NOLA in September?
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JustLaura, If you'd only been told elsewhere that you didn't have ample tummy fat (whoever thought these tummies would turn out to be so useful...) I would disregard. I was told by my fancy NYC surgeon that I would be an "A-minus" if he did a DIEP. Also told similar by a second surgeon. At NOLA I was told that I could be about the size I was with implants -- big C, littleD -ish. They said they would do an Extended DIEP, meaning would use the blobs of fat on each anterior hip to kind of stack with the tummy fat. I actually never asked if they ended up doing that....my incision goes hip to hip, but I think they all do. I started out a big D and I'm not sure if the limiting factor was the amount of fat I had (looked like LOTS to me), or the skin envelope I was left with after MXS , then tissue expanders. At my consult I asked about intentionally gaining weight and they, of course, said no, we want you to just eat in a healthy way, etc. I did find myself indulging a bit more -- haha-- thinking of the re-purposing ahead. When I came back 6 months later for surgery with 10# of extra tummy, Dr. S certainly didn't seem disappointed!
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Dragonfly, I will eventually post my pics on timtam's site. Since 2 of my tumors were apparently close to the skin I had to have a bunch of skin removed for clean margins. I'm not positive of Dr S's reasons for leaving on some skin from the flap, but he said he'd be able to remove it later. I cannot recall if he said 'should' or 'would'. I don't know if I was overstuffed for potential rads, overstuffed in order to be shaped later, too soon for my skin to be pulled tight together..or what. The Why is on my list for the stage 2 visit!
Usually you see the skin patches on the delayed recon in the football shape. Mine is an archway! From the inframammary fold to the (former) nipple area, barely offset toward my sternum. I have to accept it otherwise it freaks me out. Thank God I know it's temporary. I just wonder if it will look as good as my prophylactic side in the end.
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I am so confused, I mean my whole breasts are a big patch because of the delayed and the radiation. How can that ever be fixed? I think I need before and after lol this is strange. I'll have to ask Dr S when I'm there I suppose.
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Yeah - I've done my binder time and am free.
As regards to fattening up - when i got diagnosed again and knew i would be having DIEP I stopped going to the gym and ate. I told this to Dr. S and he said thanks for helping him. Now I have to heal up and back to the gym I go. lol
For those who have had Stage 2 - how much time did you take off from work. For Stage 1 i am in the midst of a 6 week time off from work. I am wondering how much time will be needed for Stage 2. At some point I am also looking at a 4 week recovery from BSO so just trying to figure out my weeks off in relation to 12 week FMLA.
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I was laid off before stage 1 so not sure on the whole going back to work thing. I felt great though after stage 2. I think I could of went back to work within a couple weeks. Maybe part time but hard to really say now. Each person varies so much!
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Oh, Dragonfly, I think you'll understand when I post pics sometime. Have you seen Sandy's pics on timtam's site? Hers are the closest photos I can relate to now. My surgery was skin sparing mastectomy immediately to DIEP and I started with a sagging F cup. That's the only reason why mine could possibly go away. Plus the shape is a bit boxy and can still be taken in. I think Sandy's original surgery was SSM immediately to DIEP as well. I believe the delayed flaps can never have the flap skin removed because there's no other skin to go over the flap.
Sorry to confuse matters! That's one reason why I've found the photos so helpful and why I want to put mine out there to help others. I think it would be neat to see progress shots on the Center's site.
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I think that's what makes sense, delayed flaps is what I have. So my breasts are made up entirely of a flap. I wish we had somewhere here or on the centers site for our own pics. The timtam site to me is too confusing.
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JustLaura... I was told by a local surgeon i didn't have enough belly fat... then Dr Allen in NYC said I did... then I went to NOLA for a consult and Dr D said I did NOT have enough, and would need at stacked DIEP OR a DIEP with implants later at stage II... so I am opting for Stacked DIEP... My belly fat is really not in teh right places... I don't have a ton of below the belly button fat... I for sure have love handles and if I lost 50 pounds I'd be perfect... so to not have enough belly fat is disappointing, but we are what we are... and if your surgery ends up being a stacked DIEP are you ok with that??
