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DIEP Flap Reconstruction 2017

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  • Lula73
    Lula73 Member Posts: 705
    edited May 2017
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    MAPBB- I also had BMX w/DIEP flap recon in NOLA in Feb and scheduled for stage 2 June 20. I've asked many of the same questions you have and the answer seems to be make a list of what you'd like then when you gave your consult see what they recommend and then bring up anything on your list that wasn't in theirs. The docs at NOLA are true artists and seem to focus on the overall look of the whole body after MX and natural tissue recon vs focusing on just the breasts. They will make sure your shape looks normal again.

    On the size and weight. I do think there's a difference in weight-I think fat weighs more than breast tissue. Mine definitely feel significantly heavier. Have you tried on any of your old bras from before surgery to see if they still fit the same? That would be a definite tell if you ended up larger. I know I'm slightly larger than I was. Overfill seems to be the norm at least for stage 1 because they don't know how much tissue might not make it. But it's stage 1 tissue that has the best chance of making it. Going larger in stage 2 can be challenging. I just look at it as a temporary challenge on this journey.

    Hope this helps

  • trishyla
    trishyla Member Posts: 698
    edited May 2017
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    MAPBB,

    I read your post and thought to myself: Did I write this? I've had basically the exact same experience.

    Don't get me wrong. I'm very, very happy with my reconstruction. The new breasts feel like me. Not foreign at all. But they seem larger, heavier and a little saggier than my original equipment. Hopefully they'll do a bit of a lift during phase 2.

    I would also like to start running again, but I think I need to wait a little longer. I have been wearing my old bras, including a pretty underwire bra for a party last night. (PS said it was okay) They all fit fairly well now.

    I don't have any idea when I'll do phase 2. I'd like to wait a bit so I can try to lose another 20 lbs. I've lost 16 since finishing chemo.

    I'll be interested to see what your PS does for you during the stage two. Then I'll know what to ask mine for!

    Good luck.

    Trish



  • Crazywabbit
    Crazywabbit Member Posts: 54
    edited May 2017
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    hi ladies, you are all fabulous posting advise and experiences. I posted in the 2016 group and will ask the same question here for anyone in PA area. Where did you go for Your DIEP. I live in north central PA and here they only do Tram flaps or Lat flaps and I Refuse to sacrifice good muscles. I am looking in the Phili area or Pgh area. NYC could also be an option. They are all 3-4 hour car rides so I would need to do a hotel post op for a couple of weeks to avoid trips back and forth.

    Any advise is appreciated.

  • BigSister-2015
    BigSister-2015 Member Posts: 298
    edited May 2017
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    Beckyb, the swellig in your breasts will go down. I don't recall how quickly. I was pretty big (D?) right after surgery. After 2-3 weeks I settled into where I am now--C cups.

    I didn't have any fat necrosis, which shows up as hard lumps. My doctor was trained at Penn State where they prefer taking multiple perforators to ensure a better blood supply. (The perforators are the blood vessels that feed the flap. It is called the deep inferior epigastric perforator, hence the acronym DIEP. The term perforator indicates that the vessel pokes through the muscle.)

    Taking several branches of the DIEP blood vessel sacrifices a little more abdominal muscle, but the benefits outweigh the cost.

    My doctor further explained that even in a pure DIEP they have to dig through the muscle to access the perforator, so a little muscle is lost in every DIEP surgery. My doc is a self proclaimed DIEP Geek--he delighted in explaining all the details as I continued to ask questions. I am a nurse and a bit of a geek myself, so we got on swimmingly. Lol

    Anyway, I found the paper that the docs at Penn State wrote on their multiple perforator procedure and agreed that it was a great way to do the surgery. It doesn't make a diffeeence in the survival of the vessels, but it does reduce fat necrosis.

    My stage 2 was done 4 months after my initial surgery. They did fat grafting from my waist and thighs to fill in the poles of my breasts and cleaned up the incision lines--any puckers or flaps. He also made nipples.

    Adding the nipples really helped! It made me feel like I had breasts instead of lumps. Also, nerves do regrow, albeit slowly, so a lot of the numbness will go away. They won't be super sensitive, but some feeling does come back.

