DIEP Flap Reconstruction 2017
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jenpo- so sorry you had such a difficult time with the DIEP surgery. Thanks for sharing, you're so positive considering the ordeal you went through. Sending prayers and hugs for continued healing
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Tpralph - no, I didn't get permission to ride a bike, but the PS said normal exercise was fine after 6 weeks, just no jogging or weightlifting. I figure if I ride on smooth roads it's no more jarring than walking. I probably won't tackle any hills for a while where I need to get out of the saddle.
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Question for folks who have had DIEP a while ago - does the flap tissue ever get more resistant to pressure than in the early rehab days? I tried wearing one of my normal bras for a few hours; the seams made a deep groove in the breast that took 24 hours to completely disappear. Sort of like under-baked bread. I know fat tissue isn't the same as breast tissue, but is this something I'll have to worry about the rest of my life? Since there is no deep pain sensation to warn me, I'm worried I could pinch off a section of the flap, even years down the road.
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I had the same thing after my stage 2. Love the analogy of bread. I don't have that now at all.
There is more sensation to pressure now so I am less worried about hurting myself. But early on I didn't have much pain sensation to warn me if I was hurting self. Yesterday I noticed a little scratch--have no idea where's that came from!!
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Jenpo, I am heartbroken for you. Losing a flap is devastating emotionally. I didn't lose my flap but came out of surgery with one flap and one expander still in place due to bad veins. 3 months later I did a different flap ( from the hip)and it started failing and I lost about 60% of it. After months of healing and a wound vac I started the long process of several fat grafting procedures to rebuild the breast mound.
Hang in there, it is challenging but at least you have another option.
Many Hugs.
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i'm sorry to JenPo about loosing the flap, and to Jbdayton also. Makes me worry about my flap surgery to come, but not until Sept 18. If my flap would fail, I think I'd go flat because I hate these expanders! Every bra I have- the prior underwire, the new ones after surgery with front closures, and soft ones I bought off the internet with no closures (like a sports bra) all bother me somewhere, mostly underneath. The sports bra ones are the most comfortable but after my surgery I'm guessing my arms aren't going over my head for a while again.
BTW- is that true, do you have the same restrictions with arm movement after the DIEP as you did after the MX?
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jenpo, I am very sorry to hear about your experience. I am sending positive thoughts for a speedy recovery. Your bravery in the face of adversity is inspiring. And jbdayton, you are an inspiration. I am 15 days out and still have 3 drains making me miserable. Your notes remind me to try to keep things in perspective and count my blessings.
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Hi Ladies!
I am finally having my delayed DIEP on Thursday, 07/13/2017 at Fox Chase Cancer Center in Philadelphia, PA with Dr. Neal Topham. It's been a long road to get here. I've been reading and reading. Thank you all for posting your experiences! I will do the same and I also plan on starting a thread in the picture forum.
I have lots of pics along different parts of my journey, but I could kick myself as I never took a before pic of my real boobs! Oh well. Glad to finally be joining you gals!
Maryann
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Ladies,
Thank you for all your positive messages. It's been 10 days post-mastectomy/post-failed diep flap/2nd surgery for expanders. 2 days after my expanders were put in, my PS sent me over to UMD Hosp in Baltimore for Hyperbaric Oxygen Therapy to save the breast tissue and also the nipple/areola. I had two dives that Friday. I've had a total of 10 treatments/dives, both at UMD Balt and Georgetown Hosp. They used a "Spy Machine" to check the oxygenation/blood flow levels of that left breast. At the baseline, I had readings that were 0. But by the end of the 10th treatment, most of the readings were above 20%, which according to the doctor, is good news in terms of blood flow, wound healing and basically saving the tissue. There is a small section that read a 11%, so I'm going in for another week of 10 HBOTs. For those of you who don't know what this entails, it is approximately 2 hours plus of compressed oxygen that one breathes in. It works to promote wound healing. Many diabetic patients use this with much success.
