Two-stage implant versus DIEP her2+

Just completed 6 cycles of chemo+immuno therapy and now in between waits to my surgery (I had Neo adjuvant). I would need a mastectomy on my right breast since MRI and PET CT shows different area affected with the largest lump around 6cm. One suspicious lymph but was missed out during biopsy as it didn’t look suspicious on the ultrasound. However is tagged and will be taken out during the surgery for PCR test.
Now the main worry that I have is if I should go for the DEIP flap or 2 step reconstruction which needs to be decided beforehand. I am an active mom with 2 fairly young kids (5 and 11). Ideally I would like to have as much down time as possible and am worried about having an extra area of healing when I am focused on ‘healing’ from this cancer. My plastic surgeon and breast surgeon seems to favour DEIP for some reason and there is little information on patients who have opted for 2-step implants on the forum or how satisfied they are with this option. Going flat is not yet a consideration for me as I am 47 years old and still some vanity left in me. The 2-step implant choice is to allow for radiation to be performed after surgery. Also, I will still need 12 extra cycles of immunotherapy (3weeks apart) due to being Her2+ve and currently suffering from really bad diarrhoea from Perjeta - therefore a long scar across my tummy seems likely to be cumbersome and painful since I have quite a lot of stomachs cramps and spends many mins seated on the toilet on bad days. Additional multiple trips to the clinics that may aggravate healing leading to numbness/scarring.
Downside of implants that I am worried about besides healing is that it will need to go under muscle instead of above and I am worried about long term mobility impact. Sorry for the rumbling…. The decision making is stressing me out. Hoping to hear some experiences and advice - thanks so much in advance :slight_smile:

@winterflower I had mastectomy with immediate reconstruction and never looked back. Not sure about the 2 step op. I had 15 radiotherapy sessions after my operation. I was 43 years when diagnosed and for me also going flat wasn’t really a choice. I’ve been going for my yearly mammograms and my surgeon is happy with how the implant feels even though is hard I can still sleep in that side and do everything. Went on holiday recently no problem whatsoever going in the water. But mine was on top of the muscle.

Wishing you all the best.

1 Like

@winterflower It does seem to me that the consultants favour the DIEP Flap procedure. I am going to insist on an implant as I do not want major surgery or the large scar across the tummy that you are left with. I’ve been told I don’t have enough fat and that it will mean also having a reduction on the other side so that they match. Therefore, for me, it’s a no brainer. A major operation on both breasts and my stomach or one implant. Implant for me, thanks. I have a meeting next week with my consultant as my latest letter talked of DIEP Flap again so I immediately got in touch to say that I was happy with the implant decision and did not want to change unless there is a good reason for it. Stick to your guns.
Best wishes,

1 Like