DIEP Flap Reconstruction 2016
Comments
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Not a weird question at all! They usually get the tissue from the flap. They make an incision that looks like a bird (circle with wings on either side). They take the wings and wrap them around to make a cinnamon bun type thing and stitch together the place where the wings were. Thus, you end up with a line on either side of the nipple.
Here is my attempt to draw what they do:
Some people call this the "origami" method. Because they are using some of the tissue from the flap to make the nipple, the flap ends up a little smaller. Also, the nipple there draws the eye and makes the flap scars seem less pronounced.
My doc said that nipple reconstruction is something that varies from doctor to doctor because there is no "right" way to do it nor is there a "standard" size to shoot for. Some docs take a graft from inside the thigh, but that leaves you with another scar somewhere else on your body. Recently on the 2014 DIEP forum, caligirl3 said her doctor used a Cook Biodesign Nipple Reconstruction Cylinder, and she liked that very much. My doc said that some docs even save the cartilage that they take from the ribs and use that to create a nipple!
So, be sure to discuss how/when/why for your situation.
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Had oncoplastic reconstruction on my right side during lumpectomy in 12/2014. Since the tumors removed were from the inside portion of the breast, it was hoped this would fill in the "hole" that was left and maybe just some fat grafting would fill in the rest. Developed a seroma after the drains were removed and (not-so) patiently waited it out to see if the big, hard lump would reabsorb, which it hasn't. The consult with my plastic surgeon yesterday has me leaning toward a DIEP to fix this once and for all. Since the hard area has to be cut out, the first option was to put in an implant, hope it would fill in most of the hole, then continue on with fat grafting till we got it all filled. Then we discussed the DIEP procedure. I am really excited about the use of my own tissue (which is why I tried the oncoplastic reconstruction in the first place. I never liked the idea of implants and having something foreign inside my breast. Everything I have read on these board (2014, 2015 and here) is very positive. Yes, there may have been some setbacks, but even with those (infection, pain, scar), almost everybody says they would do it again and absolutely didn't regret it.
Waiting now on preauthorization for the CT to check blood vessels. But if that looks good, I don't see any reason why I wouldn't go ahead with the DIEP procedure. I have read all about the procedure, am confident with my plastic surgeon and read the experiences of all you ladies. I feel well-prepared. I know it won't be a walk in the park, but I think knowing this is almost the end of the road will make recovery that much more bearable.
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BigSister -- I was told to keep gauze on the nips for between 6-8 weeks -- which sounded crazy to me, but I guess they are fragile little things. I tried a bunch of things and ended up using a small stack of those round cosmetic pads with the centre cut out, held in place with a bit of tape at the top and bottom. I wanted small nips (I told the whole operating room before they put me under:)) and I'm happy with them -- enough to look like a nip, but not enough projection that I have to worry about covering it up.
I just got my tattoos last week -- they are under wraps for another few days and then I'll see what the colour looks like.
Good luck to everyone on the 2016 board!
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hello everyone! hope everyone is doing well. my healing has been slow but every)day is a bit better. tomorrow i will be 8 weeks post op. i am experiencing some delayed healing on each breast and abdominal incisions but things are looking up for 2 out of 3 incisions! we have been putting inadine dressings covered by medipore pads over the incisions to help remove some of the "slough" and that has healed up my right breast and abdominal incision.
today we had to go in to see the PS as my left breast (the one that caused all the problems immediately after surgery) is taking it's sweet ass time healing. there are two crater like holes in the lower incision with fat necrosis so....today we went in and the PS flushed the holes with saline, clipped some stuff out etc etc (didn't feel a thing, just some pressure, also couldn't see anything). she put a PICO vac dressing on which will basically suck out all the goop that keeps forming in the craters. totally reminds me of when i have to wear my 48 heart monitor. as annoying as it is, it is still way better than the original drains, and it will help me heal quicker.
back to having homecare in but if it helps these craters close, i am all for it.
so, overall, as frustrating and scary as these "craters" are, our trip to the hospital today was welcomed. we feel so much better. slow and steady and it will get better.
keep your chins up, everyday does get better.
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BigSister- Wow thanks so much for clarifying that. For some reason I haven't even thought of nipples. I will be sure to ask at my next appointment.
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Tanya. You are amazing. Just a had to tell you that again. You are absolutely right and everyday it does get better. Sending you lots of love and prayers that this wound vac will heal up your incisions and you'll keep moving forward all positive here on out.
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I'll be going to pre-op on Monday, just got the confirmation phone call,
and hopefully into surgery on April 28th, so have been doing some more online searching for information on how to prepare. Here is a link on how to prepare for surgery and recovery that may be helpful to many of us:
http://www.breastrecon.com/prep--recovery.html
And here is another one (Canadian):
http://www.myreconstruction.ca/ar.html
Although, reading about personal experiences of all of you here to guide me is priceless.
I am so looking forward to putting this behind me - less than two weeks to wait for the first stage!
