[norkdo]

Julieta, would it be callous of me to say you look absolutely gorgeous on your pic? I have NEVER (okay, maybe 25 yrs ago....in a one-piece) looked as sexy as you do in your bikini top pic?
My plastic surgeon is kind of a boy wonder genius guy with an awesomely great reputation. I was asking the same question you are asking when I was referred to him by another doctor with the rave reviews.
You will find all my posts here somewhere when I was asking same questions you are right now.

So. I went to him last May. I had finished 30 rads in April.
here is what I learned. By the way I continue to have faith in my excellent Plastic Surgeon.

1. Six months is needed after last radiation as rads continue to work deep inside and might destroy the new breast. (ironically he did mine 5 mos after instead of 6).

2. I asked "diep or tramflap or silicone or salt water or....." and the answer was this:
(which i think is awesome and shows how smart and experienced he is

3. "If you look at the research, some recons fail. (result of radiation still working, or infection, or skin being too thin to regenerate after infection...etc etc) Statistically. A Plastic Surgeon has to therefore keep in mind these potential failures which X percentage of the time (twenty? can't recall, but high enough) occur. I have to therefore leave in the future an operation which can be done after the potential failure. In your case, the tramflap or diep...the abdomen muscle etc is an operation I do not wish to COMMENCE reconstructing you with, but is an op i wish to leave on reserve in case the first operation fails. If I start with it, we cannot do the silicone/salt water afterwards. If I start with expander (salt water)/changed up to silicone implant, then afterwards, if that fails, we can always do the diep/tramflap. Not the other way round. If the tramflap is the first operation and fails....you're screwed."

4. By the way, people here like Chrisy? (forgive if wrong) told me you can just leave your expanders in for life and never swap em up for silicone. You do not have to decide before the surgery.

5. My PS (plastic surgeon) did not give me an option (thankfully as he had a brilliant plan to prevent further problems in his head) about choosing the size of implant. He chose an implant on my skin-sparing, non cancerous, alternate breast side HALF THE SIZE OF MY OLD REAL BREAST. On the morning of surgery he was drawing on it, showing the senior resident what kind of wrapping of the silicone implant he was going to do. Turns out he CHOSE THE HALF SIZE IMPLANT so he could double wrap it in skin~. The reason is that if the skin dies off from the frequent post-reconstruction infections that occur, THERE IS STILL ANOTHER WRAP OF SKIN AROUND THE NEW SILICONE!!

So consider asking for a double wrapping of your skin around the new silicone if that is what you are getting.

Also, if choosing skin-sparing on your "good" side, consider nipple sparing too. My nipple, on my non-cancerous side, where i still had a breast, a year after the mastectomy of my cancerous breast, was not aesthetically, at 52 years of age and me being overweight and all something I wished to duplicate. I simply asked the PS what he would recommend, and he said "I will give you far better looking nipples than you had before" so I take him at his word.

Somebody on here recommended a thread on the sadness pre-recon of losing breast sensation, not necessarily as a woman having a sexual partner, but even if you are celibate, the sadness of losing nipple sensation altogether while you sleep ...the sheets giving you nice dreams etc...and that is an excellent thread to read. Yes you will have to grieve that ahead of time, so start that early cos I did and I got that out of the way, and am seriously no longer in any grief about that at all, but you need to go through it before you come out of it i think. the thread can be found on breastcancer.org and you can search "nipples" there. It is completely frank about a taboo topic. helps tho. I am just saying I do not know if by doing a nipple-sparing op on your single existing breast you will have any sensation or not. I was offered one on the morning of my surgery by the surgeon that does the digging out of breast tissue on the good breast. The Plastic Surgeon (the one you go find and meet with several times prior to the operation) is the one I consulted about this offer given by the other.