As you said, you must have an excellent plastic surgeon. When I first made the decision to have the mastectomy/diep flap, I went to a well respected surgeon...what a mistake! My thinking is that she does what is easiest and more $$$$ for her and she was blunt and crude. She also sent you to her preferred plastic surgeon. I was beside myself because I did not want implants and she told me I was too old for diep flap. Fortunately I had attended a lecture given by a plastic surgeon. I liked that he seemed so focused and really took pride in his work. He brought several before and after pictures. I determined that I could not keep trying to find a breast surgeon for the mastectomy...it was going to be more frustration, so I decided to make an appointment with the plastic surgeon from the lecture. Thank heavens. He asked me what I wanted and I told him nipple sparing mastectomies with diep flap reconstruction. He told me that he would not do nipple sparing because both breasts has been treated with radiation which can cause problems because of damage to the skin, but he would do skin sparing mastectomy and my age was not a problem for him. Wonderful! He had said at the lecture that he does not do any surgery that he knows will have a problem. That was reassuring. So he advised me of a breast surgeon and he and his associate who is also excellent did the reconstruction. This whole experience has been easy and practically stress free. The only bump in the road was the fierce headache I had after the surgery! Other than that I had no pain and only mild discomfort. I was back on my feet about 75% within three weeks. This has been one of the easiest things I have ever done. I had revision of the nipple area a couple of weeks ago. Next, he will make the nipples and then tattooing after that and I will be good to go. I am glad I made this decision and I am very glad that I shopped around and found excellent doctors. My advice is to do your research and determine what you want and then find an excellent plastic surgeon and he/she can hook you up with a surgeon that they work with who would have to be excellent as well. They would not send you to a sloppy doctor. One thing, this was not cancer surgery for me, so time was not a factor. My first cancer surgery was in 2007 and the second was in 2018. My reason was because I found that I had the CHEK2 mutation. I knew mentally that another cancer would put me over the edge. Don’t just go with a surgeon or oncologist that someone told you about. Check them out. The doctors make a huge difference in your experience and recovery.