Implant after Radio therapy?

I have nearly finished TCHP chemo and will have a mastectomy and node clearance in Jan. My NHS hospital have been great so far but they say that all reconstruction is on indefinite hold due to covid, and to expect 2022! 
luckily I have Bupa cover and I have booked a consultation with a private surgeon as well as the NHS one. The private surgeon said that only diep flap surgery is suitable after radiotherapy. Having consulted Dr Google it seems that some people have an expander put in for radiotherapy and then an implant afterwards. If this would work I think I would prefer this ( less invasive surgery, quicker recovery, expander in place while I wait for the radio to heal so not fully flat).

I don’t know if the private surgeon is chasing the big Bupa payday, or if his advice is genuinely to get the best result?

Does anyone have any experience of expander during radio and subsequent implant? Any advice? Or if you think your diep flap is amazing that would help too. I think I’m hoping that I might end up having the other boob implanted too to make a nice matching pair ( not like the current ones sitting under my armpits!) Am i kidding myself that I can get anything like ‘back to normal’ after this?

Also , any advice on whether it is better to have the same surgeon do both mastectomy and reconstruction? Or is it ok to have the mastectomy done without a decision on the future reconstruction?

Hi renpen- it really is a minefield out there isn’t it, I hope you can get some answers from people on here. I can’t answer your exact question but am happy to share my experience in case it helps at all.

I had an implant at the same time as my mastectomy, I had one surgeon do the mastectomy and a different plastic surgeon to do the implant, I assume they were both in the operating theatre at the same time. I do know that lots of surgeons don’t like putting implants in before radiotherapy (mine was happy to do it as mine sits on top of the muscle), so I wonder if the same reluctance applies after radiotherapy too.

Have you asked your surgeon to show you any photos of examples of diep versus implant? I think the diep will look more natural but I’m very happy with mine, it doesn’t quite match my real one but I haven’t yet been ready to have any further ops to match them up. I will probably leave them as they are but it’s a very personal decision. I also chose implant for the quicker op and recovery time.

As I say, I can’t really answer your exact question but I’m happy to answer any questions if you think I can help. My best wishes to you whatever you decide. Evie xx

Hi there…just wondering what you went fir in the end as I am in this exact position now?