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I am 37 and underwent a bilateral mastectomy with a diep flap immediate reconstruction. The reconstruction is not complete, and I'm thinking of adding implants because I am very disappointed with the appearance. I am extremely depressed. advice?

By Anonymous January 23, 2009 - 9:45pm
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appearance of implants and diep flap reconstruction. I feel so unsure about everything and I am so disappointed with the initial results of surgery. Scars are not symetrical, tissue islands are not symetrical and too high, breasts are droopy. I was hoping for perky, but I feel disfigured. I am finding life difficult every day. See my plastic surgeon this week. What do I need to ask him? any suggestions?

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I have had implants added, but the position of the breasts is still to low for me. This was the problem from the beginning and my surgeon was not very open to changing the position. I also feel much too large now. I sought a second opinion and will probably go with this surgeon. He gave me many more options and seemed to understand that when it isn't right it brings back all the trauma of the experience over and over everytime you look in the mirror. My husband is afraid that he is just a good salesman, but I felt he understood me and my expectations. He was more precise, communicated more, with more details. I am a nurse, so I feel the need for more technical details. My husband doesn't want me to endure any more surgery, but I feel the need to have closure. It will only be a 3 hour surgery, changing out the size and shape of the implants and sizing me down to a C cup. I am nervous as well, this is a new surgeon. Will I like the results, how can I trust now that I have been dissappointed deeply twice before? I don't feel comfortable the way I am now at a 35DD and I'm 5'4". So I am moving forward and going to go through with this third and final surgery. Thank you all for your support. What do you think of this move?

August 29, 2009 - 7:20am
(reply to Anonymous)

I'm so glad you've shared this with us. I was hoping that you were feeling better. It sounds like you're making a good move for you, because even your writing seems more upbeat. It's so important to have a voice and to know that you're being listened to, and it sounds like you are being listened to by this new doctor. I can understand your husband's opinion, but also feel that you definitely need the closure you deserve after the nightmare you've been through. Since you're still nervous about this new surgeon, have you looked into references (talked to his former patients, doctors that might know him, medical associations he's a member of, etc.) at all? I'd do that, just to feel more confident that he's the doctor for you.

Good for you for moving forward. It can be such a scary thing to do.

August 29, 2009 - 4:23pm

Hi Anon, I'm sorry you're not happy with the results of your surgery. We asked Lillie Shockney, a professor at Johns Hopkins and Director of their Breast Center about what to ask your doctor. She came back with a wonderful and helpful response.

Here it is:

"You need to see yourself as a work in progress- like a beautiful painting. Ask the plastic surgeon how soon to expect the breasts looking better and how symmetry will be accomplished. Usually some tweaking is needed as an additional surgery for some cases. They also will soften up in about 3 months. All good things take time."

You may also find this link to Johns Hopkins Breast Center helpful. Please update us on what your doctor says.

January 26, 2009 - 12:25pm


I'm Kristin's friend and I'd love to chat with you. You're a brave and proactive patient, and your hard work during this time will pay off.

I had a unilateral mastectomy with augmentation on the other side. I was pleased with the results because I had never really had breasts before. :-)

I understand your frustration with results during this emotional and highly charged time. I can say that breast implants worked for me, and they may work for you as well. Feel free to contact me or continue this thread for more info.

Laura Gable

January 26, 2009 - 12:08pm


On your behalf Sunday I reached out to Dr. Jay Harness, the nation's leading oncoplastic breast surgeon, who is not only the former President for the American Society of Breast Surgeons, but a member of EmpowHer's Medical Board.

I told him all about your question, which you posted above, and asked him if he wouldn't mind replying with some guidance.

Dr. Harness asked me to connect with you, so the two of you can have a personal phone call.

Anjie, would you please email me a way to call you? I'll call you back with the number to Dr. Harness' personal assistant, who is expecting to hear from you. She will schedule a conversation where you can ask Dr. Harness every question you'd like.

I'm sure you'll love Dr. Harness. Few doctors care as deeply for their patients.

Thank you posting your health question on EmpowHer.

Todd Hartley
News & Media
[email protected]

January 26, 2009 - 10:21am

Hi, Anjie,

I'm so sympathetic to your feelings. And I'm so happy you are here.

You underwent a traumatic diagnoses and a major surgery, and I'm sure recovery was difficult. By now you'd hoped to see much better results, and you haven't. That's so disappointing. But try not to give up -- I think that while it may take some more surgery, you ultimately can be happy with your final results.

Have you been happy with your doctor? And with the plastic surgeon you have for reconstruction? Do you feel that you can confide in one or both of them how you feel? Does each of them have a good bedside manner?

While we're waiting for our experts, I thought it might help you to see some pictures of completed DIEP flap reconstruction. Of course, the missing element here is that we don't know how long after surgery any of these photos were taken. Though I imagine that for doctors to put them up on the web, they are either finished with recovery or well into it. But I thought it might be good to have pictures to refer to when you see your doctor again. This first one (scroll down on the page) is from the University of Texas' MD Anderson Cancer Center (this was a left mastectomy):


Here is another woman who is clearly not as far along in her healing process (this was bilateral):


Here are several, from the website of the doctor who originated the procedure:


and here are several:


this is another before and after gallery:


and this is a forum with before and after pictures of all types:


What I am noticing from looking at these pictures with you is that while the breasts tend not to be perfectly symmetrical (like all breasts, lol), the reconstruction does tend to create two breasts that are similar in size, placement, coloring and nipple placement; also, that the scars do seem to fade very much with time. It seems like this is what you should be able to expect from your final results.

This is a blog written by a woman who is going through breast cancer and who writes about her diep flap reconstruction. She does not put pictures on the web but she does write about a dissatisfaction with one of her results and when it will be fixed:


Take care, Anjie, let us know where you live, and let's see if we can get you some more information.

January 26, 2009 - 10:16am
EmpowHER Guest
Anonymous (reply to Diane Porter)

Wow, thankyou for all the research you did. I think I was a little too critical of my results. I have beautiful symmetry and shape of my reconstructed breasts, but they just fall a little flat. Thank you for your help. you don't know just how much you have helped me.

January 30, 2009 - 4:04am

Hi, Anjie! I'm so glad you've found EmpowHer. I'm sure our wonderful moderators and experts will get you the info and resources you need. I'm so very sorry you're going through this. You've got immediate friends here at EmpowHer -- please know that we're pulling for you and hope that this gets resolved so you're feeling better about the reconstruction. I have a childhood friend who had implants immediately after her mastectomy and she's really happy with the results. I'll try to get in touch with her to see if she has any advice for you.

January 26, 2009 - 9:45am

Hi Anjie -- I know this must be a hard time for you. A friend of mine recently had her other breast removed and needs to heal properly before reconstruction starts. Unfortunately, she had difficulty in the healing process her incisions are not healing correctly. It is very frustrating for her and she doesn't feel like herself. All I can say is hang in there. Hopefully your plastic surgeon will be able to do more. Please let us know what he/she says.

January 25, 2009 - 3:17pm

Hi Anjie:

I just read your post. Hang in there as I'm sure our community, EmpowHer team and experts can provide you with resources which can help.

Thank you for having the courage to reach out for help.

Take Care,


January 25, 2009 - 1:21pm
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