DIEP Flap Reconstruction 2016
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Just wondering it seems like the time frame people have been talking about between Stage 1 and Stage 2 is about 4 to 6 months is that a average time frame? Im still waiting to get a date for my deip flap, I was told sometime in May or June but still no date. I'm having concerns about my left breast now . Hope its nothing mamo showed nothing but that doesn't mean anything to me. I had an ILC that was 9cm in my right breast and mamo didn't show that. So going for ultra sound on the 13th. Just want this journey to be over with.
Thanks DizzParkMom for saying Stage 2 was painful. I have been assuming from peoples comments that its a walk in the park, compared to Stage 1. I guess you just helped me keep an open mind and remembered to be prepared for what ever comes my way.
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Taag, Stage 2 Timing is usually done about 3 months after Stage 1, but it can be later if life needs to be attended to and you don't have time to recover from another surgery. (That is American timing. I am not sure if it goes for Canada?)
I did mine 4 months after because that landed on spring break from my teaching duties and gave me more time to recover without taking too many days off.
Stage 2 Recovery. As DizzParkMom said, Stage 2 was a bit more than I expected! It was a 3 hour surgery, so compared to the initial DIEP, it was easy, but that isn't saying much! I felt great the first 24 hours, but then the lidocaine wore off and boy did I hurt! Not so much that pain meds couldn't take care of it, but if I twisted in the car to talk to someone in the back seat--OUCH!
I took off 2 weeks to completely rest (needed it!) and then another week of taking it really easy. I wanted my bruising to heal well and my moved fat to have all the chance to find a good blood supply and not die off, turning into necrotic lumps.
I was on lifting restrictions (no more than 10 lbs) for 4 weeks. I am at that 4 week mark today and finally feel pretty much back to normal. So far so good! No lumps and everything is looking good. I am just waiting for the rest of the nipple sutures to dissolve. I feel like a porcupine there!
It couldn't have been that bad, though, because I am willing to do it once more if I need to in order to fill in a couple of minor divots. (I figure after all this work, I might as well get it finished completely!)
Swelly-Belly. Daboys, I had my surgery around the same time as you did (December 10), and my belly has settled. I would get puffy and sore through the day and then it would settle as I slept, but that is much better now. Using yoga pants REALLY helped.
I remember women on the 2014 forum talk about "swelly-belly" that lasted quite awhile, but yours sounds worse. The ladies on the 2014 forum surmised that since the lymph drainage of the belly was disturbed with the DIEP, it made sense that it took awhile for the lymph to find new paths and for new vessels to form, but swollen and tender this far out does not sound good.
I am especially concerned regarding the tenderness. I wonder if you have a seroma going on that needs to be drained. Make an appointment with your PS so he can examine you and help you out.
No One Regrets DIEP. Whipluc, I read through all 200+ pages of the 2014 forum as well as all of the 2015 forum and did not find a SINGLE person who regretted their DIEP in the long run--even those who had complications and failures. That is saying something! I am SO HAPPY with mine.
DIEP with Implants after Infections. LisaMarie, I too had infections--two of them, and the second tried to kill me with sepsis. Like you, I had one implant and one side that needed my own tissue. I decided not to be lopsided and went with a bilateral DIEP. I couldn't be happier!!!!!
Remember, implants can move around, they are always at risk for infection, and they need to be swapped out every 10 years. So, while you are getting the DIEP on one side, you might as well to both. If you don't, you can't go back and do it later because you will have already sacrificed your belly. They would have to use another site if you decide on it later.
Your DIEP breast will gain and lose weight with you as you age. It feels so much more like the real you. The implant won't do that, so although they will start out even, it is not guaranteed that they will match forever.
If your BMI is on the high side of normal or more, you should have enough for 2 breasts. My first PS told me I didn't have enough belly fat, so that is how I ended up with implants in the first place.
The DIEP surgeon said that actually I was the perfect body type--enough fat for 2 breasts, but not too much to add complications. He thought he could give me 2 B cups. I ended up with 2 C's, and they can always make them a little bigger with fat grafting in later stages. So, consider doing both!
