newly diagnosed and need mastectomy

You will find a ton of information on the DIEP 2011 thread in Surgery Before During and After and DIEP 2012 in the Reconstruction forum. 

Several people have posted that some specialized centres can find fat to do a DIEP where other PS will say "you are too thin" so look for second opinion if you need to. There are also other places to get flaps such as hips. 

I had the same values as you (did not want muscle flap or implants). Someone posted a comment from their surgeon that anyone who is eligible for TRAM has enough fat for DIEP. Interesting information. I had the mx as soon as I got the same news as you: the lumpectomy might have missed something, but the surgeon would not do a prophylactic mx on the other side at the same time. I escaped to another hospital via the reconstruction route, and had the prophylactic mx at the same time as a bilateral DIEP.

There is no need to have anyone with you in the hospital at most modern first world hospitals anyway. You will be in a step-down intensive care unit and checked every hour at first. I stayed 5 nights. I did need some help at home but it was primarily for fetching things. I had a home care nurse to help with drains and remove them.The drains came out much sooner than with the mx.

I was told to expect to be off work for 6-8 weeks. I will be off longer simply because I can't get in to see the surgeon for the letter of fitness to work sooner. (I don't care; I have plenty of sick leave. Management is grumbling but the obstacle is of their creation. I'd work if management would let me, and have secretly been working a bit since the second week.) Return to work depends on the nature of your work; you can't lift >10 lb for 8 weeks. The other obstacle that isn't really documented on the rehab agenda is the mental concentration; I found even from the lumpectomy I had a hard time getting my head back on straight, and the DIEP was a longer surgery and spotty sleep for a while, and that can affect concentration. I can focus; I just can't decide when my ability to focus turns on and off.

As you will see in those threads, it's a very do-able surgery. Picking a very experienced surgeon is the most important step because at the most important times, we're asleep and in their hands. 

I am very sorry about your pathology and the doc's recommendation.  It is a rollercoaster for sure and emotionally draining.  I opted for BMX with a Stage 1 dx.  I met with two plastic surgeons and was not a candidate for DIEP which was disappointing.  They would not do any muscle procedures on me either because I workout a lot and they feared it would change my quality of life after.  I was only a candidate for implants for reconstruction.  I went with it.  I completed reconstruction in December and am very pleased with my implants and results.  I was not crazy about having a foreign item in my body (implants) but the alternative of being flat was not an option for me personally. 

Things to consider for BMX for UNI - if you do both, you lose sensation in both breasts.  You also will have a better chance of good symmetry between your breasts as they will both be done the same way.  If you do a UNI talk with your surgeon about matching them to your other breast.  Sometimes they have to lift or augment the good side so they can match things up so you end up having work done on both anyway.  You will be able to keep your sensation if you don't have to mess with the other side so much.  Just things to consider.

Best of luck.  I hope all goes well.

I was a dx with both DCIS and IDC in the left breast. The Breast Surgeon offered a lumpectomy with rads but because it was multifocal, she felt I wouldn't be satisfied with the results (she'd have to take a huge wedge of tissue out), and that a MX would be better. Well, I was a 38DD/38DDD, and there was no way they could match the girls up even with a reduction on the right (which I had always wanted) so the decision for a BMX was easy.

That, plus the fact that with my history (Mom had BC) and that I had very dense breast tissue making it difficult to diagnose the right side, made me feel very comfortable with my BMX decision.

I am 9 weeks out from surgery, healing very well, and 2/3 of the way through my fills. I got TEs in preparation for saline implants in a few months.

Mayentes: Your question of whether to do uni or bilat is one you have to make yourself.  Just educate yourself all that you can and make your decision on what you can live with.

As for myself, I had DCIS in one breast but opted for bilat mx with immediate DIEP reconstruction. Like many others, I couldn't live with all the checkkups and scans, etc.  I just wanted to do all that I could the first time around and hopefully not have to go thru it all again. .  Also, I avoided rads by doing bilat.  (another note: my pathology report came back with 2 more DCIS spots in the cancerous breast, so I did the right thing!).

My surgery was supposed to be a 14 hr one but the two surgeons did it in 12 hrs. Surgeon said when she got in there all the arteries, etc. she needed were just laying right on top (that was from God and lots of prayers) and she had no problems at all!  Recovery was a hard one, but any surgery is hard. I was back to work in 6 weeks.. Only after the 5th week did I feel really good enough to do anything, then it was almost time to go back to work!

If I can help with any questions, please yell on here or PM me.

Hugs and prayers to you. I hope your journey is a smooth one, with no complications at all!