Hi again Heidi
I probably wouldn't go for a TRAM flap if you don't have a good pain threshold - it is certainly more painful than the Lat Dorsi reconstruction that I had on the other side! I only needed a couple of Panadol after the Lat Dorsi and had very little pain at all! You may be lucky and they may be able to do the op without using your muscle.....I'm not sure of the pros and cons but I know that my surgeon uses the muscle to get a better end result, but other surgeons obviously think differently based on what Ree has had done.
You shouldn't need to have any lymph nodes removed unless there is evidence of cancer in the breast. I only had 5 taken out from the second time and none of them were cancerous. My risk of lymphodema is fairly low.
My reconstructed nipple is healing beautifully :) I am REALLY happy with the result. You wouldn't know that it wasn't a real one other than the lack of colour at the moment.
Have a good day,
Louise