Breast Reconstruction: How to decide? Implants? Natural flaps?

Hello everyone,

after my double mastectomy, the last thing I wanted to think about was my breast and more surgery; however, I am finally getting to the point where I think I am considering it.

Through my research,

it seems there are really two options: implants (silicone and saline) or natural flaps that use your own tissue/fat for the breast.

Did anyone go through this process before? Any opinions and experiences between the two? 

I also saw with the implants, if I decided that option, that I would have to choose between silicone or saline, and an expander or direct insertion. Does anyone have any opinions or experiences?

I would appreciate any insight.

Thank you

Hi I’m, Ericka. I recently had a double mastectomy 1 Mar 2019, right side as a prophylactic measure. I had direct silicone implants and in 10 days got a bad infection that’s mostly found in hospitals and had to have the left removed. It was devastating, actually still is. I have been advised to wait 6 months and try again. I will be treated with preventative broad based antibiotics before and after the surgery. 

Thank you for sharing @njoylife13‍. I am so sorry to hear about the infection? I cannot image the devastation, after having just undergone a mastectomy to now have an infection and to have the implant done again in the future. 

I am sorry to hear that happened to you. If you do not mind me asking, what does the doctor/hospital do in such a situation? Will they cover your next breast reconstruction for the left that had to be removed because of an infection that was caused by them?

@larab5 I had silicone implants but required tissue expanders to stretch the skin to make room for the implant. I went to the doctors basically every week if not every other week for expansion and then finally the actual implant insertion. I have not had much trouble other than more scarring than I would have preferred.

Fortunately, I am retired Air Force so my care was performed in a military medical center so there is not a charge in my instance. I’ve received very good care thus far aside from someone not following protocol!

Hi @larab5‍ I have never heard much of the natural method you mentioned. I tried to do some research but did not find much. Care to share your knowledge also on this topic.

Hi all thank you so much for the input. It is interesting to see that both of you went with silicone. Was there any reason in stead of saline? Again, I am not very knowledgeable about all of the options, so thinking you all may know more.

@njoylife13 I am so sorry to hear about the infection. How are you doing today? How is the scare and the reconstruction now? Overall are you satisfied?

@notup! I do not know too much, but from what I learned is the natural flap procedure is one where the doctor will take tissue from some other part of your body - like the fat in the abdomen - and then use it to reconstruct the breast tissue. It is supposed to look and behave more like natural breast since it is actual human tissue and when you lose or gain weight, the breast is supposed to also - as in natural breast tissue. But I heard also that the scar is often worse - not to mention you will also have a scar at the site where the doctor cuts the tissue out from.

I was hoping to hear some stories comparing both too so I could make a decision.

I would like the tissue to be more natural in feel and behavior, but I would rather have less scarring and less surgery time. But I guess ultimately, after the recovery is done, the main thing is the satisfaction with the procedure.

I chose silicone because it looks more natural. There’s rippling involved with saline. If you have stretch marks at all for the flap, I was told they would be visible in the breast area if that type of surgical procedure is chosen. Also, the scar involved from hip to hip was not appealing to me.