    The fat grating left me pretty bruised and it was quite painful--kind of like I had been beaten with a two by four, but it gave me a lovely hourglass figure again. I might go for one more round as the poles still need more, bit we'll see.

    In the meantime, I am scheduled for my nipple tattoos with Vinnie next month. I am pretty excited to get them done! After all this work, I didn't want just anyone doing my tats. I'll post pictures when they are done.

    Here is a link to an article about Vinnie and his team.

    http://www.today.com/health/magic-tattoos-how-vinn...


  • trishyla
    trishyla Member Posts: 698
    edited May 2017
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    BigSister-2,

    Lucky you! I so want to get Vinnies! I'm only seven weeks out from my BMX with DIEP flap recon, but I'm already counting the days till phase 2. Once that's done, I'll see about scheduling a trip to Baltimore, or check to see when he's coming out to California. Either way, I'm getting me some Vinnies!

    Happy

    Trish

  • songbird72
    songbird72 Member Posts: 22
    edited May 2017
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    Hi guys --just checking in. All drains are gone but one. The seroma is still there unfortunately. I go back tomorrow so we will see if she takes the final drain out or leaves it just a little longer. Overall I feel like my healing is going quite well. My new breast is very hard though. It almost feels like my prosthetic did.


    I hope everyone is healing nicely and everything goes well for those having the surgery in the next few weeks!

  • JenPo
    JenPo Member Posts: 6
    edited May 2017
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    Hello Everyone,

    I'm so grateful that I found this forum. I am scheduled for DIEP Flap surgery following a bilateral mastectomy on June 26th. I'm still not sure about whether the DIEP Flap is the right choice or implants. With the DIEP Flap, I've read that for women that may plan for future pregnancies, this may not be the better choice for breast reconstruction. Does anyone have any experience regarding this? Also, with the "gummy bear" implants, has anyone experienced an onset of lymphoma? Thanks.

    Jennifer

  • Falconer
    Falconer Member Posts: 801
    edited May 2017
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    Songbird, glad to hear healing is going well! Let us know how your latest visit to the PS went.

    I've done all the pre op stuff and am cleared for surgery next week. Now it's just wrap up the school year- I'm a teacher- and get the house in order!
  • moderators
    moderators Posts: 8,057
    edited May 2017
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    Hi JenPo, and welcome to Breastcancer.org! We're glad that you've found us and this particular thread, and hope you're finding the forums helpful. If there's anything you need help with or have any comment for us Mods, please feel free to contact us. We're here for you!

    Best,

    The Mods

  • Tpralph
    Tpralph Member Posts: 281
    edited May 2017
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    dis anyone get a bit if chest congestion after surgery? I find I have a bit of a cough occ. No other SX. But woke up last night having to cough to Clear it. If I take a deep breath seems to help as well. Surgery was 5 days ago and last night was the first night I slept well except for the one time cough spell

  • mustlovepoodles
    mustlovepoodles Member Posts: 1,248
    edited May 2017
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    Do you still have your incentive spirometer? If so, you need to use that about 5 times per hour, 10 times a day to keep your lungs well expanded. If you dont, practice taking a deep breath, hold it as long as you can, then breathe out, 5 times per hour, 10 times a day.

    Your congestion is probably related to surgery. Call your surgeon promply if you have shortness of breath or pain with breathing.

  • Tpralph
    Tpralph Member Posts: 281
    edited May 2017
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    mustlovepoodlea.

    Never got a spirometer. Just told me preop to do some deep breathing post. I do it occasionally but must need to do it more thanks

  • BigSister-2015
    BigSister-2015 Member Posts: 298
    edited May 2017
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    Hi JenPo. I have not heard anything about DIEP and future pregnancies. That would be an excellent question for your DIEP plastic surgeon. Don't ask a regular PS. I learned the hard way that they know nothing about DIEP.

