Need answers to reconstruction options

Cbrenner, I can't help much, because I have not had recon. However, I do know that a DIEP would mean getting rid of the TEs and not having implants. That is the big advantage of the DIEP.

It sounds to me as if you should take this time to talk to several PSs. Also, always, always ask to see before/afters and insist that you only be shown before/afters of women who had your stage of cancer and your treatment. It is fairly easy to make recon look good on a woman who had a skin and nipple-sparing BMX with no rads, for example. So showing you pictures of those kinds of cases would be very misleading.

Also, it's hard to get a good idea of what the final result will be by looking just at the TE's.  They are only meant to stretch the skin, PS's do the refining during the implant stage.

I think you need to get opinions from 2-3 plastic surgeons and discuss your options. I am very happy - so far- with my bi-lateral reconstruction with silicone implants. Had TEs expanded through chemo and exchange for permanent implants before starting rads. Had 28 rounds of rads completed on May 1st. Everything looks very good 2+ months out.

Cbrenner:  My plastic surgeon would not put TE in side that was to receive rads.  I ultimately opted for bilateral diep, however, with not the desired result.  Everyone has good advice about talking to more than one plastic surgeon that does the diep.  I contacted four different ones in four different locales, but had to stay within my health plan coverage on just one being authorized.  If you want to PM and let me know if you have more questions, please do.  I wish I would've listened to my gut, but at that point I just wanted to look as real or normal as possible.  I was not a fan of implants, considering having to replace between 7-10 years later. Hope this helps.  --  

A side note talking about skin thickness.  My radiated side had something like 1/8" skin thickness, compared to the other side which measured more like 1/2" thickness.  That alone makes the girls look off balance, not to mention they didn't say how hard it would be to actually shape them to match.  My diep tissue feels much heavier than previous breast tissue, although it is supposed to be comparable.  I had a very skilled PS but even so, there is only so much that can be done with the aftermath of mastectomy.  He also said diep tissue will always behave like it is still in the belly, so losing weight may not affect how it looks or feels.   

cbrenner, after much research, I decided that I was better off with a plain scar than going through a lot of pain and surgery and a high risk of complications only to end up with a couple of numb, odd-looking lumps on my chest. I know that for some women it is really important, but I knew that, for me, a poor result would bother me far more than just a scar. It is so extremely personal, and you really have to work through it for yourself.

The only thing I would strongly urge is that if you are not 100% sure either way, then wait. I am almost 3 years out, and there are days when it would be really convenient and nice to have "built-ins." It is not that I have not considered it, but I am just not comfortable with the potential downside, nor am I particularly bothered by how I look. I do, however, wear small fakes most of the time when out and about for various reasons of my own.

Give yourself some time to feel it out.