DIEP Flap Reconstruction 2016
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myajames thank u so much for the brochure it is great. It gives so much info and makes me calmer to know what to expect post operatively. I am scheduled Feb 11 in Toronto. have to start getting all my ducks in a row
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Hi NotAgain. Man I am sorry you are dealing with this right now.
(((. Have they cultured you yet to make sure you are on the right antibiotic? I'll be thinking of you. Try and rest. Pink I'm glad you are doing what gives you peace. Please keep up posted after Tuesday on how things went.
Myajames that's a great list for surgery I know a lot of ps give you a list at your pre op appointment but not all do so thank you for sharing that with others
Big sis how are you doing? How is your energy level and lower back doing?
Less harp when will you have to do another revision? Did she say how involved this one will be? Does insurance cover more than 1?
Hugs ladies
G
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Happy to help ladies! My surgery is in 17 days... So I am trying to get all my ducks in a row. It's alot to prepare for, I'm kinda suprised.
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Happy Friday everyone! I have been diagnosed with atypical hyperplasia with high suspicion of DCIS. I am having a prophylactic bilateral with DIEP on Feb 18 @ Toronto General Hospital with Dr. Reedijk and Dr. Zhong. My mother died of breast cancer at the age of 50 after battling cancer for 10 years. She was 40 when she was diagnosed. Both my grandmothers died of breast cancer as well. I am 39.
I had Ewings Sarcoma (bone cancer) when I was 8 and had my left leg amputated above the knee. I was also diagnosed with Rheumatoid Arthritis the same year my mom died. I have been through alot so I have this motto of LAUGH, and LAUGH LOTS. Last year (2015) I celebrated being 30 years cancer free by going to Ireland. So beautiful.
I promised myself the day my mom died that if anything showed up on my scans that I would remove my risk. It is a very emotional journey but I have a wonderful partner who is holding my hand all the way through. I plan on being cancer free for another 30+ years.
I have plans to rent a medical lift chair for my recovery as my mobility with missing limbs & rheumatoid arthritis will be a tad more difficult than the average person. Is there anyone else on this forum that has a fake leg? lol
Did anyone get a raised toilet seat for home? I am having trouble finding a bra that opens in the front to wear home? I am currently a DD but should be a C when I leave. how do you buy a bra for going home when you won't be the same size as you are now? I have a list of things to take to the hospital (thanks to this forum). How long were you in the hospital if you had the surgery in Toronto????
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Tanyarocks30, welcome to the forum, though I'm so sorry you have to be here. You have truly been through enough for a lifetime, and I hope that translates into a perfectly flawless surgery and recovery!!
I'm new to this so I have nothing to offer, but at least we're all in it together.
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hey Tanya - I am a couple of years out from the same surgery at Toronto General. Dr. Hofer is my PS. Re open front bras, I found some at Sears or the bay I think. Don't worry if they are too big. You won't want anything too tight, may have some swelling and will have bandages that take up space. Feel free to PM me if you have any other questions. I am very happy with my results
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great! Maybe if I buy for my current size of DD when I come out a C cup it should be good. Lol
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Check with your plastic surgeon. I went home with no bra and didn't needn't for at least 2 weeks.
I got a zip front sports bra ages ago after my mastectomy. That worked well. Others I have heard have gotten the Genie bra.
Regarding your leg, the recliner sounds great. I know others have used them.
The main problem after a mastectomy is that you can't use your arms much. Having help at home for a week or two after your BMX/DIEP is crucial.
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Hi everyone, I was stalking(jk) your page even though I was a part of DIEP 2014; we had a board called moving on after the flap but it doesn't seem very active.
I just thought it might help to hear my experience bra wise. I went to UPenn and had a very good experience. I was given a binder kinda velcro bra to wear home. I then purchased several front hook soft cotton bras at WalMart or Kmart and they were wonderful! They were huge though because although I am not sure everyone is swollen, my breasts were larger when I first came home. After drains were out I loved the Soma bras but since have purchased some soft NOT underwire ones at the Hanes outlet that are WONDERFUL
What I would encourage each of you to do, is take it one day at a time and slow down to appreciate every single blessing. There are no guarantees about infection, or outcomes but now that it is almost 2 years out I am grateful and glad I did it. Getting a DIEP does not guarantee you will never get a recurrence, marry the man of your dreams, or get on American Idol, but the way I looked at it was: even though they are different, my breasts are still my tissue. There is still a small amount of breast tissue remaining but I have never heard of someone getting breast cancer in their abdominal tissue. We do not all know our future but that was true before breast cancer, right?
