[Louise O'Brien]

Hmmm. It turns out this surgeon - who is considered the best in the area and who all the chemo nurses told me would be their surgeon of choice - specializes in the "pedicle" flap which does cut into one abdominal muscle.

Apparently in this procedure, the strip of muscle and flesh is left partially connected at the muscle. They then "tunnel" from that part of the body to the chest. Unlike the tram flap, this does not require blood vessel reconnection as the blood supply comes from the abdominal muscles.

He does not specialize in Diep flaps but has referred me to two doctors who do. I have no idea how long I'll have to wait to see them - but I'm guessing many months.

The problem is - they have less experience and the operation itself is eight hours compared the four hours he said it would take for the "pedicle" flap.
I'm not crazy about eight hours under antiseptic as it can bring its own set of problems.

So I guess I'm going to have to wait and see and weigh my options.

No matter where I go - I'm going to have to wait. This is Canada and while the procedure is free, there's still a waiting list. I waited seven months to see this surgeon and now that I'm "in the system" for him - he can operate on me as soon as I've finished Herceptin next March. No more waiting.

And that means I can get the whole thing over with and move on as opposed to possibly having to wait a lot longer for the Diep flap.

But God the whole thing, no matter what I chose, sounds like an ordeal.

He was honest about the implant and said it would be harder to get an even match. And he agreed that a reduction on the "good" side would be advisable.

One last question: Shouldn't I wait to see if I'm in the clear after my second mammogram next June or July before I have any procedure? He didn't seem to think this was an issue but then he's not an expert on HER2.