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Hi Again,
Don't be afraid to ask questions! There is no such thing as a silly one and if you don't ask, you won't learn :)
I have an eye shaped cut in each breast which is where they did the mastectomy - there is no cut underneath, everything was done through this "eye". The nipple was removed as part of this eye shaped incision. After everything is all settled down after surgery (really it is the last thing to be done) the surgeon did the nipple.
I had to wear a crop-top type bra after surgery (and still am now) for about 6 weeks. This is very comfortable and doesn't push on the scars.
If you already have a C-sec scar they may be able to open that back up (but extend it - the cut goes hip bone to hip bone). I certainly had more tissue than was needed for the one breast that I had removed and they did a lovely tummy tuck on me :) I got rid of all that extra fat and it was the one really positive thing to happen at that time of my life. They just used what they needed to make the breast.
It is not an easy operation - you need to have a really good, positive frame of mind before you get this type of op done. After you have a TRAM flap it is very difficult to stand up straight and it can be a bit painful to do this first of all. You need to work hard at the physio exercises that they give you to do and, if you do, you will have a great outcome. I wish I could have used my own tissue both times but it wasn't to be.
Louise