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Thank you BigSister. I originally went in wanting to do DIEP on both sides, but my PS says the type of implant I have will probably never need replaced. (who knows) and doesn't think we should mess with it. He also said I do not have enough belly fat to do both, and may even need a small implant with the DIEP side to get a C cup. I also feel it is only logical that the DIEP side will change more than the implant side and cause me to be lopsided later. He mentioned we could do a lot with fat grafting as well. I guess I need to ask him more questions and really give it a lot of thought.
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LisaMarie, italso may behoove you to get a second opinion.
You might want to post on the 2014 and 2015 threads to see if anyone did DIEP on one side and an implant on the other.
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My PS originally also told me that I didn't have enough fat for B cups so while waiting I gained about 10 pounds. It doesn't take much for two breasts. He used 480 grams (a pound) for each and I'm more than happy with solid B cups. And I didn't even need to buy new clothes - the jeans were tight but still fit (barely LOL). I now have two love handles left that he can use to balance and top me up in stage two.
I also think you should get a second opinion.
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Thank you guys so much. Posting on the other threads is a good idea. I did find one lady on here who has one of each, and she isn't having any problems as of yet. I do agree I maybe should seek a second opinion. The problem is I believe he is the only doc in my area who does DIEP.
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grateful99 - thanks for the exact gram weight. Do you mind me asking what your weight and height were at the time? I am 5'2, 138 lbs, and currently wear a size 8 in jeans. Just trying to see where I stand in comparison. I have some extra belly, but not too much.
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LisaMarie, I am 5'2" and at the time of surgery was 135 lb.with clothes and shoes on. I did have that extra 10 lb. around my belly though, the rest of me was usually quite lean including breasts. I now have more up top, a flatter belly and am thrilled to bits. Here is a photo of my belly before surgery.
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Thank you grateful99. You and bigsister have been so helpful!
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This is all I had to work with, and I got 2 C's out of it, although the PS told me Bs. He said they usually guess conservatively.
If you go back to page 10 of this thread, you can see my DIEP flaps after the swelling calmed down.
After fat grafting last month, they are a little bigger!
Choose what is right for you. I am sure your gut will guide you.
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I was so worried that I would end up with a flat chest unless I agreed to implants that I probably put on too much weight. Hoping, like you, BigSister my PS will use any extra to top me up in stage two.
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Thanks JBDayton! I appreciate your help.
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Just a note of thanks to whoever posted on here to tie a strap to the end of the bed for pulling ourselves up. I did this in the hospital and now at home with two shawls tied together and then one end to a bottom leg of the bed and the other end next to me on the bed. This way I can pull myself up using my arms instead of the abdominal muscles. I don't know how I would ever get out of bed any other way without help.
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That strap idea is wonderful. I will definitely be doing that.
Bigsister, Thank you for the pic. My tummy looks almost identical to what you started with, so that gives me hope. I also went to page 10 and looked at your pics, and what a great result.
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Gratefu and everyone, to get up you can always roll to your side and push up from the bed sideways. I would think that would be better than risk pulling with your arms--remember the lifting restrictions!
If you were like me and had implants removed before your DIEP, they disturbed your pectoral muscles. I am still a little unclear about what exactly was done, but my PS said something about resuturing the muscle in place and hope for the best.
After hearing that, I decided that I wanted to give my chest muscles all the chance to heal correctly, so I was a good girl about not lifting, pulling, or pushing.
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Hi Everyone: Does anyone know if they staple you or "glue" you together in lieu of stitching? I saw a youtube video of a lady who got staples, but I think I remember people talking about glue... Thanks!
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It is physician preference, but plastic surgeons prefer sutures and glue because they produce less scarring.
I have had 5 surgeries now with 2 different PSs. The first (implants) use sutures and the second (DIEP) used dissolvable stitches and glue.
Staples are fast and easy, which is why regular surgeons use them.
(I am an RN who used to work on a surgical unit.)
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Can people tell me their experience with swelling in the breasts? I am three weeks out from SGAP.
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FePrincess, what are you wondering about swelling? I seem to remember that it was pretty much under contro after 3 weeks.
If it continues, there might be a seroma developing. A seroma is a pocket of fluid, and it usually needs to be drained.
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Thanks Big Sister!!
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Hi big sister, My sgap breast is quite larger than my right one. It is overall swelling which doc says is normal, I had a reduction at my original reconstruction. I have alot of swelling at the doner site and have had to have it drained. I fainted the last time. I'm not sure why because I could only feel pressure. My doctor said it would still reduce for months.
