My wife is having a double mastectomy with reconstruction. Current plan is tissue expanders first (around 8 hours), then a second surgery a few months later to swap expanders for implants (around 4 hours).
We’re worried because she has APOE4 and early-onset Alzheimer’s risk plus multiple other medical issues, so two rounds of anesthesia (or one long one) is concerning.
She also has a lot of loose, saggy breast skin, which makes us wonder why direct-to-implant isn’t on the table.
For anyone who’s been through implant reconstruction, did most people you know go expanders first, or did some get direct-to-implant? If you went direct-to-implant to skip a second surgery, were you happy with the results? Any major downsides or risks to doing it all in one surgery?
Not asking for medical advice, just real patient experiences. Trying to figure out if a staged plan is the norm, especially for someone with saggy skin and other health issues.