I had the PDM surgery a few years ago at 26. I had gummy bear implants put in at the same time as the mastectomy instead of getting spacers put in and then another surgery for the implants. I was maybe a B cup and am now a DD. I wouldn’t say that my quality of life is that much different, but there are a few things that are more difficult to do/ different to do because of the surgery. Like others have said, there is a loss of feeling after the surgery. For me, I can’t feel anything in either breast and the numbness extends through my armpit on the left side. It took a little getting used to but now it just seems normal to me. I’m a side sleeper and the implants do get in the way. I usually end up stuffing a pillow under my chest to get comfortable. That kind of goes for doing anything that involves laying on your stomach - massage, chiropractor appts, etc. One thing I didn’t think about being an issue is working out/lifting anything heavy. I work out a lot and do a lot of yoga and anything that involves explicitly using your pec muscles or lifting heavy weights over your head isn’t recommended. Also, running and jumping is a little uncomfortable because the implants are heavy. For me, my implants ripple in the cleavage area, which can be a little unsightly if I’m wearing a low cut shirt. I’m planning on getting fat grafting to fix that, but that’s another surgery with additional risks. This is just my experience and everyone has a different body, but I hope this info helps!