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holl's avatar
holl
Member
1 hour ago

Unilateral mastectomy with delayed reconstruction

Hi everyone,

I’m currently in treatment for TNBC and starting to plan my surgery and reconstruction, and I’m really hoping to connect with others who have had a similar pathway. Others who chose unilateral mastectomy with expander/implant reconstruction

I’m 41 and currently undergoing chemotherapy (AC followed by weekly Paclitaxel). Surgery is planned after chemo finishes very soon.

My current plan, pending final discussions with my surgeon and a plastic surgeon, is:

  • Unilateral mastectomy (left side)
  • Nipple removal (due to previous lumpectomies and blood supply concerns)
  • TExpander placed at the time of mastectomy
  • Later exchange to a permanent implant (skin is tight and I'm too small for immediate reconstruction/DIEP)
  • Possible fat grafting and/or minor adjustment to the natural breast for symmetry

Genetic testing was negative, so my surgeon feels comfortable with a single-sided mastectomy rather than bilateral.

One of my biggest challenges right now is that most of the stories and photos I find online seem to be double mastectomies and DIEP, and I’m finding it hard to visualise what unilateral reconstruction looks like long-term.

Some things I’m especially curious about:

  • How close did the reconstruction get to your natural breast over time?
  • Did you end up having adjustments to the other breast?
  • What did the expander stage look like under clothes?
  • Were you happy choosing unilateral rather than bilateral?
  • Anyone who slightly increased their size with implant?
  • Did anyone here go on to have fat grafting to improve symmetry?

I’m quite small-framed and originally around a B/C cup (medically-induced menopause and weight loss have decreased this somewhat), and ideally would love to maintain a similar size and shape if possible.

I’m also trying to understand what the timeline looked like for others, particularly between mastectomy, expansions, and implant exchange.

I would really appreciate hearing from anyone who has taken this path, especially if you:

  • had unilateral reconstruction
  • had expanders then implants
  • were younger (30s–40s) when treated

Even just hearing your experience would help me feel a little less like I’m navigating this blindly.

I’m finding the lack of similar stories and images a bit overwhelming, so I’d really value hearing from anyone who’s been through something like this.

Also, anything to potentially be aware of for out-of-pocket expenses. 

Thank you so much in advance.

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