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DIEP Flap Reconstruction 2017

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Comments

  • Falconer
    Falconer Member Posts: 801
    edited March 2017
    jb
    Great news! I'm so happy for you! After all this time to feel a sense of completion must be such a relief.
    I'm wondering- did you stay on Arimidex through your surgeries? Any need to come off that med?
  • jbdayton
    jbdayton Member Posts: 163
    edited March 2017

    Falconer,I was asked to stop my Arimidex one week prior to surgery this time. My previous PS did not make me stop.

    I guess it is up to the surgeon. My oncologist said he could agree with either request, but of course preferred I did not stop at all.


  • BigSister-2015
    BigSister-2015 Member Posts: 298
    edited March 2017

    Jeanwash, sorry you are not getting any response. I wonder if you looked at older threads for a Chicago listing? I thought there was one in the 2014 or 2015 groups.

    I had mine in Indianapolis with Dr Chu--fantastic surgeon. He is a self-proclaimed DIEP geek with tons of experience and skill. So thankful for him!

    I am a year out from my stage 2 and am finally ready for my tats. I decided to go to Vinny in Maryland. Just called yesterday and they are wide open forJune, so I just have to pick s day!

    They have offices in TX, CA, and LA, but MD is closest for me. After all this work, I decided to go to the best for the frosting.

  • BigSister-2015
    BigSister-2015 Member Posts: 298
    edited March 2017

    Jeanwash, here is the link to the 2014 DIEP thread. The is a Chicago listing right at the top. Hopefully you can private message her!

    https://community.breastcancer.org/forum/44/topics/816167?page=227#top --ugh. Link isn't clickable. I'll try on a new post.

  • WGraf
    WGraf Member Posts: 17
    edited March 2017

    Jbdayton - so glad to hear that the end of this journey is in sight for you. So glad that your recovery has gone so well. Mine won't come until late 2018 but thinking about it all of the time.

    I'm curious about your breast shape after the DIEP. My breast do look very natural when looking at them in the mirror however when I look at my profile they appear to be very flat. It's like they don't have the projection that I once had. I was a full D cup prior and DH says they look just as big. But I can't wear anything knit bc it shows my stitches where my areola should be. My PS doesn't want me to wear any kind of bra yet, so I'm left to wear blouses. I'm just wondering if you had anything similar to this after your initial procedure. Still waiting on abd incision to close back up. Closing has slowed with the wound vac removed. Hoping to start chemo next week

  • BigSister-2015
    BigSister-2015 Member Posts: 298
    edited March 2017

    WGraf, I have the same issue. Looks great from the front, but looks kind of flat from the side. I was fairly thin, so I ended up with close to a C cup, which is a little bigger than I was, o I am happy.

    In any case, I am very happy with them. Having had the expanders, I know I would have hated implants. Although the implants might give you a little better shape, I'll take my own tissue any day.

    I am so sorry about the darn wound delaying your chemo. Praying that it will close up so that you can get on with things.

    JB, so sorry about still being stuck with that drain, but I am so glad it looks like he might have gotten the on done!

  • aquilegia
    aquilegia Member Posts: 54
    edited March 2017

    I'm considering DIEP flap reconstruction for my right breast. I have a few questions that I hope you all can help me with.

    Anyone in their 60's that has gone through this operation? In particular, if you were healthy and in decent physical condition before the surgery, how long and difficult was the rehab?

    I'm hoping for a C cup result - currently D on the left breast, so will need reduction to match. But I'm a little worried I don't have enough abdominal fat for a C. If you had a "C" reconstruction, how thick was your "belly pinch" before the operation? I do have 3 months until I'm planning to schedule this, so could load up on the calories if necessary :-).

  • WGraf
    WGraf Member Posts: 17
    edited March 2017

    Aquilegia - I would have to defer on the age question to your doctor. The surgery is a big one to say the least. Mine was 10.5 hours and required a partial rib removal due to complications. I have recovered well. It's only been 6 weeks since my surgery. At 3 weeks post op my abdomen decided to open up requiring me to do sterile dressing changes for two weeks then I ended up with a wound VAC for a week and a half and now I'm back to sterile dressing changes. My chemo has been postponed until I am able to get this incision to close from the inside out. I have never been a smoker nor am I a diabetic so no reasoning for why this is taking so long to heal. Just something to consider that can happen at any age. I am 47 and reasonably in good health. If you are only doing one side reconstruction they can do what is called a "Stacked DIEP" and can stack the flaps to create the fullness desired. Ask your surgeon about it. Good Luck 🍀

  • Kali44
    Kali44 Member Posts: 30
    edited March 2017

    Hello everyone,

    Thank you for welcoming me ☺ I am really bad keeping up with all posts thus far. I hope everyone who has been through surgery are healing well and that all goes for those of us who are soon to have surgery.

    I do not remember being told about MR I scan or a CT scan either. I do have pre-surgical tests to be done, I am now wondering if it includes one of the two....??? No one mentioned specifically what these tests were....maybe I missed that part of the conversation. Gonna have to ask my hubby. If this MRI , I prefer no more rads on my still darkened skin, will make my surgery more sucessful....I want it too!

