DIEP Flap Reconstruction 2017
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rlsteadman- I think I noticed that my new breasts felt like me again about 10-12 weeks out from surgery. The feeling of them being lumps on my chest started going away at about week 6-8. Yes there is hope! On the dentist waiting 6mos, they may be worried about inadvertently causing an infection (that could end up being life threatening)or bleed factors.
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TJL3, I pursued a DIEP after my implant got infected twice, the second time resulting in sepsis. I initially went for the implants because my original PS said I was too thin for the DIEP. not!
After the sepsis, the original PS wanted to do a lat flap. I was not sure that was a good idea. Not only did I not want to lose muscle, I did not want an implant again since they kept getting infected. I heard having different recons also made symmetry a problem. After reading posts about the LD flap, I decided no way.
I did meet with a couple of local women--one had implants and the other an LD. Both had done OK, but neither were thrilled. I hated the expander--hated the feeling of something under my muscle. A new friend who has bilateral implants despises them.
I had to travel to get my DIEP since no one in my area does them. My DIEP surgeon said I was not too thin--he said I was actually the perfect body type! He thought he could get 2 Bs out of my belly. I ended up with 2 Cs.
I agree that a second opinion is warranted. They can always add an implant to the DIEP if you don't have enough. But I would think you'd get better results with the same recon on both sides.
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just wanted to give an update, surgery last Monday, got 3 drains out today, last one should come out Thursday. I can't believe how much better I feel each day. I have mostly discomfort in my abdomen, and get fatigued, but other than that , feel great. I am walking pretty good, almost completely upright. I waited so long to do this surgery, when my kids finished high school, I feel like I am in a really good place.
A
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Day 9 after DIEP 2. I removed the original dressing on day 7 and put on fresh one. There was dried blood everywhere and I was concerned about infection. While doing it, I noticed a small leak on what's left of the left dog ear. I pray it doesn't open up like after DIEP1. Went for a short walk but worry that too much walking and exercise will open up the abdominal incision. The plastic pill cups they gave me at the hospital to cover the nipples show through my tops even with a light bra on. Anyone have better ideas?
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Rlsteadman- your comment made me call my dentist, as I am scheduled for next month, 4 months after 1st surgery. The dentist said if I was feeling fine it was ok, but to check with both doctors to be sure.
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Mmcmom, thank you for your update. Glad to hear you are doing fine so soon after surgery! My surgery is the day after tomorrow and I am very grateful for this site. I definitely need all the encouragement I can get having waited 7 years...
Are you still taking heavy duty pain meds? I was surprised about almost complete lack of pain with mastectomy. But I know this surgery is very different ... especially with the abdomen being involved.
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Jeanwash...Tylenol during the day and OxyContin at night, which I've been doing for several days. I really think only a few more days of the OxyContin. To me, the discomfort was with my abdomen, really nothing at the Breast site. My surgeon attached an OnQ ball to my abdomen which was a numbing medicine, that really helped. The hardest part is sitting up, but moving around really helps. I too have waited a long time, and i think that mentally really is a great advantage with recovery.
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LMichele,
Although not identical circumstances, I am happy to share info about my recent UMX and immediate recon with Dr Kanchwala using PAP flap. I was not a candidate for DEIP at 5'8" and 135 pounds, but lucky to be a pear shape with some extra cushion in my thighs. After much deliberation around UMX or BMX, flap seemed like the best option for symmetry once I chose UMX. Dr Kanchwala has not done many PAPs but given his experience with TUG and DEIP I felt comfortable he was the right fit for me. I consulted with 3 other PS, none of them seemed experienced with PAP and after understanding the difference between TUG and PAP I knew that was what I wanted. I'm fairly fit and active and didn't want to sacrifice any muscle. I am almost 2 weeks out and things are going well. I only spent three nights in hospital and had a smooth transition to home life. I am still taking it easy, but mostly as a precaution and because I still have a drain from the donor site. I had a great BS as well (Dr Sataloff) and Ive heard that makes a big difference in recovery. I did have a brief meltdown night two in the hospital thinking I had made a huge mistake and mangled a perfectly fine body part. (It may have been from exhaustion as well not having rested much the day after surgery opting for visitors instead of sleep... not a good idea) After a visit from Dr Kanchwala the next day I decided to take a page from the Sixers and "trust the process". He assured me my concerns would all be addressed with the revision surgery and I am confident they will.
Have you discussed TUG or PAP options with him? I imagine he would have offered if he thought you were a good candidate but doesn't hurt to ask. Let me know if there is anything else I can share to help ease your mind.
cwink
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cwink/ sounds like you were in the hospital around the same time, I figured that as soon as you said your doctors name and trust the process. I agree with you 100% about the quality of the surgeon and the care. I felt my aftercare in the hospital made all the difference. My PS was Dr Serletti, he gave me a few options and I chose the free flap, bc I did have enough from the donor site (thank you instant menopause). He also performed both my sisters surgeries (preventative due to brca).
