Q: I’m in the process of preparing for my double mastectomy with plastic surgery and trying to make an informed decision on implants vs my own skin. Just had a zoom meeting with FORCE and found out how the ladies liked the Diep flap vs the implants. A: I am sorry to hear that you have to research mastectomy and breast reconstruction, but very glad that you have found an excellent resource for advice on the subject. As you already know, pioneer founder Dr. Sue Friedman and FORCE have been empowering women and families to face their risks for hereditary cancer for decades. Overall there are generally two types of breast reconstruction. The categories include using your own natural tissue and using an implant. Within the two general types, there are many specific variations, and it can be difficult for a person to determine what is best for them without some help and advice. You mentioned the women you communicated with were discussing the advantages of the DIEP vs. implants. In general, the DIEP is a natural tissue procedure that utilizes the extra fatty tissue and skin of the lower tummy and does not require sacrificing your important muscles. If someone doesn’t have extra tummy tissue or surgery has made that area unusable, then the same principles can be applied to other areas of the body where the tissue is present. Overall, this approach has the best chance to provide a natural and permanent result with little to no risk of needing to be redone in the future. Compared to the alternative option of using implants, using your own natural tissue can give you a chance to restore the sensation that gets removed during a mastectomy, and that cannot be restored when implants are utilized. Many other considerations might or might not impact what is the best choice for you depending on your situation. If you would like to learn more, I would be glad to have my office make arrangements for a virtual consult. Just let me know-- Until then, I hope you have success and health through your journey.   Dr. James Craigie