For me, it appears that my breast tissue can be saved. No need for further surgery except for a very small section of the areola which can be performed as a outpatient procedure. But we'll see what the next 10 treatments yield.
My only complaint thus far is the occassional pain from the expanders, the sutures on my abdominal wall, the drains (argghh!), back pain, and tiredness. But hey, I'll take that instead of chemo and radiation.
Thanks again ladies and best of luck to you on your journeys!
-Jennifer
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aquilegia- I also have noticed creases from my underwire bras or other seams on my breast. I am 4 months after surgery and it eventually goes away now but at first it stayed for awhile. I only started wearing underwires after 3 months post surgery.
Everyone - I started going to a physical therapist specializing in lymphatic system. She was great and I learned how to massage my abdomen area to reduce my swelling due to surgery and chemo. She said our bodies need to relearn how to drain and massaging lightly in the proper pattern will help that. She told me to expect the swelling for up to a year. If I can get some diagrams of the massage patterns, I will post them. Mainly making full palm swipes started at the bottom of abdomen upwards to right undertake breast. Only do it in one direction, upwards.
She also said the stronger our core muscles, the more the swelling goes down. The muscles press against our skin and causes the lymphatic system to move fluid along. She also suggests I wear a compression garment like a spanx higher power panty for at least one year and to wear them while exercising. She stated the combo of exercising while wearing the compression garment does double good for lymphatic system. The skin (lymphatic system is right under skin) is squeezed between your muscles and compression garment so it moves the fluid along.
I'm hopeful I can get rid of my hard basketball belly
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Hanley50 - good luck on your upcoming surgery. Sending prayers and hugs your way for a successful surgery and smooth recovery 😊
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Pambc - thanks for the lymph info and suggestions from your PT. I need to find a local PT to help me with cording under my arm. My BS and PS suggested 10 minutes a day of gentle massage on my stomach and breast. I will try the techniques you suggested and am interested in any visuals you might post0
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Maryann, did your PS take a efore picture? I too forgot to do so, but I was able to get it from my doc.
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Hello Ladies. Finally having reconstruction after 2 cancer diagnosis. Very excited, but nervous. Surgery scheduled 7/17 at Penn with Dr. Serletti.
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JenPo I hope today brings you comfort and that you're feeling better each day.
Pambc, seeing my physical therapist for the first time since the DIEP. I worked w her after the Mx and TE placement. I'm eager to get back to running, so I appreciate your info about the Spanx. I'll def ask her.
Welcome, mmcom! I hope that all goes smoothly for your upcoming DIEP.
Hope everyone who has had surgery these past few months is feeling better every day. Gentle Hugs to all.0 -
a question for you ladies. I plan to have DIEP flap. I have a bi-laterel mastectomy July 19th. Did any of you had radiation after reconstruction? Or will they wait till after rads to do reconstruction?
Thanks for answering
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hello mm mom - welcome and best wishes for your upcoming surgery!0
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shelabela- it depends on your dr recommendation. Many of us have MX with immediate DIEP reconstruction in a 1 step process (this is how I did it-went into or with breasts and came back out with ones that looked almost identical). Rads can come after if needed. Sometimes having MX will mean you don't need rads. Some drs prefer to do MX and do the recon later. If this is the case for you, will they be doing skin sparing MX or not?
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Shelabela I had to wait until after rads for my DIEP surgery. In the interim, my PS put a tissue expander in to stretch the skin. Good luck to you however it goes!!0
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Shelabela - Six years ago I had immediate DIEP
reconstruction after my bilateral mastectomies. Six months later, after chemo, I had radiation. I had no difficulty with the radiated skin or flap.
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Mmcmom - I had my reconstruction with a PS (Dr. Stephen Kovach)in the same practice as Dr. Serletti. I had terrific results and great care at Penn. I understand Dr. Serletti is a very skilled PS, so I think you are in good hands. When you are ready to consider tattoos you should look into using the micropigmentation specialist that Penn uses - Mandy Sauler. She was great and my tatts look like the original equipment! No need to travel to Baltimore!