Just take notes when talking to your physicians/NP/etc and call them if you get questions. I visited another surgeon who did not seem a fit to me and a friend told me about Penn so when I called them it was like a well-oiled machine and I was in there in no time. I will be praying for you 2016 DIEP friends! Eat healthy, the night before consider washing your skin with Hibiclens, stay active to help your recovery, and just ask any of us who have been there questions....
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hi all,
Welcome to the new people. Great advice from enjoy
Tanya - you are so brave - you rock. My first diagnosis was ADH - DCIS and I wish I had done all of this then. I had contemplated it. You likely won't have to do radiation. Just get through this surgery(ies) and hopefully don't look back.
As far as bras.. My surgeons are like big sisters - I am wearing nothing at all and it is fine. No compression garments. At first because of the drains it us nice to have camisoles with pockets, but I found anything this opened in front was not necessary. Just so long as you can reach in or pull up, you are fine. Though it does seems the recovery methods differ between surgeons. Today three weeks out I either wear a simple camisole or tank top or soft tee shirt.
An update on my temperature and ab scar redness, I ran the highest fever so far last night called the after hours line and was seen today. They opened my ab incision about an inch and a half to let the fluid collection escape. I felt better immediately from that abcess pressure that was building. The took a culture so we'll know exactly what it is soon. Still running a slight temp tonight 99.6 but have my fingers crossed I will improve from here. I am relieved and exhausted!! Will keep an eye on it all weekend.
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Hi Everyone,
I had skin-sparing double mastectomy with tissue expanders on Nov 17, 2015. At that time, the doctors didn't know if I needed radiation so I didn't have immediate reconstruction. Thankfully no radiation is needed.
I would like to have DIEP reconstruction (love the tummy-tuck bonus), but PS said I barely have enough fat for 1 breast. She recommended that I do latissimus dorsi flap with implant on one breast first (in Feb 2016) and then decide on the other breast once I see the result of the 1st one. I have the following questions:
1. If I don't have enough fat for 1 breast of DIEP and must have Lat flap on both breast, wouldn't it be better to do 2 breasts at the same time to avoid additional surgery and recovery time?
2. If I don't have enough fat for DIEP, can an implant be added just like with Lat flap surgery?
3. Would I get good result with one breast using DIEP and the other one lat flap?
4. I will have my 5th TE filling next week (total 500cc). With DIEP and/or Lat sugery, does the volume of TE filling matter as much as doing implant?
5. My TE is not symmetrical. My BS isn't concerned. She said the purpose of TE is to preserve/safe my skin. Should I be concerned?
Thank you,
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Welcome to the forum, LoveJoyPeace. Sorry you had to join us. Here are a few answers from my perspective:
1. If I don't have enough fat for 1 breast of DIEP and must have Lat flap on both breast, wouldn't it be better to do 2 breasts at the same time to avoid additional surgery and recovery time?
I don't think that it would be a problem to do both lat flaps at the same time. There is a forum on the lat flap. That would be a good question to post there.
I am also not sure that you aren't truly a candidate for a bilateral DIEP. You might be. My first plastic surgeon said I was not a candidate because I was "too thin" and recommended implants. Two infections later he was recommending a lat flap, and I wasn't happy with that idea, so I got help from my original breast surgeon to see a doctor who specializes in DIEP.
The DIEP PS told me that actually I was the ideal candidate for a DIEP. He thought I could get two A-B cups out of my abdominal fat. I think I am a pretty solid B at present--very happy.
So, I would get a second opinion from a doc who specializes in DIEP before you give up.
(fwiw, I am 5"11" and weighed about 178, which gave me a BMI on the high side of normal. Most of my fat is in my thighs, but I did have a belly that I could grab, and it was enough.)
2. If I don't have enough fat for DIEP, can an implant be added just like with Lat flap surgery?
Yes, they can do a little implant under the DIEP to give you more volume, or they can do fat grafting. You will need an implant anyway with the lat flap, so it would be worth checking around.
3. Would I get good result with one breast using DIEP and the other one lat flap?
Good question. I know that a lat flap is an option if something happens and you only get one breast out of the DIEP. One lady on the 2014 forum had that happen, and I recall she was pretty happy with the results.
4. I will have my 5th TE filling next week (total 500cc). With DIEP and/or Lat sugery, does the volume of TE filling matter as much as doing implant?
My DIEP PS had me get fills to 300 in my one TE that remained before I had my DIEP. It meant that they didn't have to use as large of a skin flap on that side. The volume is not as important because they will be using a football-snapped skin flap anyway.
5. My TE is not symmetrical. My BS isn't concerned. She said the purpose of TE is to preserve/safe my skin. Should I be concerned?
