Thank you for your kind words. I’m sure I will feel much better once I have made a decision. I have written a list of pros and cons and not having reconstruction looks the best option in black and white. What I’m struggling with is having the confidence to make a decision at a time when I feel an emotional wreck! Thank you for acknowledging that this is normal. I’m hoping that talking things through with a counsellor will help x
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Hi! Thank you for all your helpful comments and support. I have made the decision not to have reconstruction (at least not for now). I’m going to see my breast surgeon today to discuss. I’m feeling soooo much better now I have decided and finally have some head space to think about something else and enjoy Christmas 
. Merry Christmas everyone x
Has anybody’s surgeon refused expanders?
Mine seems very nice but also says HE will make the decision and that most oncologists don’t like expanders cos they have metal in them. I haven’t made up my mind what I want so had my heart set on an expander so I can make a decision post radiotherapy when hopefully my brain works a bit better (my chemo brain is awful).
He seems to be pushing for me to just get an implant (be it silicone or diep). I don’t think I want the latter as recovery sounds grim (I thought I could handle chemo but I was immediately signed off work and haven’t been back yet).
I’m pretty good at advocating for myself and I don’t need to make a decision til January but I’m just wondering if I should speak to someone else.
Has anyone else had a surgeon try to discourage them about expanders?
Hi @sez
I was in a similar situation as you (but on the other side - my surgeon only wanted to do expanders and nothing else haha!) and you are absolutely right about wanting more information is your damn good right. I ended up getting a second opinion and you can get it privately for £250 or so, if you want to speed up the process. For me, it was the money well invested.
I understand that expanders vs one stage is usually a personal preference of each surgeon and there is no right or wrong. It is for you to decide what you prefer. I must admit it is the first time that I hear that expanders cannot be used for radiotherapy (my oncologist explicitly said in her clinical letter that this IS the reason why we use expanders, it was unclear at the time of surgery whether I need it or not, so installing implants straight away would have been too risky and I didn’t want to go flat).
Some pros and cons of implants vs expanders that I’ve identified for me when making the decision.
Implants first:
- just one surgery, one and done
- if you are generally healthy, you should heal well and get on with life quickly
- may require some follow up surgery to improve the look
- slightly higher risk of failure
Expander
- Two surgeries (both quite major)
- Easier to fine tune later
- Slightly less risky re failure and when healing
My second opinion surgeon didn’t like expanders, as I thinks that the second surgery is unnecessary for a young and healthy woman who is likely to recover quickly and heal well. Basically, no reason to do it. After a long contemplation I went for expanders, as my surgeon promised to make my tits look really great and with a double mastectomy I take all benefits that I can get haha! I must admit he has delivered (and I was also able to go up in cup size)
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Thank you for replying. Maybe I need to speak to my oncologist if he’s putting words in her mouth.
He didn’t say they don’t like expanders cos they stop radiotherapy from working but said they ‘interfere’ with it.
My Macmillan nurse has told me of two other surgeons at another hospital I could talk to (I’ve sent her an email about this and hope to speak to her next week if she’s working).
I definitely don’t want to go bigger (DDs are more than enough for me right now, and I might try and lose some weight). I’m only one-sided mastectomy, I’m having ovarian cyst surgery too probably later next year so I really wanted to hold off til maybe 2026.
I think I still need to talk to some more people. Thank you for validating that it was odd he was saying it’s all his decision.
It is definitely not his decision, as you are the patient and you’ll get to live with the consequences of this decision. His job is to help you make the decision by answering your questions and providing additional information. This is the reality of it. It definitely helps talking to different people, at least it helped in my case. I am well aware that consultants often don’t like when patients challenge their views or ask for clarifications (like “interfere with radio - how exactly?”). However as I said it’s you who live with the consequences of this decision and not them and sometimes it’s worth reminding them of it.
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