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You get better cosmetic results when the DIEP is done immediately with the mastectomy. The flap ends up the size of your areola, so all the scars are hidden with the tattoos. If you go with delayed DIEP, you end up with football shaped flaps.
I have heard both preferences for radiation. Some docs want that all done before the DIEP, some do it after. Thus, you need to ask your doctor.
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BigSister2 - interesting what you just stated. I had an immediate DIEP after double mastectomy but my flaps look like a football shape about 3 inches long. I have my consultation regarding my stage 2 surgery tomorrow. I'll ask him how he will remove the flap and what type of scars to expect. I'm wanting mine to be a little smaller so maybe he will have more options. Who was your doctor? I went to Dr. Robert Paul at St. Vincent in Indianapolis and Carmel, Indiana.
I remember my PS stated I would need radiation before he could perform a DIEP on me. I had lymph node surgery first, before my double mastectomy and DIEP. Since my lymph nodes were clean I did not need Radiation. He told me radiation could harm the tissue and Flap if I did radiation after surgery.
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Pambc - My PS was able to reduce the size of the scars during the nipple construction surgery. Using the flap skin, he cut and twisted up the skin to form the nipples. I believe some refer to this as 'origami nipples'. During this procedure he was able to clean up the scars and reduce the diameter of the flap skin. The tattoo artist I used applied her ink within the boundaries of the scar, allowing the scar to become part of the tattoo's design. The effect is amazing! I no longer feel like a barby doll. I actually have breasts that look real. The nipples did flatten a bit, but you can still see a hint of a nipple when wearing a t-shirt without a bra.
My BS and PS prefers to do immediate reconstruction if the patient is willing and able to withstand the long surgery. With immediate reconstruction you do not need expanders or a second surgery. I had to wait a few weeks for the BS and PS schedules to coordinate, but it was not a problem for me to wait. We knew going into surgery that I would need radiation as I also had ALND on both sides prior to surgery and my left side nodes were not clear.
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I went to my plastic surgeon today to discuss second stage surgery. I have not seen him in a couple of months since I had chemo. I told him that I notice my abdomen was bulging after my second chemo treatment. I'm not sure if the chemo caused it or not. During my second stage surgery he is going in and use mesh to cover my organs. He said they were basically falling forward and he needs to tie them down. So I will just discontinue physical therapy until after this surgery on August 4th. I really hate that he has to open me back up again in the abdomen area, but it appears it is the only way to fix this. I'm hoping I will only feel tight, and not a lot of pain.
Has anyone else had this happen and had to have a second surgery on the abdomen? He said it is not a hernia. Yuck
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Hi rlsteadman, I remember that hypersensitivity. It was horrible. I know what you mean about just your hair brushing the middle. I'm 18 weeks out from my DIEP and just over 4 weeks out from stage 2. That hypersensitivity is gone now. It feels normal between my breasts. Hope yous goes away soon.
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Question on recovery, how long till you are comfortable reaching and bending. I know it sounds strange, but just wondering what to expect. Thanjs
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mmcmom- it depends on how fast you heal & what techniques your surgeon uses. I was able to reach at 4 weeks (no arms raised above shoulders til then anyway) and pretty good with bending in that 4-6 week range. My job requires a lot of bending and lifting and getting in and out of the car all day. I didn't go back to work til 8 weeks.
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mmcmom - everybody is different but I had no problems reaching with my arms at all right away.I was afraid I couldn't reach for a glass of water or feed myself but I had no problems. As far as bending over at the waist, it took me about 2 weeks before I could bend at the waist. But, I could squat down using my legs to pick items up off of the floor.
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Thanks for the feedback, very helpful! Been through 2 mastectomies, so I think I am ready for those restrictions. I'm concerned about the abdomen. Optimistic about going to the shore at eeek 3. I know it's crazy,
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