DIEP Flap Reconstruction 2017
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2Brandy- I didn't have a csection scar but I did have one from a surgery on my ureter where it meets the bladder that was about 4" long and positioned right above the pubic region. They used that scar and extended to each hip for my DIEP.
I went with bilateral mx and immediate recon. I'd say it's about 50/50 for those of us that choose to take both breasts vs just the one. Symmetry, if you're going to have to have surgery in the other breast for symmetry why not just go with BMX, desire to have a matching set, the fact that you can only do DIEP once so what happens if the other breast develops cancer down the road, testing positive for any of the genetic mutations for breast cancer, desire to avoid having mammos and the accompanying stress every 6 months with hypervigolance from now on, having other things going on in the other breast (dense tissue, lumps, calcifications, microcalcifications), and greater peace of mind are the most commonly cited reasons for BMX with DIEP recon when cancer was diagnosed in only one breast.
I've never had implants but here's what I understand are the big differences: natural tissue breasts are warm and soft and movable. They move with you and age with you just like your originals. And they look natural. Implants are cold, relatively immovable, and not very soft. And they don't typically look natural without clothes on. Implants for recon are not like implants for augmentation as they are having to fill in the concaveness that the mx leaves you with as well as creating projection. Both require multiple surgeries. Recovery is typicallya few weeks longer for natural tissue recon vs implants but implants require weekly trips to the surgeon for fills until you've reached the desired fill level. Both surgeries have risk of complications and failure. Finding a good micro surgeon who died at minimum 1 DIEP flap recon per week or a really good plastics surgeon who specializes in recon after mx is VERY important for a good outcome. Ask to see plenty of before and after pics of their work for that particular surgery. Do you have a center or microsurgeon in mind for DIEP recon?
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Hi to the new folks on this thread. I'm jumping in as a unilateral mx, tissue expander, radiation, DIEP recon to the left breast. I'm happy with the fleshy moveable noob I have twelve weeks after surgery. I haven't gotten to stage two but I'm confident it'll fix a few flaws. I was adamantly opposed to my PS touching my right breast. My left side is still very painful and I'm going to physical therapy to regain range of motion. Since my right breast showed no signs of malignancy I am thrilled that it's still there, as is. I know there are women who must choose a BMX but if you are going for aesthetic purposes alone, please know the risks double (obviously). Good luck as you weigh your choices.0
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Hello Ladies, I have a UMX and had chemo, surgery, rads as well, and have been following your progress and recovery. I still have TE since My UMX in 11/16; had it filled 3-4 times but I am still undecided to go through DIEP which is from what I read has tons of trauma and inflammation. My preference is to have implant because the less invasive it is the better for your body. In my case, with rads, implant is out the window. So I wouldn't do DIEP if I can help it. I have read and know people who did not choose recon or no DIEP and lived up to 20 yrs. And I read an article about a study that shows surgery can trigger recurrence. The more extensive the surgery, whether unilateral or bilateral can make difference in recurrence. In short, I think it says the more traumatized your body, the greater the risks of recurrence. Not to say that no recon does not mean no recurrence neither. I just want to limit my risks, at the same time DIEP is the only option, while I do have a little flabby stomach that fits nicely with one breast. IDK if I want to go through lengthy surgery (12 hours!)and lengthy recovery with complications.
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Hello Ladies, I have a UMX and had chemo, surgery, rads as well, and have been following your progress and recovery. I still have TE since My UMX in 11/16; had it filled 3-4 times but I am still undecided to go through DIEP which is from what I read has tons of trauma and inflammation. My preference is to have implant because the less invasive it is the better for your body. In my case, with rads, implant is out the window. So I wouldn't do DIEP if I can help it. I have read and know people who did not choose recon or no DIEP and lived up to 20 yrs. And I read an article about a study that shows surgery can trigger recurrence. The more extensive the surgery, whether unilateral or bilateral can make difference in recurrence. In short, I think it says the more traumatized your body, the greater the risks of recurrence. Not to say that no recon does not mean no recurrence neither. I just want to limit my risks, at the same time DIEP is the only option, while I do have a little flabby stomach that fits nicely with one breast. IDK if I want to go through lengthy surgery (12 hours!)and lengthy recovery with complications.
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Must love Pooodles - Your defintely right, I am a rule follower and will not submerge at all. It will be nice just to get away from all this craziness and relax outside of my messy house lol! It will be fun just to watch the kids have a great time. Thank you so much for answering. Not taking any chances at all.
Monica
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Hello, I am 6 months out from DEIP surgery and I am now experiencing a similar pain when I cough and sneeze in my right breast (cancer side). It feels like nerve pain or hundreds of pins and needles shooting into the muscle in my chest wall. What you wrote sounds like this. Have you been told what it might be other than the nerves regrowing and or what did you do for this? I also noticed that prior to the pins and needles part there as itching that happens on and off, anyone else experience this. This really is my only complaint but I have having a hard time not getting paranoid about the new pain. Any insight would be appreciated.
