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Nov 29, 2009 07:43PM, edited Nov 29, 2009 07:45PM
Cleomoon & CMB35,
I have a small B cup and had unilateral stacked-DIEP 3 years ago. I would have done it for an A cup, as well. Like you, I wasn't interested in being bigger, just being the same as I was before cancer. I was also thin and was told by the DIEP surgeon here that I didn't have enough fat to construct a breast. I did lots of research - reading and online. I found a clinic in New Orleans that does the "stacked" DIEP. They pioneered the procedure and are the only surgeons who do it. They use both sides of the abdominal area, stacking one side on top of the other, rather than discarding half, which is what a surgeon who doesn't know how to do this procedure would do. They specifically created this procedure for women such as us - those who are thin and don't have a lot of extra body fat.
It doesn't matter how small or big your breast is in deciding which procedure you want. I disagree with the poster above, on two levels. One is that it is not clear that any one procedure - implants vs. DIEP - is riskier than another. Both involve surgery, probably at least two, unless you are having a skin-sparing mastectomy. That will give you the best result. If you have already had your mastectomy, then with DIEP you will not have to go through the expansion process -, as you would with an implant - which can be pretty grueling. Also, there is always the risk of capsular contraction with an implant, as well as the need to have it replaced at some time down the road - meaning another surgery.
The second point I take issue with is that, somehow, having a smaller breast to replace makes DIEP not worth it. The benefits from using your own tissue - which you've no doubt already researched - are the same whether your breasts are large or small. The size of your breasts shouldn't impact your decision at all, in my opinion.
I don't think it is unusual to do DIEP for an A cup. I know that my surgeon has done them. You can look on the clinic's website photos at all the different sizes of women (and breasts) who have benefitted from DIEP recon.
Good luck in making your decision about which procedure you want. But be sure to spend just as much time (or more) on deciding which surgeon you're going to use. DIEP surgery requires a great deal of skill, which can only be obtained through lots and lots of experience. That will greatly affect your outcome. I'm going to paste two links here, that I hope might be helpful. One is the link to the clinic I chose, and the other is a video thing that I was part of for BC awareness month - there were 31 women's stories, one for each day of October. I agreed to do it if I could make reconstruction my "issue." I feel very passionate about women knowing all their options and not being limited by what the surgeons in their area tell them. Go for the best! If you have any other questions you want to ask, please don't hesitate.
(Pleomorphic LCIS)Dx 5/2006, LCIS, 4cm, Stage 0, 0/1 nodes, ER+/PR+, HER2-