Help… Flap surgery or implant

I was in exactly the same dilemma and what helped me was realising that whatever you choose DIEP lap procedure can be done at any point even if you don’t choose it now. Implants can be great, and involve much less daunting surgery. They are also reversible. However they have quite a high failure rate of 1 in 10. My plastic surgeon says if that happens they sometimes remove the implant and let the pocket heal, before re-implanting later. Like DIEP implants can also be done later. Implants do however need to be replaced about every 10 years, although they could be removed and you go flat, or have a later DIEP procedure.

In my situation I didn’t feel able to cope with major surgery just now, and I didn’t want to go flat if I could avoid it, so an expandable implants seemed a good compromise. The problem is that I’ve been told the bed situation in my hospital might mean the plastics part of my procedure may be cancelled! Still fingers crossed. If I can’t be done on Friday I’ll have to have delayed reconstruction.

Good luck in making your decision 

I really wanted my Breast Surgeon to advise, but she refused. I think it's because they want your own "buy in" to the treatment. How are we to know what's best, especially if we are not used to surgery so just no clue how our bodies will perform/put up with many hours of an op? I didn't fancy ICU which seemed to be what DIEP was about, the longer op and need for 2 surgeons doing it, or the massive scar on tummy in addition to scars on breasts. They try to present it to you as a "tummy tuck" . Went for implant as easier option. Less invasive option too. Had haematoma as it turned out (bleed) so implant had to be done again, but usually people are fine. It's not like a real breast, but it's OK and no-one can tell when you're wearing clothes.

You don’t normally need ICU for DIEP but it’s a 10-12 hour anaesthetic, which was an issue for me with bad lungs, and you have a hip to hip wound on your bikini line. A good friend of mine had it done 2 years ago. She’s very happy with the results but found the recovery gruelling, and couldn’t sit up from a chair for months due to damage to her core (they said she was a tad too skinny for the procedure which might have been why). I have plenty of tummy to use but I’m not keen on the long recovery.

I'm so glad I chose not to have it. I had bad effects from the GA I did have. Didn't really have high enough oxygen levels. What your friend had was what I was put off by, plus the longer recovery. Younger women probably OK with it but I also didn't think the results looked as good as the Surgeon was making out who did DIEP surgery.

You get a good lifelike bounce with DIEP which women like, and the breast is soft like a real breast. It tends to match the natural breast, although mine has been significantly reduced so looks a bit weird at the moment. My friend has a good natural cleavage. But stuff it in a firm bra and who can tell? I think the main advantage is DIEP means no foreign body, no risk of rejection and no need for replacement every 10 years ish. Also DIEP can cope with radiotherapy which can damage implants

Are you intending to have DIEP procedure ?

My health is generally poor at the moment so I’m opting for the implant. In future? Who knows, but it’s partly dependent on how treatments for my other conditions go. At the moment it’s touch and go whether I’ll get any reconstruction due to the hospital bed situation 

The situation is very grim isn't it ? What I said to my Breast Surgeon was that I found the decision making very difficult, but if implant failed we could look at DIEP or flat later down the line if we had to, and she said that was a sensible decision. I do find the actual idea of DIEP absolutely fascinating that it can be done, and am in awe of the expertise of the Surgeons who can do it, but when its your own body it's a different kettle of fish. If I'm honest  I found recovery very difficult - I just wasn't prepared for feeling so weak, though I was warned it was a major operation. All a messy business, which I didn't really expect, what with node removal, blue dye, haematoma problems and drains, plus of course the healing that had to take place. Main thing of course is the cancers were removed of course, which was done. Do hope everything goes well for you later in the week.

Thanks You so much Anabrock, im waiting for my gene testing to come back and and see if that is postive and if so i would think about having implants if i dont hear back before surgrey i think i would go flat and deal with chemo and raidotherpy then get implants, i dont want to have the flap and then my other boob as to come off and then they can only do an implant it just wld feel werid and wrong to me and also as the DIEP flap produce just seem to be too much and scarey road. fingers are crossed that it can be done for you please come back and let me know how you got on  xx 

I've just checked through your complicated "history" that you've given. I had multifocal cancer too, requiring the mastectomy in the first place. It is horrible to know so much has gone so wrong in an area of your body and yet everyone oblivious to it. I hope you don't have to hold on any longer than this Friday. I was extremely lucky to get mine dealt with on NHS so fast. I was never one to worry about the speed of getting the results as results were always so bad......I was happy and relieved when the Surgeon arrived on the day of the op and was very calm, although when she drew all over my chest, demanding a new pen for the job, I nearly fell over - for a small person she leaned very hard !!!!!