seeing consultant tomorrow

Going to have my first meet with the consultant tomorrow to discuss a poss recon. Does anyone have any advice as to what to ask or listen out for? If poss I think I want the tummy one but would also like a tummy tuck and breast reduction on ‘good’ side. Do you think that is possible? Cheeky? I know this can be done as there was a lady in my hosp when I had my mastectomy.

I also want to lose weight first as worried the breasts will be very uneven if I lose the weight after the op. Any tips on that too?

Thanks ladies!


I wasn’t lucky enough to have a tummy flap, if only.
I do know that tummy fat has a “memory” because I thought gaining weight would qualify me but apparently when you lose weight then the breast mound will lose some as well so that wouldn’t work.
TRAM flaps seem uncommon these days because of the muscle wastage, bit of an irony considering the bigger wastage with LD flap but anyway DIEP flap is probably your option and seems to produce the best results with the fewest real risks.
It’s a while since I logged on there but is supposed to be a good site.
You might find it worthwhile to read the NHS audit of recon but I expect you realise that standards of surgery do vary although with DIEP there will be less variation than LD flap because only plastic surgeons do DIEP and so the skills are different/better.
Good luck

Hi Irene

I had tram flap op in Dec 2010. I am very happy with the results.
Any questions you want to ask please do.

Carolyn x

Hi Irene
I can hear the excitement and nervousness in your posting!!
Ive been for my initial consultation and am just waiting for a date for a TRAM.
I let the surgeon take the lead as I wanted to see what he/she would recommend. I know its a bit late for tomorrow, but BCC can ‘match’ you with a volunteer who can talk to you by fone about different types of surgery-you can speak to more than one. Maybe you could still do that after your meeting to check out any issues.
I would ask if they have any testimonials and pics of their previous patients. Some offer patients who have had the op to talk yoi you. They may have a DVD of procedures for you.
I wanted to know what made ‘good’ candidtate- he said:
-no previous stomach surgery
-non smoker for at least 3 months
-plenty of tummy skin!!
-ideally BMI of below 32, but I understsand thats often negotiable

I went hoping for a TRAM and he suggested that too, so I was pleased!.
They can do follow up tidying and making sure you are symetrical.
Ask about waiting times too, and see if you can meet his BC nurse-they can offer great info and advise

Best of luck for tomorrow

Cathie xx

Thanks Ladies

Sugar, I have had previous stomach surgery, scar very low down nr pubes, ectopic that went wrong so needed a bigger incision. Is DIEP flap the back one? My friend had that and she has weakness down that side. Also, dont think the end result is that good, she has a big hole in her back visable in summer when wearing strappy tops, and boobs dif sizes. Same hosp I would prob have to go to. She is happy though.

Feeling a bit sick now just thinking about it!


Irene the DIEP is the tummy op where they take only the fat but not the muscle… the tram takes the muscle and the fat.

the back flap is called latimus dorsi (LD)i have a lot of friends who have had this and the results are excellent… the scars are generally done level with bra straps so that they arent visible unless your naked.

having a small incision in the pelvic area shouldnt stop you having a TRAM or DIEP only bigger abdo surgery like open gall bladder op or bowel surgery.

i had an abdominal hysterectomy last sept and the scar is low down but i can still have a TRAM although they said im borderline as i dont have a lot of fat… last consultant told me to go home and eat more pies LOL

good luck for tomorrow


Well it went well. I now know which op is which. Because of my mild lymphodeama and node removal he doesnt think the lat dorsi one would be my best option, though its not been ruled out.

He has suggested I have the diep as sadly I do have lots of fat! It may be poss to alter other boob and have a tummy tuck at same time! wowzer, I was amazed at that, it being NHS!

I have to now see the plastic surgeon from Newcastle and take it from there.

I do have a question though. I really want to lose weight but if I do there may be less fat to work with. Also, if I lose weight afterwards, will the recon get smaller too? Dont really understand the physiology of it!

Any advice welcome


great news irene…

how much weight are you planning to lose? and how big do you want your boobs to be? if you are planning a reduction then you could perhaps have more of a reduction if you dont have as much fat available.

but yes if you loose weight your boob will loose weight too… although often if you lose weight your boobs will get a little smaller anyway so not sure if they would be massively different but they can do a lipofill which is a transfer of fat from other areas of the body eg the thighs and the back.

i dont know your weight or bmi but my bmi is about 23 and they have said i probably can still get tram/diep if i wanted.

Lulu xx

Irene all I can say is I was a definite size 8 pre op, lost weight after dx,stress and radical change of diet, my surgeon was concerned one week before the op and told me to go home and eat cake basically which I did (first time in my life I’ve been told that)! I am very small framed but with big boobs( ff/g cup), and I was amazed at the result. I had tram flap, and have ended up with probably a DD/E cup. After chemo I will have a reduction and uplift on good boob. I am happy with the result, it has the shape and feel of natural tissue, still a little hard in places but I’ve been told it can take up to a year to soften totally. I have put weight on during chemo, 4 out of 6 fec done so far but can’t notice any difference in the size of new boob. Feel free to pm me if you have any questions xxxxx

Irene, I had bilateral mastectomy with immediate DIEP. I have the most wonderful, natural feeling boobies, they were reduced at the same time (well, why not?) so I’ve gone from aDD to a C. My plastic surgeon laughed and said there’s always enough fat! I’m also planning on losing a bit of weight but the amount I want to lose isn’t going to have that much effect on boob size.
Don’t let what you read put you off a DIEP. Its a big op but I have found it very easy and am so glad I had it done.
if you’d like specifics, PM me
Nicky x

Thank you so much ladies, that’s really helped! I am about 15 stone and 5’ 7’’ so hide it well. My dream would be to return to 10 stone, my natural weight even after having babies, but would be happy with 12 stone. My consultant said the diep was the best when done right so really pleased, and really pleased to hear how well Nicky is recovering from this op. I love your name on here, lol!!!

So looks like I can lose some weight and still have plenty to work with need to get myself into gear now!

Great to feel positive about something at last.


Hi IreneM,

Was reading your post and feel we have a little in commom.

I have chosen to have bilateral MX and reconstruction but due to personal circumstances, (my husband having heart op next week) I have a provisional date for September to allow him time to recover.

It appears we are roughly the same height/weight with probably the same to lose in preparation for our ops. I have quite a fair bit of fat to move from the tummy and having had an abdominal hysterectomy almost 10 years ago I think I will go with the tummy option. I had considered the implant but the success rate is better from the tummy ops.

My sister has stage4 mets and due to family history I have taken the decision to be proactive and have this done. I am scared at the thought but I know deep down its the right thing to do.

I started the gym about 4 weeks ago and will speak to my instructor on Monday to ‘up my programme’ as I now have a target to reach. 3 stone in four half months. If your like me, I lack will power terribly so this will be harder than the op for me.

Hope you don’t mind me messaging you.


Hi Girls
I had breast cancer ayear ago, picked up by mamogram, big family history, mum, sister, 2 cousins and an aunt. No faulty gene detected…yet! Who knows how many more defects they’ll be able to detect in another 10yrs! I’m 5’4" and weigh 12 stone something, so I guess we’re similar proportions relatively.
It was a no-brainer really. My sis died 2 yrs ago and my mum spent 6 months having treatment for a second lump and then died of something else! I am determined to be around for another 48yrs and to stay healthy. This seemed the best way of doing it! At least I feel like I am in control and no longer in limbo.
The relief is ENORMOUS!!!
Nicky x