My chemo buddy had mastectomy and reconstruction performed during the same surgery before beginning chemo. She regretted the reconstruction because, prior to cancer, she was very active and the tram left her unable to do a sit up. In fact, when lying on the ground she has to roll over onto her belly and push off the floor. Months after completing treatment, she still experiences chronic pain.
Another complication arose during radiation. MDAnderson doctors said that it was not desirable to have expanders in place during radiation.
Before my double mastectomy, I wondered if my chemo buddy's experience was unique or ordinary. I asked the plastic surgeon to provide the contact information for five individuals who'd had reconstruction. All who had had the tram flap complained of chronic pain. The individual who'd had the lat flap said she didn't trust the arm to carry anything heavy.
DIEP surgery, which transfers only the fat, and does not require perforation on the muscle wall, is not offered by doctors in our area. The plastic surgeon I met with said DIEP had a four percent failure rate (3% higher than his tram flap).