Don't be concerned; what you are experiencing is pretty common. The TE is pretty much just a placeholder. Implants tend to shift around and can be moved out of place by scar tissue, so asymmetry happens. They can fix that in your next surgery and make it all right.
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I just had a bilateral diep December 14. I was told not to wear a bra. He did not want any pressure on the flap. My cancer was also bilateral.
I got an infected drain and had to have a new one placed, and then got cellulitis on the other side of the ab scar. I have existing, chronic health issues and they do effect my immune system which is why I went with the diep instead of implants. I am going to have a second surgery, eventually, to reduce the size and even me up. Trying to get these fevers under control but getting better. Pain wise, the surgery was not so bad
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Love: I agree with Bigsis. The original PS I met said I would be smaller than I was already. I went to NOLA and I am exactly the same size, which was what I asked for. Sometimes you are referred to a PS and maybe they haven't done the most or aren't the best at THIS procedure. Where do you live?
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Hi ladies!
For those of you that have chosen NOLA, where did you and (if you had someone) your support stay before and after, and did you drive to and from? I am pretty sure that I will go there now, but am concerned about the logistics and the expense. My BF will be going with me, and will need a place to stay, not sure if my insurance would cover that kind of thing, and I want to go a few days before things get started anyway, as I have never been to NOLA and want to explore the city a bit. And the drive home scares me, as it is almost 8 hours. I've made that drive before going through LA, and their roads are BUMPY! I remember coming home from my DMX was only an hour and it was hell feeling every pebble in the road.
Funny, this surgery has me more afraid than my DMX.
- jeni
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JWoo: Flights to NOLA are cheap from Chicago. Take a look. We flew a direct flight. 2.5 hours. Easy. Insurance won't cover a place to stay but there is something called Hope Lodge that will let you stay for free. We didn't stay there but many women on here did. Have you contacted NOLA yet? The first thing you should do is call them and tell them what your insurance is so they can tell you what your cost will be.
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I am happy to answer an NOLA questions anyone has. You might get a quicker reply if you message me since I don't always check this board.
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I originally posted this in DIEP 2015 and then I saw this one. I'm scheduled for my DIEP flap surgery June 6th, 2016. I was DX with DCIS in my right breast last May. Had a lumpectomy, re-excison, and 33 radiation treatments that ended in mid October. At a follow-up appointment with my oncologist I was scheduled for a mammogram so that they could check my right breast every six months. To my dismay there was some suspicious calcifications they were concerned about. Biopsy revealed Atypical Ductile Hyperplasia which is not cancer but they wanted to remove it asap. I decided (with my husband) that I was over this and didn't want to deal with it any longer. Had rt MX just before Christmas with plans for MX for the left when I do reconstruction. Six months need to pass on my radiated breast before PS will do surgery which works for me because I'm a 46 y.o. "atypical" college student in her senior year. (I'm over that too. Just want to be finished with school as well.)
Originally I wanted to have a GAP surgery because the stomach scar from DIEP is very disturbing to me. (Vanity I'm sure). I live in Boise and had to drive to Salt Lake City for a microsurgeon. I found a great surgeon in Dr. Reuben. I'm active...I mnt bike, ride my horse, kayak, paddle board, yoga and I had met with a PS here in Boise that wanted to do a Lat flap on both sides. Using my back muscle was not within my comfort zone. I'm fairly thin. I'm 5'9" and weigh between 140-145 depending on how close I am to finals. (I forget to eat when I'm studying hard.) After being given the options of DIEP and IGAP by Dr. Reuben, with both producing a small B, probably an A cup I almost decided not to do either and remain flat. I haven't been bothered by it too much and a long surgery with a long recovery was not very appealing for a cup size that will potentially be smaller than I am now. After reading so many stories on these discussion boards I decided I'm going to do it. (PS did tell me that he could add more fat if needed by fatgrafting at stage 2.) My vanity had me looking at tattoos to cover that stomach scar and there are some great ideas out there. I decided not to do the IGAP for a couple of reasons. My surgeon has not done very many of them, and I was concerned over possible problems long term with sitting. I have a bony sit bone type of butt now. I don't need to expose those bones too much more. Especially since I need them for my saddle on my horse and my bike.
Anyways, I'd like to thank everyone for posting their stories and experiences. I have read through this one, DIEP 2014 and DIEP 2015 too. I wanted to find the right choice for me. This forum was a great way to make a decision that would be my own.0 -
I'm starting to get worried that I'm NOT going to NOLA for reconstruction! I think my husband would lose his mind if I even suggested it.
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Surgeons are all different regarding the compression or bra or whatever. I just did what my surgeon said and it all worked out.
