Which reconstruction to have?

Hi everyone,
New to posting on forums but really need some advice. Had WLE for high grade DCIS last June followed by re-excision to get clear margins a few weeks later. 15 sessions of radiotherapy in September. Life back to normal, everything fine till my 1 year mammogram. The DCIS has returned in several places and found out today I must have a mastectomy. I know I want immediate reconstruction and the surgeon has told me I am suitable for an LD flap with an implant or a tissue expander with an implant later. As far as I am aware I dont need chemo. Do i go for a bigger op now and get it all over and done with, or a smaller one which looks like the after effects last months with hospital visits and further surgery? I think I am leaning towards the flap but want to know about recovery from both operations.
This has come as a bit of a shock, wasnt expecting a recurrence this quickly and to have to make a decision so soon.

Hi Helen,

Welcome to the BCC Forum. I am sure other members will soon be along to offer some support.

You might find it helpful to get in touch with our one to one support service. They may be able to put you in touch with a couple of trained volunteers who have had each procedure. I’ve attached the link for more information.


Hope this helps

Very best wishes


BCC Moderator

Dear Helen, so sorry to hear DCIS has returned and you now need a mastectomy.
I was discharged from hospital only Thursday from having an mx with an immediate tug flap recon a week before. So far I’ve been ok, blistering of my breast (not the actual flap, that is fine) where my mx surgeon had to go so close to the breast wall to clear me of cancer. This is like a graze.
My donor skin is absolutely fine. My leg where I had the donor taken from, the cut/scar is tight, so am walking very slowly, but am improving day by day.
I met a lady just before I went in to have my surgery, she had this exact procedure not that long ago and was very happy with her outcome. I must say, she looked amazing!
I had originally planned to have the expander implant with no other surgery, but didn’t want to have the maintenance of the implant and so decided to have the big surgery all at once with a tug recon, although initially the thought of more surgery anywhere else on my body didn’t appeal to me at first at all! I also heard that if you have an implant it would be harder to detect cancer if it returned again.
I am very pleased I decided this, I am so pleased with my breast. Once it has healed it will be the perfect shape and droop naturally with time along with my other boob. (Im 42, but you have to think ahead).

I hope this helps you, if you have any more questions, please don’t hesitate to ask. I was very confused right up until I made my decision and believe that was the hardest decision I have ever had to make!

Take care and good luck

Dear Helen, I had non hodgkins in 89 which resulted me in having chemotherapy and radiotherapy. Thank goodness I opted into early breast screening as unfortunately I developed breast cancer. The only option was a mastectomy but I could have breast reconstruction at same time. The hospital I went to offered a full consultation with Breast recon. nurse who took details and preferences with me. i choose lat dorsi and hoped not to have implants. My surgeon managed as O had a lot of tissue in my back. I did have to have a lot of seromas drained and steroid injected into my back but it did settle down. I had the op Dec 2011 and so pleased with results. I am sorry the cancer has returned and it feels like you have to make decisions quickly. It was my husband who pursaded me to go straight for recon and I am so glad he did. It was almost a bonus considering what I went through and I still flash my new boob with pride.
I dont know if that helps you. I know different trusts do it differently I am keepingy fingers crossed you reach the right decisions for you. Take care Michele

Hi Helen I had bilateral mx and expander implants 8 weeks ago. I was driving at 3 weeks post op and felt fairly normal by then. I am pleased with outcome although one side is not heling but that is down to rads 14 years ago. The good side is nearly complete and I will probably keep expanders in to avoid further surgery.

Wendy x x

Hi all, thanks so much for replying. Having had an awful weekend deciding what to do, then almost a moment of clarity making final decision. LD flap it is, op booked provisionally for just over 2 weeks. At the moment feeling quite OK about it. Except that I almost feel like I’m on a rollercoaster knowing I have 2 weeks of being fit and active, thinking what needs doing that I might not be able to do later. Fingers crossed SNB is clear and the surgery is all I have to go through. Everyone at my clinic is wonderful, explains things,takes time. Apart from having my children I have never had anything to do with doctors or hospitals until last year and I think I am lucky having a good hospital looking after me. I really hope everyone out there has as good care as I am getting. I am sure the next few weeks are going to be the most emotional of my life.

Good luck, hope you keep us posted on your progress. xx

Hi Helen, I hope you are doing well. Like you I had the most awful time of my life trying to decide what to have done. No one can help you and it was so stressful with wakeful nights. I eventually decided on the backflap reconstruction. Everytone thought this was a litle “OTT” however now we have the pathology reports it has made us very aware that I made totally the right decision. Cosmetically it is looking really good. Post operative recovery is not too bad. Two weeks post op I am walking around doing the reccomended excersises and pottering etc. Pain whilst there is nothing cpompared to the constipation through taking codeine…Support has been amaxing from every source. Hope you are coming through it as well. Take great care and dont over do things too soon. xx

Hello all,
Had my op last Tuesday and am so pleased I chose the LD flap. My new boob looks amazing even though its swollen at the moment.I am amazed how much skin has been saved, it really doesn’t look as if I have had a mastectomy. I have so far had no trouble with my back, the scar is a lot shorter than I thought it would be and hidden beneath my bra top. Pain relief has been good, I had an epidural before the op which was directed to the right side and left in for 3 days, now I’m on Gabapentin, not sure if that’s usual but is working fine. I came home 4 days after op with 2 drains which came out yesterday. Results on Friday, I just had 2 nodes removed, so fingers crossed. Yvonney1, yes pottering is the right word. I am finding it hard to sit down and do nothing but as even walking at normal speed seems impossible that’s all I can do. Im sure another week will see a huge difference. Hope you are recovering well. Regards and good luck to you all.

Hi I have had SNB and lumpectomy for invasive bc and high grade DCIS In June. The DCIS remains which means I now need mx. I was given the choice of recon, with silicone. I don’t have enough other tissue for using back or abdo. So the only choice was tissue expander and silicone implant. I agonised over this for days. I have chosen the recon option, which is due on 12 th August.

i was told that due future detection of bc is not more difficult with the implant and I am holding onto this fact. Also, complications are not common and I have faith in my surgeon, so all positive I think.

i have found there is a lot of info on recon, but not so much on silicone implants.