What choice to make

I need to have a mastectomy on my left breast and have been recommended to have immediate reconstruction, which is the right way forward for me as I feel I couldn’t cope with out a breastin place.
Initially my decision was for a DIEP reconstruction but now I am not so sure. My plastic surgeon made me feel that the op has too many risks which has frightened me and now I’m worried that I’m putting myself through more than I need to.
So now I’m unsure, will an implant give me good results I can live with, it will be a more straightforward and less complicated op with better recovery times. If I have a DIEP what happens if the other breast develops cancer later. Really confused but don’t want to delay reconstruction as I’m finding it difficult to keep going with everyday life and can’t face extra waiting.

Hi jackiejoyce

Iv not had mx myself but i have seen plastic surgeon to discuss it as i carry a gene… Each ps seems to have their own personal favourite procedures, my ps was really keen for me to have double LD (back) flap with implants as that is what he liked o do and told me i didnt have nough tummy for a diep or tram flap. But what i wanted was an implant only recon but he was very reluctant as he said it wouldnt look natural… But i have seen others ho had double mx with implant only and it does look good… With one mx it can look a lot different as it sits higher on the chest and has no real drop so can look very different to the other side… At my unit LD plus implant is the bread and butter bog standard treatment which all the breast surgeons can also do as well as the ps.

The diep is a more complex procedure and generally needs a ps to carry this out… As i said abive my ps said he couldnt do that but i did later see another ps who said he could do a double diep recon and tat is the type of procedure he preferred to do… Why not ask if you can see an alternative ps.

Good luck

I had an LD flap with reconstruction done way back on 1989 when I was 39. I have been very happy with the outcome and have no complaints even although I am an old lady of 62 now. I did have to have a wee tweak after a year but things were fine after that. When I am wearing my underwear I am completely happy with the outcome but when I undress the normal boob has succumed to gravity and so is not se pert! But just wanted to let you know that I have been happy with the result. Hi Lulu (waving) love Val

It is very much a personal choice - my Plastic Surgeon (PS) happened to do a lot of DIEPs so I was happy to let him do mine (right mx (mastectomy) with immediate recon). It is a longer recovery time but it is a more natural look and grows old with you (so to speak) and I personally did not want a foreign body in me with the possibility of rejection that that entails.

I do recommend that you do more research and ask your PS if you can look at his results - most of them are quite happy to show you their photographs but bear in mind when you look at them that they are taken for surgical assessment purposes rather than for beauty!

If you are determined to have a different procedure then ask for an assessment by a different Plastic Surgeon - one who specialises in what you want to have done. You should be able to discuss things such as this with your Breast Care Nurse (BCN). Remember it is your body and your decision.

I am very happy that I had what is referred to as the Rolls Royce of reconstructions - I was prepared to suffer the long recovery time because a) I wanted to get rid of a very big spare tyre and b) I was not prepared to have a silicon implant. However I had a lot of support and TLC from my OH as I could do very little for the first few weeks.

I hope all this has helped and not muddied the waters further!

Best wishes


I think you have to go with your gut feeling. As others have said, it is such a personal decision (and a scary one). I had a delayed LD flap two years ago. I knew all along that I did not want a DIEP as I didn’t want surgery across my tummy. I have no fat there anyway, plus I have always suffered from back problems and knew I wouldn’t be able to cope with that hunched over period post op, or any possible loss of muscle tone.
Also having no back fat, I had an implant with my LD flap. As I was very small to start with (AA) my PS suggested I have an implant in my good side too. So now I am pert on both sides! No problems with one side going south. I do wonder what it will be like when I am 95 and still have pert boobs!

I had an implant with Strattice Mesh to save needing expanders. There is a maximum cup size they can do this one (C?). I have been told that if I want, I can have the good side lifted to match, but so far (aged 47) it is holding up quite well. When dressed you really can’t tell and even naked it is more the scar and lack of nipple that makes the difference.
I know not everywhere does the Mesh + implant. The recovery was pretty good. I was in hospital 24 hours, but it did take me a few days post-op to be able to move from lying down to sitting up without it hurting.

Hi jackie,

It really is a very difficult time to be making a decision about something that’s never been on your agenda before. I was diagnosed a year ago and in shock for about three weeks. I hated the idea of surgery or scars anywhere. However my daughters pointed out that once you’re under GA you don’t notice if it’s four or eight hours. I had a mx and DIEP, and the op was only six hours. My main pain was backache, which a physio solved, I really didn’t have any actual post op pain. And I live alone so I coped with friends popping in and doing main meal for a week or so.

Have a look at my other posts and those of lots of ladies who have had DIEP surgery…and I’m happy to share photos along the way, if that would help. PM me with your email address if you’d like.

I didnt want BC or any surgery, but I felt pleased that I was considered suitable for this op…in the longer term it tends to have less likelihood of complications that can arise with implants over time and you lose no muscle strength either. But I lost all my stretch marks!

Hugs all round, Nonsuch xx

Good luck in your decisions

I’m in a similar position to Jackie - needing to make a big decision on Monday. Seems to me - & please help me if I’m wrong! - that the DIEP has more to worry about in terms of recovery but the LD might require more ‘maintenance’ / problems in the longer term? I’m going to have my surgery at St Thomas’ in London - anyone else been treated there & how did it go?

Hi Slaney
I was treated at St Thomas’s and I have nothing but praise for them there. The nurses are wonderful and the surgeons keep you informed. Feel free to ask any questions - they are very good at answering them clearly. The aftercare is fantastic too. I had to go back every week for my dressings to be checked and the Plastic Surgery dressings nurses are really lovely.

I think your assessment is probably right about the difference between silicon implant and DIEP being the maintenance afterwards - the DIEP there is no maintenance - but LD flap I am not sure about as I have not researched it sufficiently. Hopefully someone else can tell you about that!

Good luck with your decision tomorrow :slight_smile:

Liz x