feedback on choice to reconstruct from C/D cup

Hi there. I was a DDD before diagnosis. I had direct to implant reconstruction and was then a full C. It took me awhile to get use to being smaller, but I'm ok with it now. I also could not have nipple sparing. Good luck!

I was a 36 large C/D in some bras and a DDD in others (Chantelle). I was not a candidate for nipple sparing because I had multi-focal DCIS directly behind my left nipple. I was not a good candidate for DIEP or other flap surgery because I have a genetic blood clotting disorder and am on blood thinners. My PS told me I was a candidate for direct-to-implant as long as I was ok with being about the same size or slightly smaller, and that is exactly what I wanted. She also said that they would not know for sure if they could go direct-to-implant until they tested the blood flow to my skin after the mastectomy part of the surgery, so there was a chance I might have to have tissue expanders, which I really wanted to avoid. Fortunately the blood flow to my skin was good, and I woke up after five hours of surgery with implants. She told me they removed about 530 ccs of tissue from each breast and the implants they ended up using were 550 ccs, so about the same size -- technically slightly larger but they project a bit less than the originals. They are firmer and less droopy, which is fine with me. I am more than two months post-surgery now and am very happy with them overall. I chose to have smooth round silicone implants by Mentor, placed on top of the muscle using AlloDerm rather than underneath the muscle, and I believe that is part of why my recovery has been relatively easy. I was able to raise my arms above my head immediately after I woke up from the surgery. I was in the hospital for two days and my pain was manageable with the medications they gave me. Once released I just took Tylenol as needed. The worst part was the surgical drains because you have to sleep laying on your back. I am not saying it was easy, but it was not nearly as bad as I expected. My incisions are healing gradually. I opted not to have nipples/areolas reconstructed. I do miss having nipples, but am relieved to be cancer-free, and eventually I will get 3-D tattoos. For now I am still wearing a sports bra most of the time but eventually I will not need to wear bras if I don't want to, which is a nice bonus. If you are a candidate for direct-to-implant, I highly recommend it. For me, I have appreciated being able to wear the same clothes that I wore before the surgery, and not having to go shopping for all new bras and tops. I feel like I look good in clothes and am getting used to the scars and the way they feel. I still have some areas of numbness due to where nerves were cut, but the feeling has come back in some areas. Good luck with whatever you decide!