  • BigSister-2015
    BigSister-2015 Member Posts: 298
    edited May 2017
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    I googled "pregnancy after tummy tuck" and it sounds like ladies have managed quite well. But, your DIEP PS would know more. :

  • aggiemegs
    aggiemegs Member Posts: 86
    edited May 2017
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    Today is my last day at work, yay! Planning to spend all day Wed and Thurs cleaning the house, doing laundry, and packing the kiddos for grandma's house. For the last week and a half, I've had some nagging pains in my left hip and right shoulder, and I finally gave in and called my MO about it yesterday. She said that with surgery on Friday, it's probably best to just let it ride, especially since I just had a CT scan of my abdomen/pelvis in March. I breathed a huge sigh of relief. She just called me back to tell me that she hasn't been able to quit thinking about me, and she thinks I should get some X-rays done ASAP, so now I'm sitting here with my head spinning, waiting for her nurse to call me back and tell me when she's scheduled me. I am really praying this is nothing. I will be so mad if I have to cancel my DIEP for mets!!!

  • Falconer
    Falconer Member Posts: 801
    edited May 2017
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    Aggiemegs, hope everything is clear. Holding you in the light, as you have enough to do to get ready for surgery in a few days.
  • songbird72
    songbird72 Member Posts: 22
    edited May 2017
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    aggiemegs-praying that your pain is nothing serious and that you can go on with surgery as planned.

    Faulkner--good luck on your surgery. Praying that everything goes well!

    I didn't get my drain out today. I really didn't expect too. The biggest pain is that I have to go back every 3-4 days until I do get it out. I live 2 hours from my doctor so I've spent a lot of time on the road! She did think the seroma looked better. I also have a hard spot on my breast that she isn't concerned about but does want to keep an eye on.

    I go back again Friday. Luckily I'm also going to see The Lion King musical that afternoon so it will give me something fun to do while I'm in Oklahoma City. Happy

  • GwennyMD
    GwennyMD Member Posts: 68
    edited May 2017
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    Crazywabbit

    I am part of the 2013/2014 group and remembered that there were a couple of ladies from PA. I checked the list on the DIEP 2014 thread and got these names from the list. I do not know if any of them are still active on this cite but you can try to find them. Good luck.

    Donna2012 University of PA

    Debiann Lehigh Valley Hospital

    Trm UPMC Magee Women's Hospital

  • suzzyq
    suzzyq Member Posts: 11
    edited May 2017
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    Hey everyone! I SURVIVED!!! lol. Had surgery last wed so i'm 7 days out. Had 4 drains in and 3 was taken out this past monday. Will get the other one taken on tuesday. The PS patted himself on the back. He was so well pleased how everything went and how they turned out. May be it just me but they look so huge and looks like 2 football shapes sitting on op of me. Im stll very soar and sometimes get nausea because of taking so much pain killers.My back hurts tooo, so last night i laid on top of my bed since surgery which gave me some rest. I decided during the day I stay in the recliner.

    Im starting to hurt again.... talk to everyone later

  • Kali44
    Kali44 Member Posts: 30
    edited May 2017
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    Hi ladies,

    I wanted to pop in and say hello and to wish everyone well. I am sooooooo tired all the time now, not really sure what that's about 🤔 I have to play catch up soon as far as where everyone is at.... sorry I haven't been around. I feel like I can't catch my breath. There's always something that needs to be done, between trying to arrange nurse visits, my kids and just life.

    I am still packing....feels like it is taking soooooo long. I can't even say it is that painful....more discomfort esp if they are measuring the wound. And I am doing injections twice a day...those really sucks. 30 days twice a day really really really sucks...my thighs are sore and black and blue now....4 more days to go. I wonder if they causing my extreme tiredness.

    Anyway sending positive vibes to everyone.


  • aggiemegs
    aggiemegs Member Posts: 86
    edited May 2017
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    Had my X-rays this morning and got the call that I'm all clear! MO is still a little concerned about possible mets, and would normally order an MRI at this point, but doesn't want to delay my surgery. I'll keep track of the pain after surgery and maybe get an MRI in the next few weeks. Now I can relax and start preparing for Friday!