    I need to start using my desktop when replying to topics as I find my iPad sux when typing especially with already tired, numb fingers 😞 I wish everyone a goodnight. Heal well. Rest well.

  • WGraf
    WGraf Member Posts: 17
    edited March 2017

    Kali44 - I did not have a CT or MRI prior to my surgery. I think it's up to the PS. I would just ask if it's something they require if you're concerned. Good luck! I wasn't aware of the upper back pain that would follow surgery so be sure to ask for a script for muscle relaxers before you go home. That was the most pain I had bc you can't stand up straight for a few weeks It's really hard on your back. Get a massage before surgery😜

  • BigSister-2015
    BigSister-2015 Member Posts: 298
    edited March 2017

    I didn't have much belly fat and got a nice "C." My first plastic surgeon told me I was too thin for a DIEP. After my implant went south I went to see a DIEP surgeon and he told me I was the perfect candidate. Had enough for the job but was thin enough to recover well.

    Incidentally, they remove a piece of the rib as part of the normal DIEP surgery. They need to do so in order to access the blood vessels in the chest. It is just too tight in there not to sacrifice a bit of the rib. But you won't miss it. It didn't cause me much discomfort as it healed.

    I did struggle with upper back pain after all my surgeries. I think it was because of the positioning on the table. For the rest of my surgeries, I had them put a pillow under my knees before we started and that took care of that!

    After the DIEP, you do have to walk hunched over for a couple of weeks. It bothered my back a bit, but not a ton. They sent me home with a walker, which helped support my back.

    I was 55 when I did mine and healed well. The important thing is to take it easy the first 2-3 weeks. I was doing computer work at 2 weeks and moving pretty well by 4 weeks. I purposely took my time to recover. (My girls insisted!)

  • cwayman650
    cwayman650 Member Posts: 63
    edited March 2017

    I am almost 6 weeks post-op. Last night my one incision started to bleed. It almost acted as if there was a pocket of blood there. But it was bright red as if it were fresh blood. It appeared to be coming from a very tiny spot on the inner left breast about 1/2 way down. I put a sterile dressing on it. This morning there was only a bit more blood on the dressing. I changed the dressing and put triple antibiotic ointment on it. I'll call the Dr. in the morning. I was just wondering if anyone else had had this happen?

  • Hammie28
    Hammie28 Member Posts: 29
    edited March 2017

    hey everyone. I'm home from my surgery 6 days ago. I'm doing ok just generally uncomfortable. My new breast is huge. Does it reduce in size much as swelling resolves? I'm hoping it will because I had no intention of ending up with something this big and don't really want to live lopsided until stage 2.

  • argynis
    argynis Member Posts: 22
    edited March 2017

    Removing a rib is not always necessary, it depends if your PS can find and access suitable arteries and veins. If he can't find anything suitable a rib will be removed to access areteries deeper down in the chest. I was lucky and still have my ribs :)


  • taag4
    taag4 Member Posts: 93
    edited March 2017

    Hi guys I have a weird question. I am going in for my second stage on Wednesday. I will be having a breast lift and reduction and the bulge in my stomach repaired with a mesh. The bulge is pretty much my left side. What I am wondering is that my surgeon does not use binders. I am afraid that if I don't use one I will end up with this bulge agin do you think there is any harm in using one even though he will not want me to. Just don't know what to do. Can anyone explain just what the binder does and why some dr. don't use them.

  • jbdayton
    jbdayton Member Posts: 163
    edited March 2017

    I just had a hernia repair (I don't think he used mesh) and he has me in a binder for three days and then I can switch to any other compression garment I would like for 6 weeks. I am two weeks out but still wearing the binder. I also had no binder for my Flap surgeries or revisions with a different surgeon.

    I am seeing the nurse tomorrow to have the drain removed.

    I can't tell you what to do I am just relating my situation.

    I wish there was a standard protocol.

    Can you ask him if it would hurt you? He may let you use one if it helps you mentally.

  • cdv4251992
    cdv4251992 Member Posts: 110
    edited March 2017

    Hi, all. Discharged this evening and am home in my recliner. I have to say the experience was much better than I expected. I have 4 drains, which are currently scaring me that hubby and I will have to care for. The incision across my abdomen is pretty low and I don't have pants slung that low. So wearing clothing will be a challenge. My follow up with the PS is Friday. I'm trying to figure out what I will wear that won't fall down as I walk hunched over to his office. If the pants are soft and loose can I pull them above the incision line (and the place the drains come out on either side)?

    I did feel a little pressured to leave today. Hubby didn't have our larger car or any of my travel in the car supplies with him. I got some beautiful flowers that we ended up having to leave there because there was no way to transport them home. The nurses Thurs, Fri, Sat, and Sun were great. The nurse who checked me out and went over the discharge instructions seemed like she did not want to be on the floor she was assigned. So I'm not sure I'm as prepared to be at home. I asked her to write down when she had last given me my meds so hubby and I can keep track of times, but when I got home and looked at the paperwork she handed me, there's nothing on there. The pain is not bad at all, so I will hold off on the narcotics until later tonight.