I think I went back 3 times for consults before I made my final decision, really wanted to make sure I was comfortable with it
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I just had my revision yesterday after a uni DEIP flap in January at Brigham &Womens hospital in Boston Dr Stephanie Caterson did it. She came highly recommended to me by a bilateral DEIPflap patient . I am so happy with my results. She and her NP Abbie are amazing and attentive. I would highly recommend them. Please contact me if you have any questions.
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mmcmom - sounds like we have both been very fortunate to have good experiences so far. I was actually down at Penn Hosp in center city since that is the BS primary location. ICU nurses were wonderful. Second opinion and multiple PS consults were key for me. If I had just gone with initial BS and PS I would be in the TE/implant forum and I don't believe that was for me.
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Cwink- that's why I took my time deciding, I felt so many things happened rapidly with both my diagnosis,my mastectomies and chemo, I really wanted to do this at my own pace. I was on Rhoads 1 for recovery,
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Hi all,
I'm new to this part of the forum. I had my BMX in Oct 2016, chemo from Nov '16 to May '17, and have completed 20/25 radiation treatments.
I was initially supposed to have TE's placed at the time of my surgery, but the PS decided he wasn't comfortable with that, due to the probability of me having rads.
So I've seen 3 PS and have found out that my only reconstruction option is a diep. I knew about it before, and think I'm ok with it, but not fully decided. Some ladies on my dragon boat team had diep done, and they both said they wouldn't do it again.
Yesterday while I was walking through a parking lot, an older man told me I should spend more time trying to look like a woman than a man. I was/am completely devastated. Who says stuff like that? I have been so thrilled with my hair growing back, but apparently the rest of society doesn't think the same. I had long hair and large C-cup breasts before this. If I do diep, I will get a small A (if that). I just don't know..
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Hi everybody. Today marks my 5th week post-surgery. I feel stronger every day so I am turning my attention to stage 2 revision surgery. I have been going through the threads here which is very time consuming. Any advice or directions to resources would be welcome. Thank you
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IronMom, I am so sorry that you were faced with such insensitivity. It is unbelievable, always. Imagine if that man knew of everything you'd been through. Imagine if his wife had to go through it. Imagine if he did.
I'm 8 weeks from my DIEP. I've started running again- today ran 3 miles- and I could run right over that jerk if you wanted. I hope that reconstruction works for you if you want it. You are strong and beautiful no matter what.0 -
Ironmom- I'm so sorry, people are so insensitive.
Did the women say why they were unhappy with the diep procedure?
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Ironmom3
what he said is horrible, but who cares? You are IronMom!
If you were still feeling like you wanted to go back to C, might implants be an option after Deip?
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My surgery is in 6 hours.... nervous, nervous, nervous...
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You can do this, jeanwash! It's a big surgery, but it's very doable. I had more discomfort than out and out pain.
The best part is that you wake up with breasts that look and feel real. The worst part is those damn drains.
The bane of my existence for 3 weeks.Best wishes for a succesful surgery and a smooth and complication free recovery.
Trish
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Thank you Trishyla... made the mistake of watching YouTube video of thesurgery. Made me very very very queasy... I stopped that now and will try to get a few hours of sleep. I know it will be fine. I will post an update tomorrow if a can.
You just reminded me to take a lanyard or two..
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No more Dr Google! Take your shower, pack your bag and watch a funny movie if you can. If you have any anti anxiety meds, take them! Just make sure you tell the anesthesiologist about it in the morning.
Good luck.
Trish
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you will not regret it ! Relax . I never took a narcotic. You are in my prayers a for smooth and pain free revovery
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jeanwash, you can do it!!! Sending you hugs and good thoughts
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thinking of you jeanwash! sending positive vibes for an easy recovery!
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Thinking of you this morning, jeanwash.
I am about 5 months out now and thinking of stage 2, which probably won't be until next year when my FLMA time resets. Something weird happened yesterday. I was checking over my scheduled appts and I noticed that my follow up appt in Sept with my PS was showing cancelled. It's when we are supposed to discuss next steps. I didn't get a call or email about it. I had to call the office for info for my physical therapist anyway, so I asked about the appt. The receptionist was very evasive and eventually said my PS was only going to work part time, one day a week now at facility even farther from my house, and they cancelled all his appts and were going to call to reschedule. She said she could reschedule for me and it ended up not being so far away from the original appt. I don't know what's going on, whether he is even still doing surgeries or not. I wish they would say something in case i need to be looking for a new surgeon. I really like him and hope everything is ok, but this is a big thing for me. There are a lot of issues with my abdomen that need to be fixed. I want to know who is going to be planning and working on me.
