Hi All,
I am new to this site and have read various threads but wanted to find out more about people’s personal experiences of the different breast reconstruction types.
I am 38 years old and have recently been diagnosed with high grade hormone receptive DCIS in the right breast. I have a 9 month old son which adds complexity in relation to recovery. I am a 38B/C in size but not particularly ‘full’ and a little droopy due to breast feeding my son until a few weeks ago.
Due to the extent of the DCIS the surgeon has said mastectomy is the only option. She believes this can be a skin sparing but is unsure if she can save the nipple. I am guessing that she probably won’t be able to.
I am going through what a lot of people on here are in terms for trying to decide what type of reconstruction to have (assuming all become available relatively soon in this COVID world)
I had convinced myself that implant was the way forward but I was very much focussing on the shorter term recovery because of my young son and not considering the longer term issues I.e. implant replacement in due course which due to my age means I am likely to need at least 1 or 2 further operations later in life due to how long implants last Irrespective of any complications. I have also not finished my family and therefore concerned about DIEP healing and pregnancy, which given my age I wouldn’t be able to wait that long to have another child.
So I am interested to hear about people’s experiences, good and bad, of prepectoral implant with biological mesh (on top of chest muscle rather than under) versus DIEP (using tummy tissue).
My main worries are:
COMPLICATIONS of each procedure and people’s experiences of these e.g. skin necrosis, fat necrosis generally. In the case of implants capsule contracture, loss of implant and rippling/kinking and infection. In the case of DIEP loss of flap, extent of numbness in tummy area. Ongoing long term pain generally for both procedures.
AESTHETICS of each procedure e.g. coolness, weight, sizing and shape of implant and in the case of DIEP how the tummy scar looks and feels and size/shape/feel of the breast. In both cases how does the symmetry compare and have you had to have further surgery to that or other breast for symmetry.
RECOVERY from each procedure. What in reality could you do after 1 week, 2 weeks, 3 weeks etc. How long is it before people returned to work?
Anyone who has experience of going though this with young children would also be of interest.
Sorry it’s rather a long post, I hope that some of you will be able to share your experiences.
Jenny
Hi thanks for your message. Sorry you find yourself with the same dilemma. I had originally convinced myself that implant was the way forward. I read the literature they gave me on both and got blinded by the extent of the surgery for the DIEP and couldn’t see past that particularly as my main concern was just getting recovered as quickly as possible for my son (and me). I got measured up by the surgeon for the implant and they were ready to book me in once they had availability, which was to follow a lady who had been delayed.
After that discussion with the consultant the breast nurse then spoke to me further separately and asked was I sure that I didn’t want to at least meet with the plastic surgeons to discuss the DIEP, noting that the recovery wasn’t significantly different and that there were long term benefits (but obviously short term complication risks). She told me to contact her if I wanted to explore it. I phoned her the next day and said she’s right I should look at all options equally to ensure I was making an informed decision and asked her to line it up.
However in doing this I had completely unravelled where my head was at having been so certain implant was for me. I was a bit of a mess and I couldn’t see how I was ever going to make the decision. I got in touch with breast cancer now charity who have a volunteer schemed called someone like me (really recommend you explore this if you haven’t already) I had already spoken to someone who had an implant and was happy with the results but asked to be put in touch with another volunteer who had DIEP. I had a good chat with her also and she was also very happy with the results.
She pointed me in the direction of some Facebook support groups - DIEP reconstruction uk and DIEP flap support group (US version) and I read so many things on there. I started to consider the long term implications of implants much more and also wasn’t convinced my breast shape - quite small and a bit droopy after breastfeeding was suited to implants as well as the fact that that are cold and will need replacing more than once in my lifetime. One of my biggest obstacles for the DIEP was the possible complications and reading about other people’s experiences really helped, in particular those who had complications along the way still not regretting going down that route. Also interesting to hear about people who couldn’t get on with implants and then went for DIEP later down the line.
As you can probably tell from my response I have decided to go for the DIEP, as I said I really couldn’t see a couple of weeks ago how I would get to a point where I felt comfortable with my decision but I do (although bricking it obviously). There are risks and some of them are major risks but they are generally short term, if you heal effectively then there shouldn’t be any long term ones. I had originally been focusing on my short term situation (young son, due to go back to work after maternity leave etc) rather than thinking long term about more ops in future, long term risks associated with implants.
oh and on the pregnancy side they said it shouldn’t be an issue, it might be a bit tighter but people have got pregnant. You should make sure you ask your surgeon about this though and any other concerns. There are people on the Facebook support groups mentioned above who talk about having a baby after DIEP too.
I hope that helps a little, take as much time as you need, ask all the questions even if they might seem silly and read everything good and bad until you feel satisfied.
My operation is booked for the 19th June 
Best of luck
Jenny