Also, someone had recommended that we call the airline (flying Continental) and request bulkhead seating for the return trip... I did call and was given the front seat with my husband... so thank you!
And thank you ladies for all your encouragement... can't wait to be on the other side.
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Hi Tigsun. Sounds like you're doing great. I am still 2 weeks out from my stage 2 so I can't say how long that will take. But I did just have my oophorectomy 2 weeks ago (laprascopic) and I was back to exercising after 10 days. I'd say take 4 weeks - but two of them can be more of a vacation!
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Hi ladies,
I am a TE reconstruction girl, but curious about the "stages" of your reconstructive surgery with DIEP, etc. I am happy so far with how things have gone with my BMX and TEs, but have not yet had exchange surgery. I know even after implants, I still have option of flap surgery. Just curious?
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JustLaura - just to echo a common refrain, I was told by all the local surgeons that my breasts were too big and I was too thin for DIEP (usually that would sound like a compliment, but not in my case!) so I consulted with 4 DIEP experts: Dr D. in NOLA, Dr. Levine in NYC, Dr. Greenspun in CT and Dr. Keller in Long Island, NY. First I spoke to them all on the phone and sent photos and they all saaid I was borderline--but as opposed to needing an implant too which is what my local surgeons suggested, they all said they could do stacked flaps. I decided to see all of them in person to know for sure (since stacked flap is almost twice as expensive and regular DIEP and my insurance only covered 80%. I was a D cup but said I would be happy as a C. Seeing them in person really helped (and I did indugle and stop going to the gym like others here so I gained 5-10 lbs) and they all said I could do regular DIEP and end up with a full c/small D. Today is my 4 week anniversary of surgery with Dr. D and I think my new breasts look almost exactly the same as they did before size wise, just a little perkier! Good luck with your consults and keep us posted.
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JustLaura, Look back through the posts, and you will see mentioned Stacked Diep. Spring had that, and a couple of others have had that as well. They are able to get alot more volume if they use fat from two different areas, for exampe, hips and ab, or commonly ab and backside. That may be the option for you. Don't get discouraged. And keep on eating! I had lost about 10 lbs before I decided to have the DIEP. From the point I decided on surgery, the diet went out the window. Which worked out well with the Easter chocolate around, and also my daughter visiting from England and having to visit every single one of her favorite restaurants. In one month of her being at home, I think we had lunch and dinner at the house a total of 3 or 4 times! Y$kes! I just kept saying, "I am growing my fat for harvest". I didn't gain any back, but didn't lose any either. And I apparently had plenty when I got to NOLA.
I feel a bit ripped off as I don't remember anything about the 'holding area' before surgery, other than meeting Dr. S briefly and asking him to remind Dr D that "I don't want to be too big. But I don't want to be too small either. You know, tell him to make them just right." Dr S laughed, but whatever, they did turn out quite nice. Other surgeries, I even remember being wheeled into the OR, one time by the surgeon herself.
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Laura, they told me locally that I didn't have enough to make even 2 A cups!!!! But Doc D (like Betsy) when looking at my photos didn't think I could be a C cup with just back or front, so I stacked - 4 flaps, but lots are doing this now and it is doable. I started out a 38 C and that is what I am now!
Christine, Welcome to exploring our thread! Lots of us here had implants and for whatever reason, they didn't work for us. I hope yours work for you and you are happy. But just in case! Stage 1 is when they remove the implants or do the mastectomy, and then they get fat flaps from either belly (DIEP) or but (GAP) or both. Stage 2 is a more cosmtic phase so make sure everything is even, give you nipples if you need them (lots have nipple sparing) and then lipo around the donor sites to make sure everything is smooth and in balance. Does that help?
Ro Ro Ro. I am so sorry. I agree with Amy that drain exiting in the groin was the bane of my existance too!! Mine was so sore, red, and white stuff coming out, that they let me pull it early, my drain was in the mid 20s, and I was fine. I tell you. Once that thing came out I felt like a FREE WOMAN and my recovery truly began. You are not alone! How much is that drain putting out? Try not to move around too much until it's out. After it's out, you will walk around like crazy!!