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I'm 8 weeks out and also starting to think about Stage 2. That isn't for another 4 months, but I need to reserve time on the PS' calendar now. In a way, it's a harder decision than the reconstruction method, because the fixes are optional. I could live with mismatched breasts (C vs D), a missing nipple, and a divot in my sternum without feeling that everyone was staring at me. On the other hand, recovery from the DIEP was not that bad, and I don't think the recovery would be as long. I'd also like to hear your Stage 2 experiences.
cdv4251992, what do you mean about the FLMA time resetting? Is there a restriction on going on short term disability twice in a calendar year?
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Hello Everyone, I'm glad there's a thread for Diep. I'm similar to Ironmom, I had chemo April -Sept 2016; Mastectomy 10/16 and ReExcision 11/16. Originally before surgery, I wanted to go for DIEP read all about it, the PS just went along with me and show me a 3D video. After surgery, I feel my body is weak and all the drains and antibiotics, which gave me rash/fever. Then I had Rads, which 30+ weeks. After Rads, went to get TE filled by the PA three times then I said I wanted implants now, PA said my radiated skin will not hold implants, later went to see PS who said my only option is DIEP. Why no one tells me about anything or the pros and cons. The fact that he puts the TE in I thought implant is a possibility.
I researched on the study on the link between DIEP FLAP and risks of recurrence. It said the longer and extensive the surgery, the greater the risks of recurrence cause our body is inflamed. I'm just not sure right now and don't want to go through this extensive surgery again and the pain and inflammation again. Not to mention infection where the stomach is. Anyone knows about the risks of recurrence? And should I wait or go ahead. Please any inputs will help. Thanks.
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Hello Again, can anyone tells me how many stages does DIEP FLAP needs, what is the process. I'm having not so good Medical team that doesn't tell me anything. I'm in dilemma not sure if I should go thru with the left breast DIEP. It sounds good but the long surgery and inflammation to me can trigger recurrence. Can anyone sheds light on this issue? Thanks.
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I did a quick search and could not find any study that stated in the conclusion that there is a statistically significant increased risk for recurrence for flap surgeries vs other recon types or staying flat. They've tried to study it but no one has benn able to state it conclusively. In one published in 2917 there were technically more patients that developed recurrence in the control group than the flap group but again not statistically significant. That means no clinically significant difference between groups. Headlines on studies are just like headlines in the news-they're meant to grab your attention and get you to read/watch; they are in no way meant to tell you what the ultimate conclusions are.
Yes radiated skin/chest wall make implants difficult. And for a significant number of us they don't work at all. You're in Houston I'm guessing from your screen name. Are you going to PRMA for your surgery? They are supposed to be good. Ask about infection rates and flap failure rates. Make sure you see plenty of before and after pics from your surgeon.
As far as stages-a lot depends on your body. Stage 1 they'll take tissue from your donor site and build the breast mounds and establish blood supply. Stage 2 is symmetry work and scar revision, stage 3 is typically nipples. Some of us need multiple stage 2s. Some of us get by with just 1. Stage 1 is the hardest. I'm surprised they didn't do immediate DIEP recon when they did your mx. That way it's all done at once. Also it sounds like you opted for umx. Have you considered doing skin&nipple sparing mx on the other side and doing DIEP recon on both for symmetry? You can only do DIEP once..
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Aquilegia, where I am my employer allows 12 wks of FLMA per 12 month period. So my first day off (surgery day) started my 12 month period. I used about 8 wks initially, so I had about 4 wks left after I returned to work full time (I worked part time the first 2 wks back.). I use FLMA for dr appts and chemo treatments. I have about 70 hours left until 3/2018. I'm getting treatments every three weeks now, but I am also in PT weekly. The FLMA protects my job but is unpaid time. I had to use all my PTO before my short term disability kicked in, so I've had to take a lot of unpaid time to get my treatments. In March, the FLMA will "reset", so I will have the job protection to get stage 2 surgery after that time.
I was also on short term disability while off for surgery and the couple of weeks of PT time. Short term disability is separate from FLMA and is something not everyone has because it is a benefit we pay for.My employer offers 12 wks short term disability. I have used 7 weeks of short term disability for this occurrence. Our policy won't pay if you are able to work more than 20 hours per week, which I was, so I couldn't access that during chemo to offset the unpaid hours for treatments.
Though I want the stage 2 as soon as possible to correct the problems, I'm also not eager for any more surgery. Waiting until next year is fine with me. Maybe I'll forget about the drains by then, lol!
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