Implants vs. Lat Flap

I had my mind all prepared for having the mastectomy and expanders put in.  Finally!  you know how long it can take to just get to this point.  Well I went to the surgeon last night and he told me I wouldn't like the end result of expanders/implants due to me being so large breasted.  I am a 36DD and he says I have so much skin and areola that it wouldn't be symetrical and I wouldn't be satisfied with the end result.  I was almost actually looking forward to the breast reduction because I wanted to go down to a 36B.  He says it is my final decision and that I need to discuss with my PS.  I will go to him next week.  

I have 2 questions.

#1. With a good PS can't I have a good result with expanders/implants?

#2. What is the expected hospital time, surgery time and recovery time (time off of work), complications?   I appreciate your response.

[CCF-RN,MSN-rf]

Dear Cathy Lee:  The right person to have this discussion with is a good plastic surgeon.  Since you are large breasted, neither result may be able to provide enough to match your opposite breast.  However, many times women opt for reduction of the remaining breast.  If this is the intent, then it may be that either option will work.  A good plastic surgeon should be able to help you determine the choice that will work best for you.  Hospital time etc.  will depend upon the procedure(s) that you choose.  The plastic surgeon will be best able to address this.

[surgeon]

my personal opinion is that the very best cosmetic results come from a TRAM flap (taking the transferred tissue from the belly). However, it's a big operation, with more potential for complications. I know many women who had expanders/implants who are perfectly happy with the results. It depends on many things, including one's own anatomy, and yes, the expertise of the surgeon. Reduction of the other side is often done, no matter what the method of reconstruction.

[nurse12hr]

While I wasn't large breasted, I had extremely good results from tissue expanders and saline implants.  And I work with a gal who seems pretty large busted, and she had expanders and silicone implants.  Her results are absolutely fantastic.  There are many gals who have changed with her in the locker room at work, who don't have a clue she has had a mastectomy.

My results were so good, that after the first mastectomy, I have several biopsies for questionable findings on the other side, I elected a simple mastectomy with the same reconstruction on the other side.

I was back on a horse on my 7th post op day after my first mastectomy, and back at work (admittedly with some lifting restrictions) in 2 weeks time.  Took a little more time off with the second one, mostly to just to take advantage of  my PTO time.  Really wasn't bad, and the follow up surgeries (tissue expander removal and implant inserting) and nip reconstruction were breezes, done on my days off.  

However, you are going to have breast reconstruction, so I am guessing that is a different ball game.  Good luck, and keep posting here!

[Cathy Lee]

Thank you Christie, I appreciate your feedback.

[jennyjenjen]

A related discussion, lat flaps or implants? was started.