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Direct to Implant vs 2-Step Mastectomy with Tissue Expanders (Plus Radiation for both)
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Hi Folks, I am jumping on to this forum for the first time and have a question. I am 58 years old and was diagnosed with triple negative/invasive ductal carcinoma breast cancer and just completed 15 sessions of chemo which was challenging. Now I am preparing for a bilateral mastectomy with implants going from a DD to a small C size. I will also be doing 25 sessions of radiation approx. 6 weeks after the surgery. I’m curious to hear from anyone who had a similar experience and had 1 step surgery with implant vs the 2 step with surgery and having tissue expanders inserted with implant swap 6 months to a year later. Having radiation after the mastectomy is a main key in trying to decide which route to go. Did any of you do the 1 step direct to implant and had radiation afterwards have any issues/regrets? How about anyone who did 2 step? Thanks in advance. #Breastcancer #triplenegative #radiation #tissueexpanders

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@AndyTechy Welcome to the site and your first post. Very impressive with the tagging as well. Some of us are still trying to remember to do our tagging.

As for your question, I personally have not been through the whole reconstruction experience. I had a single mastectomy and just use a prosthetic breast when I leave the house. I do; however, have a friend who had her expanders put in as part of her double mastectomy. She then had radiation. When she had her implants put in it was too soon after radiation. The skin had not recovered enough and there were issues. She ended up having her expanders in for a long time before the skin had finally recovered enough to have her implants put in. Having said that, she is very happy with how everything turned out. She just didn't really like the trip to get there.

I am tagging @Coffeelover. She may be able to help you. I have seen her comment on some of the other posts on this site regarding reconstruction.

I have added a few other tags that might help you find some of the answers you're looking to find.


#reconstruction #implants #implantreconstruction

22 Posts
Hi there ! Yes I had a double mastectomy with tissue expanders in August , as we were awaiting pathology to see if radiation was needed . Sadly my body rejected the expanders and ended up with one side of my breast swelling up to my colon bone and the pain was unbearable , after 2 visits to the ER , antibiotics and nothing solved I had them removed and am now flat as of mid September . I am 53 single so having no boobs scared me but now that I am flat I am happy as all the pain is gone and no further surgery needed (unless I really want too but doubt I will )

I had 38 D boobs and to be honest I’m enjoying clothes always fighting nicely , loosely without buying larger than I need to accommodate bust , I am into fitness so running will be amazing and no bra !!! Lol

Hope this helps , go with your initial thought or decision . I originally chose flat and talked myself out because of my plastic surgeon and my thinking like no man would want me . In the end I got what my original decision was :-)

only you can make the choice that suits you and your lifesytyle
2 Posts

Thank you @cancertakesflight and @Coffeelover for your feedback and sharing your experiences. I think I am going to go with my original decision of doing the 2 step process. There are risks either way but this is the one that I believe will work for my situation. This community is very helpful and hopefully I can provide some feedback in return.

@AndyTechy I had the 2 step reconstruction method but only on one side. The left side I had a mastectomy with an expander placed under the muscle (March 2019). It took about 2 months before the expander is filled with the saline. Then I had my chemo/Herceptin but didn't need radiation. My next surgery was July 2020 where the expander was removed and an implant was placed on my left side then my right side was reduced/lifted. I started out as a 40DD and was told I would be a big C or D but have yet to be measured to confirm. I was told by my Plastic Surgeon that it was safer for me as I was large chested to do the 2 step process.

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