DIEP Flap Reconstruction 2016
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Hi everyone. I was supposed to have my DIEP surgery on June 6th but in April my hubby was dx'd with prostrate cancer so we felt his surgery should come first. His surgery went unbelievably well and I had my surgery 4 weeks after his surgery (the 30th). Everything going really well but as I'm resting I've managed to read all of the post since my last one in February. I just have to tell all of you that post so regularly that your personal stories, both good and bad have been extremely helpful. I've done so much research. I have even watched videos of real surgeries, but I've learned even more reading everyone's posts. Thank you
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Grateful, hope you get to feeling better! I have lots of lumps, especially on my left breast
Found a pocket of puss tonight while a friends NP friend was here dressing her wound (horse stepped on her foot). It's been 'peeing' for maybe a week now but no odor. No redness, until tonight *sigh* Just have to keep an eye on it. Sorry to hear that TanyaRocks. Its very taxing. Takes me about an hour, each dressing/packing, 3x a day. Sucks. I have abdominal dehiscence so my incision is opened in 4 places. You'll be in my thoughts.
Thanks Donna
You should take photos daily. Really helps keep track of changes. Nite all.
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taag4
I was looking for a thread on hormone therapy... I'm only 90 days into taking Letrozole first couple of months seemed to be fine besides I'm drying up everywhere!! Then last few weeks I am fine as long as I'm moving or working but once I sit I hurt so bad in my joints... Has anyone experienced this same thing??
Thank you everyone for sharing your experiences it helps me so much.
Tomorrow I have my first manual mammogram with my BS since my bilateral mastectomy. That should be interesting since all I have going on is my foobs I'm sure she will check lymph nodes . I will be so relieved to have these expanders removed my body does not like them.
25 days and counting for Diep Flap....
God bless everyone and healing prayers to all
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Hi everyone it's been a long journey with my new normal but finally I have lost enough weight to have my surgery. So far they have me scheduled for somewhere around August 16th but they are going to let me know next week if they have anything this month. Ps said it's along surgery but I didn't realize I would be in the hospital 4-5 days. My husband's family reunion is Labor day weekend and we've already paid but I guess I'll have to miss it. Anyone that had the surgery think I'll be ok home alone if he goes? Ps said the ride is too long for me to chance getting blood clots.
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ok got questions I see online many talking about a compression garment they wear sround their stomach. Is that something the hospital will give me or is thst something I have to purchase? Am I sleeping in it or just when sitting up? I know thy pull the top of yourvstomach dow but what abut the fat on the sides or back will that move when it is pulled down?
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Hey everyone!
I have tissue expander in my left breast, & will under go reconstruction surgery in January having the stomach surgery... I was wondering if someone could give me some I for about the surgery? I was wondering if I'll loose weight since I have heard it's like having a tummy tuck. During chemo I gained 30 pounds or so.. Is the recovery time and painful level bad?? I quit smoking in November 2015, and have had about 5 cigarettes since then.. I know it's bad! I don't want to get in trouble or have my surgery cancelled because of this. I don't smoke every day just have a few drags off of one every now and then.
I am in radiation now also and will start tamoxifen in 3 weeks, I am not sure on what to expect with that. Side effects, I am 30 years old and heard it will put you in menopause
If anyone could help that would be great! Thanks
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Laura I had to stop tamoxifen before I have my DIEP this month because of blood clots, I think the thing about smoking is something to do with your veins being good enough for the DIEP. You are doing great, quitting smoking is hard to do
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Dlia, everyone is different, but by two weeks after coming home from my surgery, I was pretty much able to fend for myself. You'll still be tired and you'll likely not be fully stretched back out, but if your husband leaves you some ready-made meals with plenty of disposable dishes so that you don't have to wash them, you should be good to go to be left at home on your own. I hope you'll have someone in town to call should you get into trouble?
Regarding the binder, ask your PS about what he does. My PS does not use any binders after any of his surgeries. He felt that the discomfort of wearing them coupled with the fact that they cover everything so medical staff are able to easily view the incisions outweighed any benefit. I was sure glad he didn't use them!