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cdv and tpralph - sorry to hear of the issues you've had with healing. I can only imagine how frustrated you must be. Hope things get much better very soon, hang in there
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KCMC - enjoy your vacation you so deserve it after everything you have been through!0
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To all the newbies - welcome, I'm confident you will find this forum as helpful as I have. This is a wonderful group of supportive and positive cancer warriors 😊
I had a Unilateral with immediate recon May 9th. I am very happy with the results and am still working through the stomach tightness and cording under my arm. I started physical therapy and I highly recommend PT as it has made a huge difference in how I feel after only 3 sessions. My stage 2 surgery is Nov 30th. I am very fortunate as I have not experienced any infections or other complications as some of the other ladies have. I have an excellent PS and surgical team. I took 9 weeks off work and I think that made a difference in how well my body has healed. You really need to take it easy after this extensive surgery but I think it's worth it. I have "dog ears" and my left breast is larger than the right but that will get corrected in stage 2. I have 2 friends that have implants and they have had multiple infections and many more surgeries than me. My PS did say there tend to be fewer surgeries with DIEP than implants but the surgery is much more invasive and hard on the body.
I wish you all the best and pray your surgeries go well0 -
Houston2016,
You seem pretty misinformed about the optons available for recon, and their relative risk and possible reward.
Implants are not safer than your own body's natural tissue. They are a foreign object placed in your body, and as such, there is a risk for things like rejection, encapsulation and even rupture. None of these things can happen with autologous tissue reconstruction. Plus, with implants you may have constant appointments to fill the tissue expanders, as well as a second surgery to place the actual implants.
It is true that there can be complications from such a long surgery. But there can also be major complications from the implant surgery, or even from the mastectomy procedure itself.
I personally chose bilateral mastectomy with immediate DIEP flap reconstruction. I have not regretted it for even one second. I woke from the 12 hour surgery with already reconstructed breasts. I never felt mutilated the way some friends who chose later recon did. I was fortunate to have few complications, and I've healed very nicely. I love my foobs. So does my husband!
As far as the no recon being better for long term disease free survival, either post the study you found that little tidbit from, or please stop spreading misinformation on this thread. There are a lot of frightened, vulnerable people who rely on these boards for accurate, proven information on the various procedures available to them.
Trish
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Well said Trish. Thank you
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Jill- itching is a common symptom of the nerves trying to repair themselves. Pins and needles may follow. I've dealt with this on and off starting at age 17 after a bout with shingles that caused extensive nerve damage in my left upper chest, around the side and on my back. If it gets too bad there are steroid creams that can be prescribed but check with your PS first. You don't want to compromise anything with the recon.
Trish- thank you for your post. I read and commented on the article that was posted a couple weeks ago about possible increase in recurrence with recon surgery. Obviously no one paid attention to the posts that followed in that thread that quoted and clarified statements from the article that ended with the authors stating difference between the no recon groups and recon groups was not statistically significant. Did I mention it was an observational study meaning no controls were in place and that because of that the data is simply an observation and proves nothing.
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Trish, Thanks for reiterate info about implants but I already know that before coming on this thread. You were lucky to have immediate recon because others who had to have rads had no choice but delay reconstruction. I'm not putting down DIEP, if it works out for you, more power to you. If you read my last post, I said I PREFER the implant but because of rads, that option is out of the window, according to my PS. I went through lots of research on the DIEP and spoke to my doctors, so yes, I was very well informed.
My intention is not to scare anyone, actually, from reading this thread from individuals experiences tells me that DIEP is a long risky recovery and complicated procedure. That's a fact, but it's up to individuals preference to choose what they want and owning the risks.
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Falconer, since you have Delayed Diep Flap I presumed you're also taking hormone therapy. Does the hormone therapy interfere with your Diep Flap recovery process?
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my radiologist and bs said that the diep flaps would not be impaired by radiation, and encouraged the immediate reconstruction which I had in may. will be having 5 weeks radiation in February after my chemo and further lymph node surgery
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Hi Houston, I had delayed Diep, 7 years. I am currently almost 4 weeks out and by far best decision. It is my own tissue and completely integrated with my own body. I also was very, very concerned about the complicated long surgery and took a long time to decide. For me implants were never something I would consider as I did not want anything foreign in my body. Just my personal preference. Diep is well established surgery. I went through all the previous posts and by far most of the women were very happy. Best wishes to you in coming to your own decision. You can go through the Diep posts here and you will find very valuable information to help you make your decision
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Hi Lula73, thank you so much for your input. I am still struggling with whether to have a bmx. I did have calcification in the other breast too but biopsy was non cancerous. So much wanted to keep my left breast, but with a possible reduction and lift on it to make them match may still loose sensation. It's just so much to decide along with dealing with the up and down emotions of having to face all of this. It helps so much to be on this community with people like you, thanks again. Still so unsure and need to make a decision now. I am Her2+ and pr-, er-. I'm 59 and scared to death. My ps is at Atlanta Plastics.