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My breasts are also swollen right now (one week out) and my belly is tight as a drum. I think it will settle down over time. Of course, I also need to watch how much I eat now since I no longer need to gain weight and I don't want to put any extra pressure on the stitches.
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FePrincess, you may have fainted just because of the idea of it. You never know when your brain will decide to freak out out and stimulate your parasympathetic system to knock you out.
If your PS is not concerned, then yo can work on getting your lymph moving.
It is important to balance. Moving around (walking and light stretches) will move lymph, but too much activity after surgery will create more drainage. So you need to find a happy medium.
Short sessions of walking and stretching over the course of these is the ticket.
The other thing is to give your body the nutrients it needs to help your body heal. This means more whole foods and fewer processed foods.
Also, take a high quality vitamin with lots of C, D, and methylated Bs. If your vitamin has folic acid instead of methylfolate, it is not a good one.
Another thing is to work on healing your gut. Probiotics, the refrigerated kind, will help. Fermented foods are even better. I brew kombucha and ferment my own sauerkraut, but you can buy them too at a health food store.
Those things help restore your normal flora and helps your gut take care of the rest of the body.
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Hi Bigsister, thank you for your response. I have to get more drained this week, but I feel more prepared this time. I am probably too active. I am vegan and pretty strict about my diet. I take D3 in drops as well as magnesium. He said fluid build up is normal. It takes months for all the swelling to go down though, right?
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FePrincess, everyone is different, so the swelling varies from person to person.
I trust you are getting enough protein to keep fluid in your bloodstream and enough vitamin B12 (in the form of methylcobalmin), which usually needs to be supplemented for vegans.
The FDA recommendation for B12 is too low. You should be getting at least 1000 mcg (1mg) per day. Sadly, the RDA for vitamin B12 is only 3 mcg! What are they thinking. Vitamin B12 is water soluble, so like Vitamin C, you can't take too much.
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Day 12 for me and I just finished the hydromorphine and am now taking the occasional Tylenol to take the edge off the pain. Trying to straighten my back now, so when sleeping I have reduced the number of pillows under my back and head. Still tired and so napping morning and evening but can walk up and down the stairs several times in the row. Catching up on phone calls, netflix, magazine reading and emails.
BigSister, what is the name of that multivitamin you mentioned and where do you buy it?
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Daboys: I have the itching and I think it is 2 things…the glue that they use to hold the incision together and the opioids. I was taking one Norco a day in the late afternoon because while I wasn't really in pain, I was more uncomfortable. I seemed like those were days I was much more itchy. Also, the itchiness seemed to be mostly around the lipo sites and they nurse said it was probably the glue. She said to use an OTC steroid. I had some samples leftover after my radiation gave me a bad rash so I used those. Also, I took Allegra once a day. I think it has helped. I am still itchy…just not as bad.
I forgot to get my Stage 2 on the calendar. Overall it went well. I had to stay in the hospital for 3 nights instead of 1. They fixed my belly button, pulled my incision down and made it look better and injected some fat into my right breast. Oh yeah, and I have nipples now. I found Stage 2 to be much easier than stage 1 because I was allowed to sleep on my side. Sleeping on my back after stage 1 for a month just about killed me. I was exhausted.
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I was wondering when I will be able to sleep on my side again...
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hello,
May 17 - CoolgrammieNC - Stage 2-revisions -Charlotte, NC -CMC/Levine -Dr.Lafaive
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Grateful99, you'll know when sleeping on your side is possible again. If you're naturally a side sleeper, your body just can't wait to get back to it's preferred position. I started noticing that I was waking up slightly pitched to one side or the other, but still on my back. Eventually, the pitch was further and further. One night, I just rolled onto my side intentionally. It was still a little awkward and hurt a little, so it was back to my back. However, I continued to wake up nearly on my side and noticed that the soreness was lessening a bit every day....either that or I was becoming acclimated to feeling the soreness and still being able to get comfortable enough to sleep. By 7-8 weeks out, I was pretty much completely back to side sleeping. I think the worst soreness I had that kept me on my back was from the drainage site. It seemed like the drainage hole site was sore forever. After my stage 2, my bilateral fat donor areas and injection sites had on my back again. This time, it was only 2-3 weeks before I was back on my side.
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