Hi Kathleen - you have possibly made your decision already. I had a skin sparing mastectomy with tissue expander done nearly 6 weeks ago - I also had an axilla clearance. My experience has been extremely positive. I have had no complications post surgery and had my first fill of the expander last week. I am a D cup and I would say I came out of surgery looking like a B and now I'm a C awaiting my next fill up.
It is a temporary measure before having a complete reconstruction down the track when my treatment is completed. It feels different, the breast is hard as a rock. (the saline implant sits under muscle) - I did lose my nipple. My surgeon advised me to have it as working with my own skin for reconstruction will be beneficial to having any grafts and the like. I am not sure what sort of recon I will have when the time comes. I am also yet to consider fully what I will do with my remaining breast.
I am very happy with the expander and skin sparing mastectomy. I have found it personally a lot less confronting than I expected and to the outside world there is no real indication of what has gone on (unless they look really closely and see my "Pair" don't quite match up.
Good Luck with your decision.
Amanda