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Hi StillBlessed72, I feel blessed to have found this community and thank you for your comments. I have read where getting a therapists who specializes in breast surgeries was a life savor and have added that to my list..thanks for the reminder. The list keeps getting longer and longer but I'd rather be prepared. May I ask how old you are? My c-section was 19 years ago and will probably have the same scar tissue issue. Worried about being 59 and this major surgery. I did have calcification in my left breast but biopsy was non cancerous, still not sure if I should have a bilateral but so much wanted to keep it.
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Hi. I have read estimated and actual time Measures fora BMX with immediate reconstruction ranging as high as 12 to 14 hours here.
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Hi StillBlessed72, I feel blessed to have found this community and thank you for your comments. I have read where getting a therapists who specializes in breast surgeries was a life savor and have added that to my list..thanks for the reminder. The list keeps getting longer and longer but I'd rather be prepared. May I ask how old you are? My c-section was 19 years ago and will probably have the same scar tissue issue. Worried about being 59 and this major surgery. I did have calcification in my left breast but biopsy was non cancerous, still not sure if I should have a bilateral but so much wanted to keep it.
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Hi. I have read estimated and actual time measures for a BMX with imm DIEP reconstruction ranging as high as 12 to 14 hours here. Hospitals and centers that have experienced surgeons and surgical residents can typically complete that surgery in 6 to 8 hours.
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jbdayton, thanks so much for the list of things to have at home. There is a lot to think about and this was something I had not considered. Thanks again for your posts of surgeries and creating this thread. To the ladies here from the Atlanta area, can you tell me who your ps was? Thank you.
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I am glad for the supportive ladies in this thread. Despite the complication of infection (which isfrankly a possibility of any surgery) this was the best option for me. Having infection does not mean my surgeon is not an extremely talented and sought after micro surgeon. I read the very thorough and well thought out response to the other poster who brought up the small study about recurrence and appreciate that some people take time to exam what is posted in a scientific manner before just throwing out claims offhandedly. If you are concerned about this claim, your treating team is the best place to bring this up so you can get a response particular to you and your diagnosis and so they can help calm the fears this study has stirred in you.
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Thank you Deni1661, as long as the oncologist says I can go I am going lol! It's amazing what our "new normal" is and what we can handle. I just want to relax and watch my little guys have fun. I am tempted to crawl into bed and stay there sometimes, probably what I would do without all of this support. I keep telling myself this too shall pass. Keep breathing....
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Houston,
I do not think the HT interfered w healing at all. According to my ob/ gyn, my PS, his assistant, and my physical therapist, everything looks great! I guess they've seen this before and are not just trying to be nice. I felt better prepared to heal from surgery than I did for the MX. I ate a high fiber diet before surgery and took high doses of arnica Montana prescribed to me by my homeopath after surgery. I had a home health nurse come to change my dressings to avoid infection. My insurance covered it. I am not sure why HT might affect healing but in my case it didn't seem to have any bearing. Good luck to you.0 -
is there anyone having axilla pain 3 months after their mastectomy and diep flap? I am having tenderness on the side of my new breast under the arm, maybe a bit more tender the last month? I did have one node positive of two and worried that maybe there are a few more in there that are growing? I am taking chemo as well.
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Tpralph- definitely pain, especially when my PT massages in my armpit, intending to loosen scar tissue I guess? I'm tight and sore all over the whole area.0
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Hi Jeanwash, thanks for your comments. Actually, I wanted DIEP in the beginning because it sounds really good. Who would want plastic if she can use natural tissues. But after my UMX which went fine I get discouraged about taking antibiotics, etc. I still have low WBC after rads last March. I guessed that was your concern as well, did you have Diep Flap on one breast after rads? How does your hormone pills affected by the healing. Like you said, it's a long decision.
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Houston, I did not have rads. I completed 5 years of tamoxifen a year ago and currently not on any hormone therapy or medication. So I understand my case is a little different from yours.
Regarding the actual surgery, it did seem complicated but in actuality my fears were a lot worse than reality. The complexity is the microsurgery, but since that is what the Diep doctors do everyday itprobably not so complicated for them. The recovery for me was much better than my expectation. My incisions had surgical glue covered with clear strips. I had no bandages or any sort of compression garments or bra. So i had complete visibility to healing incisions. The clear strips washed away in little the shower so now 4 weeks later about 50% of clear strips remain. I feel almost at 100% physically now.
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Hi 2Brandy- There is a lot of information to absorb. Even after researching consulting and speaking with others in a similar situation, there is always more that we discover as we go. I look at it this way- microsurgery is a highly specialized form of surgery and not just any plastic surgeon is trained or skilled enough to perform them. Aside from med school, these surgeons complete residencies fellowships and continue to conduct research publish articles and sometimes help develop new surgical techniques. In short, we often are trying to absorb in a few short weeks or months what has taken these specialists at least 12 years of education and training to understand. So don't be afraid to take a break from information overload and ask any and all questions no matter how basic you may believe they are.
You need to be comfortable with whatever you decide.
I am 44 with a 3 year old. My c-section was almost 4 years ago. I also had a previous open myomectomy 5 years ago and my ob/gyn used that same surgical site to do the c-section. My surgeons initially though my surgery would take 12 hours given the size of my breasts and possible scar tissue issues but it ended up taking less than 10 hours.
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