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Springtime, thanks for the info. I am also hoping I am happy with the implants, the TEs look fine, but sure hope the implants are more comfortable. My PS is great, trained at Duke and does flaps/microvascular surgery, he offered me DIEP, but I was to worried about long recovery delaying my chemo, etc., so discussion was short, and I went with TEs at time of mastectomy. Nothing is clear cut in this breast cancer journey, so many choices, wish I had a crystal ball. It is good to know that I have all options still open. Now that I have finished chemo, I have started to find new things to worry about (implant rupture, size, cosmetic results, lymphoma with implants, etc). I recently traveled and Dr. Massey was advertised in the flight magazine, really sparked my interest in her work. I see you are in NC, me too!
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JustLaura, greetings from CO. I had a local PS who said I wouldn't have enough for DIEP or SGAP, but I had plenty for the SGAP. If Dr. Massey had been doing hip flaps at that time, I'm sure that would have been my source instead! Stacked flaps are such viable options, too, now at NOLA. I'll bet you'll be surprised!
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Is Dr. Massey in both Charleston and NOLA? Do you get her or an associate?
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Hi Christine, I am an NC girl also. Anyway, if you go with Dr. Massey, you get Dr. Massey. Same with Dr D and Dr S in NOLA. My understanding, though I could be wrong, is that Dr. Massey does most of her Stage 1 in NOLA now. She is working with Dr Dellacrocce and Dr Sullivan in NOLA. She was actually "in the house" while I was down there. I heard her talking in the hallway to the nurses, and was wishing I had the energy to go out and meet her.
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Hi Dragonfly , I leave Atlanta on the 13th and come back home on the 23rd at 6 am? what is up with that well i guess i can't complain Mercey took care of the flights.Alot has been going on the board i have been cooking and getting ready for my daughters grad party on friday.
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I was told that i could get to a B and I am a D (which I wanted a full C or small D and I am a 36D). I had a delayed flap after implant failure and I will always have the flaps of skin but believe me that is better than nothing.
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lesliet hopefully we can meet up while we're both in NOLA then
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I was delayed reconstruction as well and will also always have the football flaps of skin - but I don't care!!! It is so much better than the concavity and thin tissue that my expander left me with! (Although I DO wish they were exactly the same size/shape flaps... but I should have asked for that if I wanted it - SO if you are analytical and that is something super important to you -be sure to ask for it! (I didn't because I was too worried about just getting through the surgery and home to my babies!)) Besides, nobody sees my flap tissue except my hubby - they don't show in cleavage or in a swimsuit, so all is well!
I consulted with multiple surgeons prior to going to NOLA. I was told by most of them that they could give me a large A, small B with DIEP. One even said that SGAP would also only render a large A cup. Then the doc at John Hopkins told me "no way" would DIEP give me even an A cup - and he recommended hip flap (he also inadvertantly recommended NOLA...
Then Dr. D and Dr. S looked at my pictures and both said that DIEP would barely give me bilateral A cups and said that it would be doing a "great disservice" to me to have DIEP. One recommended SGAP or hip, the other recommended hip flap. Liz never said who said what, but I can only assume it was Dr. S that recommended hip flap as that is what I wanted and that is the surgeon I got! At my pre-op he asked me what size i wanted to be and I told him a large B cup. He said he could get that from my hips, but if I wanted any larger he would have to stack to get them. I went with the hip flap, and I have large B cups. Granted the bras I wear are 34D's, but there is really no way that I am a true D cup... just the way the sizing is. Anyway, back on track here - I love them, and Dr. S gave me what nobody else could. 
I feel very, very, lucky to have been able to go there. Okay, I am going to quit rambling now... I had dental work today and I actually took some pain meds... UGH. I hate hate hate having my mouth worked on... I have tolerated multiple aspirations, broken toes, sprained ankles, shin splints, pulled muscles, etc. without any kind of medication - not even a Tylenol, but stick a needle in my mouth and I want my mommy... LOLOLOLOL! And now they are talking braces for a bite correction that was recommended when I was 14 that my mom refused to do because she thought I just wanted them to follow the crowd or some stupid crap like that. Well, the orthodontist told her that if I didn't get things fixed I would start having issues with my teeth when I was about 40... H*lls bells... looks like it is here. I think I am going to send the bills to my mom... LOLOL! They might as well stick me on a morphine drip for the next two years...
