Reconstruction or not

I have diagnosed with pleomorphic LCIS in at least a couple of places in my left breast and because I have small breasts (A cup) a mastectomy on that side has been recommended. Immediate reconstruction has been offered - DIEP flap - but am having to decide between this and no reconstruction. I had a consultation with the plastic surgeon and after tugging my tummy about and then looking at the tops of my inner thighs as a back up, he said they could do it, but it may be tight as I don’t have a lot of fat there (I don’t need much for the reconstruction though  :slightly_smiling_face: ). The scar on my stomach would probably be higher than they normally do and the scar itself may be stretched (I think he meant wide top to bottom). He also said that as my nipple was quite small they would probably need to cut wider around the areola to gain access to insert the flap. Oh and the reconstructed one would probably be bigger than it is now. Perhaps they say this to cover themselves, but in my head it all sounds like the outcome is not going to be great looking! 

On top of the surgery itself and its outcome, I live on my own in a small rural village, so the extra recovery time etc for reconstruction is very scary and daunting. 

Am being pressured by my breast team and the oncoplastic team to make a decision and am so tired from sleepless nights and going round in circles, I have no idea what to do. Will I regret it if I don’t have it reconstructed? Is it worth going through all the trauma for something quite small?! I can’t believe someone can cry so much.

If you had similar decisions to make, any feedback on what you went through would be great, please.  Thank you x

Could you do a small implant instead? 

You sound under pressure which isn’t good when making big discions, not good 

I would be asking if an implant is an option. I was in your situation very little natural material on my body & also didn’t like the look of how big the op was. I went for an implant & have been pleased with it 

I lost my nipple during the mastectomy & am hoping for a tattoo next year so it looks a little better 

Hope you can have further discussion. Going luck

Best wishes x


it is a hard one, i also looked into this option and decided against it. I was told not enough body fat in the stomach area  and it will make the recovery pretty hard(even not being able to sit for a while!).

i would talk to the breast cancer now helpline, they are really good and will go though all the options with you…

please look after yourself!


Hello maxbarns,

 I’m so sorry you’ve had to join our club but I hope my experience helps you with your decision. I was offered a diep three years ago. And I am very glad that I took that route.  I was also given all the warnings regarding scars etc. I think they just have to prepare you for the possibilities.  It is true that with small nipples the access hole they need does leave a round scar larger ( but only slightly larger about a 10p) than your original nipple. But that round scar line fades over time. As for the stretched tummy scar, I was very fortunate that mine hardly shows at all. You have to actually look for it to see it.   But without doubt the best part for me is that I have two very similar shapes. They both move the same, feel the same, are both the same temperature. And frankly just feel like me. I still need to sort out a new nipple three years later but the fact that I haven’t is a measure of how well the diep has worked.  Would I do it again?  In a flash. Because despite having had a mastectomy, it is not something that I think about on a regular basis and it is not something that anyone else could tell unless I’m naked. And even then it’s only the nipple.  I hope this helps. It’s a difficult decision and one only you can decide. The 10 and a half hour operation was worth it and almost painless afterwards on both breast and tummy 

My thoughts and best wishes are with you 

Good luck

I am having a double mastectomy and have considered the same things as you. I am also slim and so can’t have a simple fat flap from the side of the ribs. I considered going flat as it is so much simpler. Looking at lots of images of different reconstructions or none and imaging looking down at myself and what I would see helped me come to a decision for myself. Do what you feel you can be comfortable with looking down or in the mirror.