As to the tummy-tuck part, they remove the fat and skin from a large oval incision. Some doctors mark the perforators as illustrated, others look for them during surgery.
The perforators are the blood vessels that perforate, or poke through, the tummy muscle. They have to dig down deep to get to where the blood vessel is large enough in diameter to work with.
After the skin/fat/vessels are removed, the top incision line is brought down like a window shade and connected to the bottom of the incision, reattaching the belly button where it belongs. Because the initial incision was an oval, things match up pretty well. Even though most of the pulling is from the top, it ends up pulling from the bottom, too. I find that my pelvic hairline has migrated north. (I am thinking electrolysis to permanently remove some of the hair is in my future!)
During the initial DIEP surgery, they leave any side fat in place for fat grafting later. I remember one lady from the 2014 forum said she felt like Sponge Bob after her first surgery. However, she had a nice hourglass figure after Stage 2.
Stage 2 is usually done 3-4 months after Stage 1. It is where incisions are cleaned up, removing dents, divots, and bulges. It is often the time that nipples are reconstructed if you want them. Stage 2 is usually done outpatient, meaning you go home the same day. I had mine in April and it went well. I was pretty tired for several weeks, but nothing like Stage 1.
I see my PS on Tuesday to decide if I am done or if we will do one more round of fat grafting. After that, all that is left is getting my nipples tattooed! I am planning on using one of Vinnie's team in Maryland when I get to that. After all this work, I want an experienced nipple tattoo artist finishing me off, not a nurse that got minimal training from who-knows-what.
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Hi Laura,
Welcome to our group! I trust others will give your their experience with Tamoxifen.
Regarding the DIEP surgery, you would think you would lose weight, but if you do, it is marginal. I had a bilateral mastectomy to reconstruct, so all of the fat from my belly went to recreate my breasts. Even Steven. If you are only having one reconstructed, there might be a little loss since they will discard any belly fat they do not use, but you'll be resting quite a bit, so it isn't hard to regain the weight.
As to the smoking, I appreciate how hard it is, but it is crucial for the success of this surgery not to smoke. The smoking makes your blood vessels tiny. If the vessels are not large enough, they will not be able to give the new breast an adequate blood supply and it will fail. So every time you think about taking a puff, consider the potential of messing up your surgery. You sure don't want to wake up and discover that it did not work because of those few drags. It just isn't worth the risk.
As to recovery time and pain level, the pain is not too bad. You'll spend 4-5 days in the hospital after the 9 or so hour surgery. You'll start out on a pain pump and then move to pain pills. I don't recall being in pain--it was quite manageable. After I got home, I was pretty useless for about 2 weeks. I couldn't reach anything, couldn't lift anything, and couldn't shower by myself, but I could hobble around and feed myself.
I was able to get in and out of bed better than after the mastectomy, but it was nice to have help to put pillows in their place and get all tucked in. I have teenage daughters who were wonderful at being my handmaidens. They had learned what to do when I had my mastectomy, so they are all prepared for my DIEP. They were also great to tell me to stop working and take it easy. I needed that scolding! It was so hard to take it easy.
For preparation, get 4-5 pillows and possibly a 7" wedge because you'll need to be sleeping somewhat upright. Some women have rented a power recliner. I just used my bed and a zero-gravity chair (image below). It was a little hard to make it recline fully, but doable.
There is a handy list of things to have in the first post on this page, so you can reference that. I didn't really need anything in the hospital other than my Biotene mouth spray--those 5 days are just a blur.
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Thanks BigSister!! My ps never said anything about a phase two... but whatever it takes to get a great result. I am excited about getting it done. My daughter lives sround the corner from me so if he decides to go she can come here for that weekend.
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BigSister where can I find that chair? I'm trying to get my things together now August will be here before I know it.
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and the wedge is that at a surgical store?
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I have seen the chair at Sam's Club, so I am sure you can find it almost anywhere. I got an oversized one from Amazon for a friend not long ago. Search for "zero gravity chair in lawn and garden" and you'll find it. They are about $70 at Sam's, so that will give you an idea. Read the reviews and take your pick.