RO - Hope you are doing well and having less drain pain.
Ref - thinking about you!!! Hope everything went well today!
PS - Yes, Deidre is the black lady without any hair. She is beautiful and so funny. LOVE her!
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This is ref's husband. Operation went well and she is doing great! She is still a bit groggy, but we will be having breakfast shortly, then out of bed for a walk. She will post more later.
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am in throws of working thru insurance..and denouement's post about insurance echoes some things have been wondering about my situation as it gets cleared...i have 80% out of network coverage also, so am wondering
1/ do we know how much unilateral vs bilateral diep costs
2/ and if stacked is necessary how much more is that?
and after a lot of posts on here, i am thinking about ditching the gym too and eating up...i have been trying to counterbalance the weight gain from chemo but if it is going to cost me $$( if not enough and am going to need stacked) maybe this is not good idea!! rosemary
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Throwing a little caution into the discussion about weight gain... we joke about it, but in reality the docs want you to be at your normal weight at the time of surgery. If you gain weight, and it goes into the area used for your flap, then as soon as your body normalizes, that flap is going to lose weight. I think if your weight usually fluxuates in a 10-lb range, then being at the top end of that range at the time of surgery probably isn't a big deal. But I wouldn't intentionally put on weight for your flap. If you do, there's a good chance it won't stick around.
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I'm with you Nordy, I will always love the new and improved boobs Dr S gave me! Flap or no flap, I could care less. The year with nothing being concaved was so miserable!
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Thank you everyone by putting my mind at ease about 'cup size'. I know that I will be happy with just about anything but it is SO wonderful to hear what you all think.
I'm starting to try to get my packing done and I am having the worst time trying to figure out what to wear on the plane home which will be on my 8th day post-op. I first thought my yoga pants and a zip (light) sweatshirt. But I just tried on my yoga pants and they seem to go pretty high so I wonder if they will hit my incision. Then I thought shorts! And remembered I would have some lovely compression socks on still. Then I thought sundress - I could hide another person under some of my sundresses! And then I remembered I would have some lovely compression socks on. So now I'm back to my yoga pants. They are slightly tight down the legs too. Will I still have a something on my torso too that would go down my legs or be seen through my yoga pants. I have heard everyone say they had a DOM on. What is that? Will it show?
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ewww jeskachi...now that is putting whole different perspective on it for me!@#$%^&...so if you are carrying more weight than usual( for eg, i have gained 30lb in the last 18 months but am hoping/was working towards clawing back to something like i was before...) then if i should in fact be trying to normalize myself closer to my former weight, rather than working on losing it post diep? so back to the gym??
and am wondering, if abdomen is where you usually put on weight first, does that mean a flap taken from abdomen is going to lose it first too? does diep flap take on behaviour of breast tissue, or remain acting like stomach fat???? rosemary
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JustLaura, keep in mind you probably won't wear half of what you take. I took a big suitcase with a ton of stuff the 1st time. Considering you're in the hospital for 3-4 days, then at the hotel/hope lodge lounging around. I lived in my yoga pants, and they have pockets so they were perfect! You will not have a DOM outfit after stage 1, unless things have changed since I did mine in September. It's just the drains. I think your yoga pants will be perfect, your insicion is pretty low from the DIEP, not up by your waist. I know that for stage 2 I packed much less, a couple tank tops, sundress, and yoga pants. With the laundry facility at the hope lodge it was nice!
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I have my confirmations and everything. Arrive June 18th. Pre-op on the 20th with Sally at 2:00 and Dr S at 2:30. Surgery the 21st at 7:00!!
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You are so right Dragonfly1976. I need to remember that as I'm getting everything together. I have two pairs of yoga pants and neither one has pockets. I think that may be a good reason to pick up another pair!
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