  • BigSister-2015
    BigSister-2015 Member Posts: 298
    edited March 2017

    Hammie, the breast swelling will go down. I went fro a D to a C after my initial DIEP, I would say.

    Cvd, glad you are home! You can certainly wear clothing over your incision. I wore yoga pants. The additional hugging felt good. Any soft pants such as sweat pants or any knit should be fine. The drains can just come out the top. As long as they are not kinked, a little pressure on the tubing won't make any difference.

    Plan to take your pain pills routinely. Don't wait till you are in pain. You can go back and forth betweenn Advil/Tylenol and your narcotics if you want.

    I could of never remember when I took anything, so I kept a paper on the counter where I wrote anything I took down. I also took a colace (stool softener) whenever I took a narcotic pill to keep from getting constipated. That did the trick for me!

  • jbdayton
    jbdayton Member Posts: 163
    edited March 2017

    Hammie good to hear the swelling can go down.

    Cvd happy to hear you are home. I also lived in yoga pants and or sun dresses for several weeks. My only suggestion is to minimize the tube movement near the skin to prevent the stitches pulling and getting sore. I kept it taped well. In fact I am going today to get my tube removed and it has been two weeks since surgery. It has not bothered me at all.

    I agree takesome colace with each pain med. It does prevent constipation.

    I am thinking of all who are healing and preparing for surgeries.


  • taag4
    taag4 Member Posts: 93
    edited March 2017

    Thank Jbdayton not sure why Im wanting to wear the binder. I guess Im just concerned, I want this bulge to go away and never come back. Just trying to think of anything that may help. Good luck having the drain removed. That is honestly the best feeling, when you get a drain removed. You don't really understand until you have to have one lol.

  • slv58
    slv58 Member Posts: 486
    edited March 2017

    Hi Taag, I had the same repair in July. My surgeon had me buy two binders (the two flap kind, much easier to put on) prior to surgery and I woke up in it. She did the repair without mesh. It is much better than before but I still notice a slight bulge. She told me I could switch to spanx after 3 weeks (if I remember correctly!) but I hated them so she approved me wearing a hernia binder which was about half the width of the original ones. I just found it a lot easier when going to the washroom than trying to unroll and squish into spanx!

    I would ask why your surgeon doesn't want you in one, maybe something to do with healing? I also found the support it gave was welcomed to my sore back

  • taag4
    taag4 Member Posts: 93
    edited March 2017

    slv58 thanks I remember you saying you had the repair also. So looking forward to getting it done. My bulge area aches all the time and when I go from laying to standing I get a burning pain that probably lasts 5\10 minutes. I think I will ask about it and why he doesn't use a binder. I would think the added support would be good, but there must be a reason he doesn't use anything. So EXCITED, tomorrow can't come soon enough. Happy

  • BlackBear
    BlackBear Member Posts: 5
    edited March 2017

    I'm hoping to get my DIEP reconstruction scheduled for April. But I have a question about the abdominal CT scan. At first, the surgery scheduler said I would need one but today I learned that the hospital protocol calls for CT scans for women with a BMI of under 30 only. Mine is 31. Does this track with what others have experienced? It seems that some doctors do them and others don't. I wonder if weight is the defining factor. I don't want any unnecessary scans (or contrast dye), to be sure, but if my vascular system isn't as robust as it needs to be, are they more likely to have to get behind the ribs to find an adequate blood vessel?

  • Falconer
    Falconer Member Posts: 801
    edited March 2017

    Black Bear, I don't know about BMI requirements for CT scans, BUT I do want to alert you to an article that was just published proving the safety of an MRA (if you have a TE). Perhaps your PS can order an MRA if you can't do a CT. Here's the link to the thread. Hope this works for you.

    https://community.breastcancer.org/forum/44/topics/852384?page=1#idx_1

  • jbdayton
    jbdayton Member Posts: 163
    edited March 2017

    I had my follow up visit with my nurse today. She removed all the bandages and stitches. That all looks good. I did not get my drain removed it is still draining a little too much.

    Taag4 I asked about the binder and she said to continue wearing a binder or other compression garment for at least 6 weeks. This will keep pressure on the repaired hernia area and helps with the back muscles as well. She said she didn't know of any reason to not wear a binder.

    I did make arrangements to go to my local GP to get my tube removed when ready.

    We stopped for lunch and headedhome. We decided to not stay the night this trip. We will in two weeks when we come see the doctor. Total drive time today will be about 8 hours.

  • slv58
    slv58 Member Posts: 486
    edited March 2017

    taag, good luck, will be thinking of you! Don't overdo, watch the lifting of heavy objects.

  • BlackBear
    BlackBear Member Posts: 5
    edited March 2017

    Falconer, I don't have TE so I don't think there's any particular reason I couldn't have a CT. It's just that supposedly having a BMI >= 30 automagically guarantees a good vascular supply in your abdomen!! I trust my PS, but I don't always trust hospital protocols.