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Was just thinking of you Barb glad preoperative appt Monday. You will find the appointment very informative and will guide u through what will take place. Nurse co coordinator is great. Two more weeks and you are there. You are correct the advice from all the ladies who had their surgeries before us gave us so much guidance and information. I'm 9 weeks out know and feel good, back to work and fatigue biggest complaint. speak soon :-)
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Good Evening,
Today is my one week mark. I am doing well. I am really not in pain at all. Biggest complaint is these pesky drains. I am so hopeful that they will come out on Tuesday when i see the ps. Everyday I feel a little stronger and I am able to do a little more each day. My foobs are looking better each day they still have bandages but they already look and feel so much better than my implants ever did. 😊
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Greatfull 99,
Good luck to you. I was so very anxious before my surgery but I also found the advice and support here to be very comforting. I am one week post op and doing fine. Am so glad to have this surgery in the rear view. I will keep you in my thoughts and prayers.
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Not a day goes by that I don't think about how glad I am to have done this surgery. My foobs are warm and comfortable and me!
I love my new nipples. They really make a huge difference because they draw the eye away from the scars. I am beginning to feel finished.
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Congratulations Big Sister! I am already looking forward to phase two!
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So so happy to hear BigSister. Looking forward to late Fall for my stage 2 and saying the same thing. Keep us posted on how your fat grafting holds and pics when your able.
Hugs
G
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Makes me very happy to hear people loved the fact that they went with the surgery. Im still waiting for a date for mine, but I am always second guessing myself. Especially when friends ask me about it and I give them the details. They look at me as if I'm crazy. The answer is alway why don't you just remove the other breast and be done with them. I never know what to say to that. But then I say because I want my clothes to fit right, and if its possible why can't I have breasts, and Ive also read the sometimes surgery improves lymphodeama. I think sometimes people don't think before they speech. Let remove one of your breasts and see what you think lol.
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taag4, great response to those people who don't know what it feels like to have only one breast. Really, it's none of their business. It's your choice and yours alone.
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Taag, good comeback!
Because of infections, I had to go flat for many months. During that time I realized that I HATED being flat. I never messed with any prosthetics while I was waiting for my body to heal enough for the next step. (Not to mention finding the time to face surgery after having my life on hold for so long!)
I am not one to ever worry about my looks--I bypass make-up more often than not--but I was initially pretty self conscious about being flat. Later, I just went with it. It was convenient to go bra-less, but it all felt so wrong. Catching sight of myself in the mirror was so sad.
So after the second infection with my options for recon becoming more limited, I went back to my trusted BS who set me up with a PS who did the DIEP.
I loved what I heard and I knew I wanted breasts. It was a tough recovery mostly because I was so helpless to start, but totally worth it. I didn't cringe anymore looking in the mirror, and the best part was how natural it all felt. Just a few weeks after my DIEP I caught sight of my new breasts in the mirror while coming out of the shower and was almost surprised to see scars! That is how good I feel.
I love my cleavage, I love my new nipples, and I love that my surgeon was able to make me whole again. I would rather have kept the old saggy-baggy me, but this is an acceptable alternative.
I am thankful the my family and friends are supportive or at least have sense enough to keep their mouths shut. It is a long road to wholeness that outsiders may not have the patience to complete. But I do. It is my body, and I hope to inhabit it for many years to come. This remodel is a necessary step to deal with what the storm of cancer did to me.
Just because something is hard and time consuming does not mean it is not worth it! Great works of art are not completed in a day. After all, the originals took 9 months
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All well put Big Sister! So glad to see 'me' in the mirror. With so many other treatment related side effects, at least I'm not having to get used to missing those parts of me.
By the way, how are you feeling post stage 2? How are the bruises doing? They should fade somewhere between weeks 2 and 3. The inner soreness eases up closer to 4-5 weeks. At almost 7 weeks, I've got surgery amnesia and am prepared to do it again if needed. It's like childbirth....the mind blocks out the initial suffering over time.
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Thanks for the heads up, DizzParkMom.
He took from my waist and my inner thighs. No bruising at the waist, but the inner thighs are quite bruised and still pretty sore when I walk, but not horrible. My waist hurts like mad when I twist to look behind me, and I have to be careful when I go to put my hands on my hips. He did a nice job as all the donor sites look pretty good--no divots.
He said he put about 60 ccs in each breast, mostly in the poles--he is pretty conservative. I noticed a divot on one of the breasts today.
It is to the side of one of the nipples. I am not sure if I slept on it wrong or something? I figure it will take time for everything to settle down, so I am choosing not to worry about it. My biggest complaint is that I am still pretty tired at 12 days post-op. I don't do much during the day and I am done. I had gotten most of my energy back prior to surgery, but I still tired easily. It is the pits to be back to tired all of the time, but this too will pass, I trust!
On a happier note, my eldest daughter just got engaged this weekend. I am so happy for her!! Her guy is a gem. So, any further reconstruction is going to get interrupted by a wedding.
Maybe I'll get tattoos for Christmas. LOL0 -
Congratulations. Having a wedding to plan and look forward to is just what you need. So much joyfulness instead of thinking about recon. and such.
I have a few divots as well. I was hopeful that we could get it all in one go, but Dr. did warn me original tissue transfered was short of original size and so the rest of the fullness would have to come from grafting. I have that same tightness at my waist, but it is loosening up. I used outer thigh this time, but will probably have to go inner thigh next time. We will see...I just flew in to Illinois for my follow-ups.
