed later if I didn’t get on with it due to allergic reaction (she mentioned this would be rare, but explained that there was such a thing called implant sickness symptoms) or needed radiotherapy.
That appointment with the plastic surgeon is what gave me the clarity I needed to make the decision that was right for me at the time (she went through various risk factors, DIEP failure rates and a lot of other information). The reconstruction options were just too involved for me, and I couldn’t see myself having multiple surgeries in the future in order to match the reconstructed breast to the other; At that particular time in my treatment journey I wanted to get on with surgery and understand what my oncology treatment plan was going to be. So I decided to go with a mastectomy without reconstruction (flat on one side) and leave delayed reconstruction as an option for the future seeing how I felt after.
I am now 21 months on from that decision and can say I have no regrets. I’m still working through finding the best fit bras and the most suitable prosthetic for various clothes I wear, which are practical lifestyle changes I’ve had to adjust to so it is a process. But other than that I can say I am happy with the choice I made and haven’t really thought of delayed reconstruction since then (but it’s still there as an option if I should want it, even though it wouldn’t be aesthetically the same as if I had had it done as an immediate reconstruction). Hoping some of the above information helps you make the decision that’s right for you.
Wishing you well in the next steps ahead… xx