I also got the wedge from Amazon: InteVision Foam Wedge Bed Pillow (26" x 25" x 7.5") with High Quality, Removable Cover
Other women just used pillows, but I found the wedge to be handy for keeping everything in place. I still used another pillow or two behind my head/back, one under each arm, and 1-2 under my knees. Hence, getting tucked in was very helpful!
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BigSister-2015. You are so knowledgeable and give such good information. Thank you! I will also be looking at a fall surgery and find your posts very helpful. I have a zero gravity chair and would have never thought to use it during recovery. I'm also going to search for the wedge pillow you mentioned because I've heard other women mention how it benefited them.
Can I ask why you had tissue expanders initially before your DIEP? Is that something that's fairly common? My PS has only mentioned DIEP.
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One day before surgery and eight days post DIEP.I am wearing a binder around my waist to help the incisions heal (at least that's what I was told). Worst parts for me thus far is the need to stay hunched for two weeks before starting to try to stand upright (low back ache), and constipation. I haven't taken anything for pain since the 3rd. My surgery was June 30th in Salt Lake City and my mom drove me home to Boise on July 3rd. I'm taking the stool softener and drinking water but my system is struggling to get back to normal. My hubby is taking good care of making sure I have healthy meals.
The pain medication made me nauseated so I laid off taking them and discovered the pain was tolerable. I'd describe it as a burning like I feel when I use Icy Hot on my skin. I sleep in a recliner and I rest as much as I need. I do get up and take 5-10 minute walks around the house or in my backyard. My weiner dogs love that I'm somewhat immobile and they can sleep next to me.
I had wanted a prophylactic left mastectomy and reconstruction at the same time as my right reconstruction but my insurance denied it. I started the appeal process but I didn't get it before it was time for my surgery. My surgeon was able to use both sides of my belly to do a stacked DIEP. I'm very happy with the results and he'll make the left side perky again at stage 2.
I had my drains removed on July 7th but one of my abdominal drain sites won't stop bleeding. That drain site has been leaking blood since my surgery so it doesn't really surprise me. Im wondering if the blood thinners I was given at the hospital and the low dose aspirin I've been told to take are making it harder for my site to clot. Has anyone else experienced this problem? (The blood is not bright red and my drains were putting out less than 30 cc per 24 hours for 2 days.
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are you only on the blood thinners in the hospital?
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I started out with a lumpectomy, then they told me I had her2 bc. I had it at the same time as two sisters. One had her2 also and the other estrogen. The one with her2 spread to her lungs, liver, brain and spine. So I decided to do the double mastectomy with silicone implants. I developed new lumps but because they were so close to the implants the ps recommended taking them out to prevent infection.
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is the gravity chair so low that you have a hard time getting up and down?
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Dlia-yes I only had blood thinners in the hospital. I think the low dose aspirin is a slight thinner as well. I'm supposed to take it for a month
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Hello, I have not posted much but I had my BMX with immediate DIEP 2 1/2 weeks ago and had my first appt with PS on Wednesday and 5 of the 6 drains were removed and my what a difference that has made😂. The last one should come out in 4 days since the output has been pretty low. Met with oncologist, breast surgeon, radiation doctor on Thursday and no new cancer was found, all margins were clear and lymph nodes are clear.😂. Even though I had 3 tumors the largest was 3cm so no radiation waiting for onco test to come back to see if I would benefit from chemo or just the hormone therapy. Go back in 3 weeks to discuss that. I am hoping that comes back low and I will be able to dodge that as well. Looking forward to moving forward
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Hi Dawn-
Losing the drains was such a relief to me too. My mom had breast cancer 6 years ago that was estrogen positive and she took Tamoxifen for five years after her lumpectomy and radiation and she is doing well. My cancer was not hormone receptive so hormone therapy was not something that would benefit me. After radiation treatment I had a baseline mammo and they found something that prompted another biopsy. It was atypical ductahyperplasia and they wanted to do another lumpectomy. I chose mastectomy instead. I felt there should not be anything there after my radiation treatment. I hope that you get to avoid the chemo if your oncologist deems it the right course of treatment. Best wishes for a speedy recovery.
