LD & Lipofilling

Hi,
I have just been diagnosed with a new primary on the opposite side (delayed DIEP in 2014).
I have involved margins and need a mastectomy & LD recon as another free flap is not possible.
I could have an adjustable Becker implant with the LD or omit the implant and try and add volume later with lipofilling.
I would love to hear from anyone who has had either of these as I am struggling to make up my mind.
I had my original expander implant removed due to sepsis, hence the delayed DIEP & am worried about this happening again.
Has anyone had lipofilling to an LD flap and managed to get a good size increase?

Hi Char2016,

 

Have you also been offered an LD with standard implant rather than the expander? If not, and there is no reason that you know of why you should not have this, would you consider this?

 

I had a mastectomy with immediate reconstruction just under 3 weeks ago. Was not suitable for DIEP/PAP/TUG etc. Really agonised about whether or not to have just a simple implant or the LD. Ultimately, as recovery time for either was similar, but results with LD more natural looking, decided to go with the LD. Consultant/surgeon hoped to reconstruct using only the LD muscle and tissue, but  if needed would also use a cohesive gel implant in order to match with my remaining breast. There was no suggestion of using an expander implant. Consultant recommended the LD {with implant if needed) as it would give a good appearance and avoid the need for repeated trips for lipofilling (which could be a bit hit and miss) to improve the appearance of an implant alone. As I was lucky to have a consultant who had performed many LDs (none of which had failed) and I had confidence in her anyway from previous surgery she performed on both breasts during my original investigation and diagnosis, I went with her recommendation. I am so pleased that I did. My LD op needed a smallish implant too, but it looks so real and so much like my other breast.

 

Although the scars are still healing, I am doing all daily activities as normal now, and have been for more than a week. I would not want to do any heavy lifting yet, and have avoided one or two gardening duties, but otherwise, everything is going very well indeed. 

 

I’m not sure whether this really answers your query, but I would not hesitate to recommend LD reconstruction with an implant. I was home three days after surgery. The surgery was less than 6 hours. I had very little pain the day after the op and none since (though dosed up fully on paracetamol for a few days post op). I was walking myself to the bathroom within hours of coming out of the recovery room, with drains and a drip stand. I would honestly say that I could have retured to work last week if it had been a relatively ‘unphysical’ type of job. But most importantly, I have a reconstructed breast that looks just like the one it replaces (minus a nipple). 

 

So, don’t know if this helps at all, but know that when I was needing to make up my mind it was so helpful reading about other peoples’ experiences. Ultimately though, you do have to work out what feels best for you as each type of op has different pluses and minuses.

 

Good luck with your decision. X

 

 

 

Thanks! It’s really good to hear that you are pleased with the result.
My surgeon said that it can be difficult to predict the final size of an LD recon so they like the option of being able to adjust it. The downside is that you have a port under the skin and I guess it might not feel as natural.
I have another appointment soon to discuss the option so I will ask about the different types of implant.