    Any last minute tips

  • kcmc
    kcmc Member Posts: 66
    edited May 2017
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    Hi everyone! I thought I would pop in - just had by Bilateral BMX with Diep Flap reconstruction on Monday. Still In ICU but they are going to step me down tomorrow - I am finally feeling a bit better. Went to the bathroom this evening and sat up in a chair today. I imagine I will be walking tomorrow. Got good news and was told no lymph node involvement -My PS waited for me to wake up before he left to tell me. Now on the road to healing! Thank you everybody who has posted - I haven't posted yet, but I will nowto help everyone along this process - good luck ladies!


    Monica

  • Beach4
    Beach4 Member Posts: 14
    edited May 2017
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    Tpralph - The hospital gave me a spirometer to use every hour. I really had to work on it as I felt short of breath and my my oxygen level would drop. Each morning for awhile at home I had congestion..once up moving around more it will clear.

  • Tpralph
    Tpralph Member Posts: 281
    edited May 2017
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    congrats Monica! I was wondering how you were doing. They kept u in icu quite a while. They had me up moving by day two. Just back and forth to bathroom and into a real room. Transferred me to step down same night as surgery. When do u go home? Seems like they are taking extra special care with you.

    Been one week for me and doing really well. Thought I'd be worse. Both drains now gone but since swelling has decreased I am more tender and sore on my sternum. Abdomen still very tight. Up walking outside about a block now. Slowly and stooped. Back not quite as sore as it was a few days ago. No one else mentioned but not my urine stinks! It is either the meds they have me on or still some anesthesia residue? Not as smelly as it was in hospital. I'm onin celebrex gabapentin Asa and t-3s.

    Beach yes the congestion is getting better restarted the deep breathing and have had occassional cough. Thank u.

    I am still awaiting my final pathology. Bs said nothing to me post surgery. In fact didn't even see him only the ps.

  • kcmc
    kcmc Member Posts: 66
    edited May 2017
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    hi Teresa: I sent you a private message not sure if you got it or not. The pain medicine at tr beginning wasn't working and set me back. They finally have it

    Straightened out. They still have have me in ICU now because the hospital is

    Full.

    I too am having problems with congestion I have been using my spirometer and yes my urine is stinky lol. Tomorrow I am planning on walking around and maybe will be released - Saturday at the latest. My final pathology will be back tomorrow and expect to See the breast surgeon before I leave hang in there good wishes to all!


    Monic

  • tnd22
    tnd22 Member Posts: 39
    edited May 2017
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    I just posted this in the April 2017 group, so forgive me if someone's already seen it, but it's about the DIEP. I had my BMX last month with expanders put in. My PS won't do the DIEP for 90 days after the first surgery, and due to his schedule it will be much longer than that. He said I don't have to have a fill if I don't want- the DIEP will use whatever tissue they get, it will expand or contract to match it. I like my size now- down from a DDD to about a C. Has anyone who had the DIEP later had fills or was it left alone?

    After all this, I wish I had had it done at the same time, but my doctor and the other surgeon I talked to in the area really didn't want to do them at the same time as the BMX.

  • Falconer
    Falconer Member Posts: 801
    edited May 2017
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    Just got the call confirming my surgery time as 7:45 AM on Tuesday morning. Woo hoo! So looking forward to moving forward!
  • songbird72
    songbird72 Member Posts: 22
    edited May 2017
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    Well I didn't get the last drain out because it is still draining the seroma. She felt bad but said I would definitely get it out Tuesday. I hope everyone is doing well.


    I never had the stinky urine but my sternum was sore for about a week and a half afterwards.

  • jbdayton
    jbdayton Member Posts: 163
    edited May 2017
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    tnd22 I had expanders placed in Aug with my BMX and no expansions, then did my DIEP the following March. I went from a D to a large B. After fat grafting to fill the poles I ended up with a small C. Don't worry they can do miracles to make you look good. I had to do delayed because I had to do radiation.

  • MariH
    MariH Member Posts: 4
    edited May 2017
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    MAPBB,

    I also feel like I have too much boob under my armpit. And not enough under the clavicle to slope into the breast. I do feel hardness in the armpit boob, and hope it isn't fat that didn't take. I see the breast surgeon in about a week. Maybe she will be able to evaluate, since my PS didn't do anything except remove drains and bandages at post-op visit. I won't see him for 2 more months.