Lisa wrote: << First, let me tell you that I'm sorry you're having to go
through this.  

Second, you might not want to rush into things regarding the reconstruction.
When I had my mastectomy about 7 years ago, the general surgeon who did the
surgery would not let the plastic surgeon in the OR.  He told me that he was
going for a cure and did not even want to, even subconsciously, be tempted to
leave extra tissue around for the reconstruction.

So I came out a monoboob. I got myself a horrible, heavy, uncomfortable
prosthesis and spent a year and a half contemplating reconstruction. Fairly
early on, I decided that I hated the prosthesis enough to change things.  I
also read Dr. Susan Love's book so I was familiar with the options.  After
choosing the TRAM flap, I worked very hard getting my body in the best physical
shape that I could.  This surgery is a far cry from a walk in the park.

I also wanted to make sure that I was doing it for the right reasons.  No woman
certainly wants to believe that a body part defines who they are.  

I agree with everything you wrote.  I was also wondering whether xiuguiami had
any positive lymph nodes involved. If so, and she did not respond to chemo, I
also would not recommend immediate reconstruction.  
The idea of going through this is horrible.   We each have different levels of
tolerance, though, based on who we are now and our past.  What I am trying to
say and can't think of an easy way to say it, is that we are so much more than
our breasts and that our survival should be top most on our list.  
I had wanted immediate reconstruction but our non-profit HMO denied it for the
wrong reasons which I won't get into now.  Although the initial shock of waking
up boobless brought a tear or two--just a couple--I was ready to get on with
whatever I could do to slay the beast (the cancer).  It has been almost 3
years, and I am still boobless--although I don't think of myself that way.
Unlike Lisa I was able to find the 'perfect' prostheses--or as good as they can
be I suppose.  They had just come out at the time of my surgery (after Lisa's).
They were lighter in weight and had a silicone backing that molds to the shape
of my skin.  I wear them in regular bras--similar to what I wore before--soft
underwire.  
I can wear almost anything without a problem--the only thing I am missing is
cleavage which might affect some evening gowns if low cut.  I have not had a
problem finding formal wear that is a bit more conservative.  I also need a
slightly higher bathing suit (to which these fit in nicely) and that has not
been a problem for me.
Interestingly, I still experience pleasurable sensations in that area of my
chest (without the boobs).  I understand that one becomes numb in that area
after surgery although don't know if it would be over the whole area.
Immediate reconstruction may be a viable option for you but I would carefully
discuss it with your oncologist and possibly get a second opinion.  One of my
colleagues who had been through this a few years earlier really helped me with
my ability to accept the situation--"what's more imortant, my breast or my
life"?
P.S.  I had the 'perfect' ones, too--in both shape and size...
Interestingly, I lost weight right after my diagnosis---and being thinner made
me feel better about my body than losing  my breasts...just some food for
thought.   We are all different.  I probably should add that at the time of my
dx I had been married for almost 25 years to a great guy.  If I were younger
and single I don't know if I would have felt the same...

Thanks for your message Lisa.

Which option was the tram flap? Is that the Pedicled Tram or a Free Tram?
Why is one better than the other?

How difficult was the tram flap? How long does it all take?

Excuse me for asking, but did she have larger breasts, Tony?
I'm an average size, not large and not small. Would this make a difference?

I am pretty dismayed to find out that the most 'natural' looking
reconstructions take not a tummy tuck, but muscle from my back or tummy. I
thought they took fat, but apparently not. I don't want more scarring so I'm
thinking silicone or saline implants. I wish I knew what would be best for
me. Least scarring, most natural, less pain and recuperation time, and
safest. Money doesn't matter as I'm Canadian. I'm just anxious to get this
all over with.

Anne