Need Reconstruction Advice

[Shirley]

Hello all,

I am going to have a unilateral mx in mid August. I've met with a plastic surgeon recommended by my breast surgeon, and he tells me that he can do (or at least start) immediate reconstruction using expander/implant even if it turns out I need radiation. There is something different he does which I don't recall, but it might just be that he waits until after radiation to fill the expanders or something. I liked him and would be perfectly fine choosing him to do implant surgery.

The DIEP surgery is not available in my town, so I'd have to travel about an hour (or more) to Seattle to have it done. This is a big inconvenience, but not impossible. I do have an appt to meet with a surgeon that does DIEP for a consult. I was told by the RN at that hospital that their docs won't consider doing implants on patients that have had radiation. So I'm very confused. One doc says yes to implants after radiation and the other says "no", and you have to wait a year to (maybe) have a DIEP recon if your abdominal blood supply looks good.

I've read the Seligo book and read some of your comments on this board. I am torn because so many women enthusiastically recommend DIEP and would do it all over again. But being numb from the chest down doesn't sound good to me (though obviously the right side of my chest would be numb with implant surgery). And I'm told the docs prefer to wait until 12 months after radiation to perform the DIEP surgery (w/out radiation they will do it as soon as 2 weeks after the mx). It sounds like a grueling process. And implants sound much easier.

Then on the other hand a tummy tuck, while not something I would do on an elective basis, might be kind of nice...but the scar and numbness? The plastic surgeon I talked to about the implants said that the tummy tuck you get with DIEP isn't as good as the elective kind.

A fake DIEP breast would probably look superior in the long run and would age (gracefully I hope!) along with the remaining breast. The implant guy said I'd get a lift on the remaining breast; I'm thinking the DIEP guys would do the same.

I'm interested in any feedback you have about your reconstruction with implants or DIEP. Are any of you enthusiastic about your implants? What about time off from work? There are so many things to consider and so many tradeoffs!

Shirley