No underwires, and the bra was not tight, just stretchy cotton and supportive. It is glorious when you get the drains out I am a lot smaller than I was, I lost weight intentionally prior to being diagnosed (God's sense of humor) so could not have the same size but interestingly enough having worn compression bras and having posture issues, back pain, and feeling like I never got eye contact (lol) when the PS told me that my husband said "you just made her day". I like the new me. I am not saying I never missed my old ones.... that is not true, but I did eventually process it all and here two years out I am content and glad to be where things are.
I gained weight after my surgery, not tons but my breasts are now bigger than initially. I am slowly losing it and if they end up smaller that is just fine.
Hang in there everyone!0 -
jwoo-I went to NOLA as well and like Trvler and she's right call NOLA, Brittany was fantastic. She sent me a list of hotels and the rates they give to NOLA's patients and when I chose one (Clarion grand boutique) she called and booked it for me. While you are in the hospital your boyfriend can stay with you. So before you go and after you're discharged you will need to book a hotel or like trvler said hope lodge is available. I'm sure NOLA will have info on that as well. As far as our hotel, I loved ours, valet parking tips only as part of our NOLA price and it is connected to a cheesecake restaurant so you don't have to go very far for food. I'm from Florida so it was a 12 hour drive I won't lie it wasn't fun but it's doable
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carolinaAmy-why are you having thoughts about not going to NOLA? Why would your husband lose his mind? Did I miss something?
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Hi Everyone: Does anyone know about sensory nerve reconstruction that is possible when getting DIEP surgery? I'm wondering if it's included in surgery that's covered by my health insurance or if it's considered a luxury that you would need to pay extra for. Does anyone know? Thanks!
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rdgc - I can't answer your question, but am interested in an answer as I just recently saw that one of the PS at my facility performs that procedure. Would be interested also in what qualifies a person for it and how successful it is and what exactly in means as far as additional sensation.
All - So, I've heard of MD Anderson, Mayo, John's Hopkins, Roswell, Sloan-Kettering and various other facilities, but I've never heard of this NOLA that many of you are talking about. Is NOLA an abbreviation given for a Breast Center in New Orleans, LA and not the actual name of the facility?
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Hi ladies. When I was researching my Diep I asked my PS surgeon team if they do this and they said it is there hope with every patient that they are able to use a nerve from the abdomen when they reattach to give feeling in the breasts. I have feeling in both breasts. I am numb in the arm pit area where they took my lymph nodes. I can't say enough about PRMA here in San Antonio. They are a very skilled and compassionate group. They have done over 6,000 Dieps since they started. Pm me if you have any questions. Good luck to everyone with surgeries coming up. My thoughts & prayers are with you.
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My husband thought I was nuts when I first suggested NOLA. He and I had a huge fight about it. But I sent him research I had done to read and we visited to meet the doctors. I wasn't going to budge. It's MY body and no one was going to tell me what I could do with it.
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I am also wondering what NOLA stands for? One month today will be my last day of work. I plan on going for a ME day at the spa 2 days post surgery (just massage/facial). The day prior I will be having my sentinal node shot. I have read a few horror stories about this shot??? I have decided to not purchase a raised toilet seat or a detachable shower head. Will see how I do at the hospital. I have a swim leg that will be "half" ready in the next couple weeks. That will be nice to have if needed for standing in the shower instead of sitting on my shower bench. I have an aritifical left leg for those wondering lol.
I told my nieces about my upcoming surgery on Sunday (11 & 6). They live an 1.5 hours away. My oldest niece was very emotional. The 6 yr old just wanted to dance (expecting nothing less)!!! That was a tough day.
Every day I finish work I realize that I am one day closer to saving my life. My boyfriend is under the impression that my armpit drains will be out before I leave the hospital but in reality, I have NEVER read about anyone's drains coming out in 5 days. Anyone????? I love him for being so optimistic lol
Still waiting for my pre-admission clinic date but my abdominal CT is scheduled for jan 27.
t
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I am seeing a plastic surgeon on Friday to discuss DIEP. I have trunkal lymphedema and am not sure if it will be an option. I also don't know if I will be deemed to heavy to have DIEP since I have more than just abdominal fat. I am anxious to hear what (if any) options will be available to me.
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So you had DIEP without the "nerve reconstruction" and have feeling in both breasts? That's great!! I emailed my Kaiser doctor about it and he said they don't do it because it "sounds" good, but it lengthens the operation and increases the risk. He said, "You have to be convinced that it's worth it..." and I don't think he's convinced.
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Has anyone had the "nerve reconstruction" with their DIEP? I asked my Kaiser doctor about it and he said they don't do it because it tends to lengthen the operation and thus create more risk.
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