P.s. about your energy. How are your electrolytes? I swear it took forever after the fat grafting to get my fluids balanced again...once replenished my electrolytes is when I really started to feel more energetic. Those tissues suck up a lot of fluid trying to heal....
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Dizz, how did you straighten out your electrolytes? Did you drink pedialyte or Gatorade?
Idrink like a fish and take a bajillion supplements. I also started brewing kombucha and have 16 oz per day.
I have plenty of size right now and don't want to go bigger. (Never thought I'd be saying that!) but I am hoping for good contour.
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Yep. For every 8 oz of water I drank, I drank 4 oz of gatorade. I also used the pedialyte ice pops....
I think I was drinking so much water and tea that I was just diluting my electrolytes. I kind of figured it out one day by accident when I had a very salty meal for dinner and felt great the next morning.
I am okay with overall size too. I've always been small and okay with small, but the pits and divots bother me. I'm also afraid I've got a big lump of fat necrosis...afraid how that will leave things. At least I hope it's fat necrosis. I don't want it to be anything else.
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I had my pre-op yesterday and had a blood test done as well as ECG. All well there. Then a meeting with the pharmacist who checked my meds and vitamins. A nurse took MRSA swabs and did my vitals and then I spoke to a nurse who updated my medical chart and a clinical coordinator who told me all that was going to happen before, during and after surgery and answered all my questions. So far so good and I'm still booked for the 28th barring any emergency surgery that could bump me. I am looking forward to this, having two breasts again and getting a bit nervous. It's been a grueling two years and three months. Going out today to buy a sports bra.
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Best wishes for a quick, painfree (okay....as much as possible) recovery Grateful!!! Waiting is the worst part, but before you know it you'll be on the other side of surgery. 🤗
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Waiting IS the worst part. It's been a week now since my PS ordered the CT. I've called the imaging place twice and was told they need the pre-authorization from insurance. I told them (twice) that PS office confirmed no pre-auth was needed for the CT, but they say they need proof of that. I guess when I get the pre-auth for the actual surgery (which could take up to 15 days, so just another week or so on that), then I can go ahead with the CT to see if it can actually happen. I have a lot going on next month anyway, so I probably won't be ready for surgery before June (plus I don't know what my PS's schedule looks like), but I just want to got going with the CT to make sure this is really doable. I hate waiting!!!
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Sorry to hear about the delay farmerma. I know that once you get your mind ready for an experience it is agony hearing that you have to wait....for paperwork to happen nonetheless. Hang in there. P.S. At least you've got a full month ahead of you for distraction.
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Hi Ladies, I'm sorry if this is a duplicate question I skimmed the board, but didn't see anything.
I'm almost 3 weeks post DIEP reconstruction and Bilat-mast.
The last couple of days the stomach area above my DIEP seems very tight, almost bloated and is actually a little fatter than the lower part. Like you can feel and see the difference in outward size along the incision between the lower and upper.
Anyone else have this type of feeling, just feels strange, not painful, but odd feeling.
Thanks for any insight!
Kit
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Hi queenshark. It's been about 6 months for me and I am getting fuzzy about specifics, but what you describe doesn't sound abnormal to me. I do remember that super tight, uncomfortable feeling. I wasn't bloated all the time exactly, but everytime I tried to eat a normal sized meal I would have bloating (I believe mostly up top as opposed to below the donar incision). Does it seem worse after meals? I know I had issues with constipation after surgery and my whole system just couldn't figure itself out. You should be due for a follow up with your surgeon soon. If it's still uncomfortable then, I would let them know. Months from now, you'll still feel tight, but it gets more normal feeling too.
Also, over the next few months thinks will constantly be evolving. It's hard not to try to predict your final look...but, just as the swelling works itself out, you'll be getting ready for phase 2 and you'll start all over. It's such a process....a long, long, process.
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Hi ladies, I am 2 weeks post op and looking for recommendations on what brand or place to find s bra that has a front enclosure and side supports. My flaps seem to be spread under my arm pits and the doctor suggested I get a bra with side supports. Do you find that the shape of your flaps change shape or size as the weeks pass? Would love to know what to expect. It feels like I have a shelf under my armpits
Thanks
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Hi ladies - had my last chemo today! Hooray! And had rads ( right) back in the fall ( plan change after 2nd opinion from Dana Farber) so next stop on this BC train is the BMX recon - happening May 31. Gearing up now! My PS/BS appointment was back in the fall, and I hadn't decided on DIEP yet, so we didn't talk details much…there is lots online, though. We are not doing nipple sparing.
I was expecting the ellipses, but some people have the keyhole and I am not sure why?
I do not have a recliner and was expecting to prop myself in bed - is this realistic?
I am obsessing a little over cami's with drain pockets - and they are so expensive (though not compared to the 600$ wig that I have worn twice!!) Are they worth it?
I love the list on the first page - any other sage advice?
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Thanks, DizzParkMom. It seems that it will finally actually happen (baring major emergency) and God willing.
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