Micki
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I posted this in the June Surgery thread but thought I would share here too.
Anyone having 4 or more drains this little kit was a god send. My hospital don't do anything for drains expect a lanyard around the neck, I could not imagine. My plastic surgeon recommended this. The kit comes with two belts (one for showering if Dr. OK's it) and cups for measuring and a sheet to write the output down on(we made copies).
Just put 0814 8221 I the search field and it pops right up.
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My doctor suggested spanks as to a binder she said they were uncomfortable after wearing for short time. I have both here and will try them out when I get this last drain out hopefully Wednesday. Micki I agree completely about the standing up straight I cannot wait I am able to walk about 10 houses down then need to turn around because of my lower back.
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Micki I started taking miralax (packet that mixed with one cup water) soon as I came home from the hospital and within a couple of days I had my first bm. Worked great
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Constipation is a common problem and needs to be addressed right off the bat. Narcotics are terribly constipation get, especially when coupled with the immobility and decreased appetite from surgery.
Miralax is great. So is prune juice. For basic bowel health, I take sugar-free Metamucil daily and drink plenty of water. Whenever I am on a narcotic, like Percocet or Norco, I add up to 3 Colace a day (one with each dose of narcotic) and use peri-Colace for one of doses if things aren't working.
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If they can't do the DIEP immediately with the mastectomy, they tend to throw in tissue expanders to preserve the skin.
The cosmetic results are better with an immediate DIEP because they make the skin flap the size of the areola. If it is delayed, the flap is football shaped.
If there are no tissue expanders to keep the skin stretched, the flaps are even bigger. That was my case. One TE got infected and had to be removed. This, one of my flaps is bigger than the other. If you go to page 10 of this thread, you can see pics of both types (mine--delayed and Myajames--immediate).
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I had a bm within 2 days of being home, but even taking stool softener twice a day I've been days in between and still not normal. Since I didn't use a great deal of narcotics for pain I'm just frustrated my system isn't behaving normal yet. It's only been with in the last couple of days that I could laugh or cough without itbeing painful. Maybe it will get better from here.
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I did not have the football shaped flaps. Since I had a skin-sparing/nipple sparing, the flaps are under my skin. I did post a pic- I'll look back for the page number
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Page 14
Can someone give me a rundown of phase 2 DIEP? What was your recovery like? I will not have nipple recon
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Simplicity - we ordered some of the Medihoney and are trying it out on my wife's abdominal spot. We can tell it is healing on its own, but since it is taking so long, we figured, why not?
My wife's surgery was "skin-sparing", but not "nipple-sparing" and was done after tissue expanders were placed at time of mastectomy (note, she had those in for a year) so she doesn't have the football scar, but it isn't the lollipop either. Not to get too comically graphic, but the progression was:
After mastectomy
----- -----
(2 somewhat long horizontal scars in area where areolas and nipples used to be...but even wider)
After DIEP
-O- -O-
(2 circular patches of skin taken from abdomen, which are a much lighter color than rest of breast skin, flanked on either side by the leftover mastectomy scars)
The circular patches are roughly the size of an areola, and will be tattooed later to be a more normal areola color. As an aside, the original mastectomy scar was pretty "thick". They seemed to have made that thinner as part of the DIEP effort.
Some women who do immediate DIEP and have both skin and nipple sparing get the "platinum" level cosmetic result where a lot of the scaring is hidden in the ring around the areola or in a vertical line going straight down from the areola (i.e. the lollipop scar).
For perhaps some realistic ideas of what to expect when its all over, you might look at Viinnie Myers nipple/areola tattoining page where he has dozens of before/after pics. Many times you can tell from the scars what type of reconstructive surgery them women had. See here: http://vinniemyers.com/section/105672_Nipple_Areola_Tattooing.html
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