Reconstruction advice, please..

I’m extremely grateful to have got the this part of my journey, and to all who made it possible for me to still be here, but I’m really struggling to navigate this reconstruction bit.

I was considered high risk (grade 2, stage 3, lymph node involvement), and it was the end of 2020, so during lockdown. I was offered a full mastectomy, and no other options were discussed pre surgery, despite me asking. I’m very slim, and not a great candidate for FLAP reconstruction, but have concerns about an implant (both safety and aesthetic due to being so slim, tear drop shaped breast to match to, etc).

At diagnosis, I would have been referred to what seems to be a great team of plastic surgeons, but that’s all changed now. I had a referral to the current ‘local’ place, but wasn’t 100% about going there. Having had a few ‘hiccups’ in my journey, I want to feel comfortable that I’ve got a good chance of getting the best result possible with my reconstruction, so asked my GP for a referral. My referral was rejected, and I’ve got another appointment at the local place I started at.

I feel like I’m going round in circles now, and don’t know what to do. I’m still struggling with body image and would like reconstruction of some sort, but no idea where to go from here.

Has anyone else experienced anything like this? Has anyone been really happy with their plastic team? Or unhappy and wished they’d held out for another option? Any advice on being slim and going for FLAP or implant reconstruction?


Hi Artbroken

Thank you for taking the time to post on the Forum, and I’m sorry that you haven’t had a reply yet.

You may find it helpful to speak to one of our Breast Care Nurses on the free Helpline, 0808 800 6000. Alternatively, you can get in touch with our Nurses in the Ask Our Nurses area of the Forum and they can respond to you online.

Sending you my best wishes x

to @Artbroken , first of all, I am sorry to hear about what you are going through with finding the right team of docs to do this kind of surgery.  My breast surgeon recommended a plastics doc who I was fortunate to get in to do my procedure. I had this done at Moffitt(Tampa) and was very impressed with his staff and team.  I go in about every 2 or 3 years to be checked unless I have a cellulitis issue which has happened once.

I had a  lat flap reconstruction and even though all turned out well, it was an extremely painful recovery.  I did have an implant infection, which I guess is not too rare. 

I totally get it that body image is now different and different can be difficult.  But, different can also be beautiful too! I am an athletic type frame and had enough fat in the thigh ( not so much stomach) to work with ,but the latissimus dorsi muscle they cut out was the real anchor for the implant.  I opted  no nipple surgery as I had had enough surgeries. Please choose your reconstruction doctor carefully as this is a major surgery. If you are uncomfortable with your team, my advice would be to hold off until you can find that peace and speak to patients that have used this particular doctor for good results and  that this doctor is going to serve you well  Maybe in the meantime, try the ACS resources for prosthetics in the short run.  Hope this information helps!


Did they explain why it was rejected?

Hi, I’m John, maybe you didn’t think that you would get a reply from a bloke!
Can I tell you about my experience, no, I didn’t have breast cancer, my wife did.
Pat opted for a tram-flap reconstruction, it was a painful recovery. It has left her with a weakness in the lower body, quite a large ‘bump’ where the muscle has been turned and a massive scar from the lower stomach right up to and around the reconstructed breast.
The weakness means that she is unable to do a lot of normal things and to add to that, Pat has associated Angina caused by the muscle pressing on the Esophagus. (her heart is perfectly healthy).
Pat had a really nice figure before the op, and to be frank, the op completely ruined it. The scars are healed but are still a reminder of all the stress and pain.
Please, if you have a slim figure don’t do it. Find an alternative or, as Pat did when she had cancer in the other breast, just have it removed. Less pain, and to be frank, from a man’s point of view, well mine anyway, I would rather see a flat chest than a false reconstruction and a mass of scars.
Of course I appreciate you want to look your best, and wearing a falsey is uncomfortable to say the least.
Pat totally regrets having the op done, and what makes it worse is that every time she changes her clothes, showers or gets ready for bed, her body is a reminder of making the wrong decision.
My main reason for writing this is for you to understand that a tram-flap will at best, just spoil your figure and at the worst, may well give you years of pain and difficulty.
I hope this helps.