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DIEP Flap Reconstruction 2017

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Comments

  • trishyla
    trishyla Member Posts: 698
    edited September 2017

    Hello Altered Artgirl72,

    Welcome to the Diep Flap thread. Sorry you've had to go through so much, but this is a great place for info and support.

    I had my BMX with immediate DIEP flap reconstruction on April 4th of this year. It was a big surgery, almost 12 hours, but I was really fortunate to have top notch care, from the surgeons, to the nurses, to the people delivered my food and cleaned my room.

    I was in the hospital for 6 days. The first couple of days home were the hardest. Hunched over, sore and I don't have to tell you what a pain the drains are.

    That being said, I found the recovery much easier than I anticipated. I was dancing (in high heels, no less!) within five weeks of my sugery. I'm just over 5 months out, and I walk, jog, exercise, do yoga. I feel like I'm getting in better shape than I was pre-diagnosis. I have complete use of both arms with great range of motion.

    As tough as it was, it was totally worth it. I would do it again in a heartbeat. No hesitation.

    Good luck with your recovery. The next surgery will be here and done with before you know it.

    Trish

  • AlteredArtgirl72
    AlteredArtgirl72 Member Posts: 16
    edited September 2017

    Thanks Trish! The abdominal aspect worries me the most. Before the breast cancer I'd never been hospitalized aside from having my kids. No surgeries, no health issues. I definitely took it for granted.

    We're going out to look for a recliner this week. We haven't had a recliner since our youngest was born (he's turning 16 next week!) so not sure what to look for but have read it'll be better for sleeping. We have two sprawling teen boys so I'm sure the recliner will get continued use after I get back to sleeping in my bed ;)

    I know I've been lucky to recover fairly quickly from what's happened the last few years. I just feel like it's hitting me that I need to take advantage of that and get back into shape as much as possible (I'll happily buy heels to dance in!)

  • Jiffrig
    Jiffrig Member Posts: 158
    edited September 2017

    Altered, just wanted to share my recovery. I had BMX with expanders last December, two weeks ago today, I had the DIEP. The first few days were tough due to stomach muscle being cut, but when I came home after 4 days, I walked right up my steps to my bedroom and slept, in my regular bed, like a baby. Needed my husband to help me out of bed and did not move much from flat on back, but much easier than bmx recovery. I just took ad dome all bandages off before shower tonight and most of the glue holding everything together peeled off to reveal a beautiful pink tight scar. Same on breasts. My repositioned navel has been the hardest to heal! I was never hunched over as he did not take more tummy than was necessary. Strengthen your thighs before to help with lifting out of chairs. You don't need recliner, IMO. Worst Is in hospital. Good luck

  • Dunes
    Dunes Member Posts: 11
    edited September 2017

    After umx, node removal and immediate DIEP, I can honestly say the worst part of recovery was the constipation! Thanks Falconer for bringing that up. The rest was surprisingly manageable. I have back pain (3+months out) I'm sure due to posture. After the DIEP I got used to hunching over while walking. I'm hunched over a computer all day. So now, I'm returning to yoga next week after a couple of years. My guess is strengthening your back now would be a good thing. Any yoga experts out there?

    Kellychameleon, I admire (and pray for) all of you with little ones! Hope you all have the help you need.

    PS. Isn't it truly remarkable that after such major surgery my complaint is my own poor posture? Our bodies are amazing

  • AlteredArtgirl72
    AlteredArtgirl72 Member Posts: 16
    edited September 2017

    Jiffrig, thanks for sharing your experience! My surgeon isn't planning to cut any muscle so thenmaybe the abdominal aspect won't be quite as bad as I feared? And as far as leg strength, my ancestry did bless me with sturdy German thighs (I've given up ever wearing skinny jeans.) Sounds like starting back with doing squats every day would help.

    Dunes, the hunching over is what I seem to see a lot of people mention. I work as a freelance artist/graphic designer and am usually sitting at the computer/work table or else in the garage sanding whatever larger project I might be working on. So the more I can do to get in better shape to continue that once the major recovery is over, the better. My work tables are a tall countertop height so I can stand if need be.

    Thanks again for all the input. My cousin's wife and another friend of mine have both had mastectomy w/reconstruction so they've been able to give me a lot of good advice. But both had different types of reconstruction so this part is all new to me. And only a few surgeons here in the Cincinnati area do DIEPs so I don't run into many people with insight/experience here locally.

  • aquilegia
    aquilegia Member Posts: 54
    edited September 2017

    AlteredArtgirl72 - I was very worried before surgery about posture, having had lower back spams in the past, but I was walking more or less upright from day 3. The docs do tell you not to straighten up, but how much you'll need to hunch over depends on how much skin is taken for the flap. I borrowed a rolling walker for the first week home, then used a cane for another week. I never used a recliner at home, but with BMX I think it would be very useful, as you won't want to use your arms to pull yourself up.

    The worst part of the whole DIEP experience for me was the first night in the hospital. I had to wear a stifling hot heating blanket over my new breast, and couldn't move due to the catheter and IV line. Several times I started hyperventilating with claustrophobia. The next night I moved to a recliner and was able to get up and walk to the bathroom - after that it was fine.

    Jiffrig - you are so lucky to have a pink abdominal scar! Mine is still purple after 3.5 months, but I have hope - I read on the tummy tuck site that 3 months is the worst appearance.

  • Falconer
    Falconer Member Posts: 801
    edited September 2017
    Dunes, I'm hardly a yoga expert but I do have a regular practice. My surgery was 5/29 and I've been slowly returning to a modified practice. My range of motion has returned to about 85-90 percent. My abs hurt still in a prolonged plank. I have a very experienced very body mechanics oriented teacher, whom I trust 100%. So please be careful when you do return to choose the right class. Like hot yoga might not be right for you if you're at risk for lymphedema. There's a great exercise thread here on bco to check out. Good luck to you! I hope you find the right moves to ease your back pain. Is it your lower back and sacrum that are giving you the most trouble or do you have pain in the upper thoracic area?
  • CatWalk62
    CatWalk62 Member Posts: 1
    edited September 2017

    Hi everybody,

    I'm considering reconstruction options and am looking for some feedback. I had serious damage due to radiation, which was delayed 10 days due to redness, and I have a slim build at 5'8 140 pounds, so not much belly fat.

    I am seriously considering the DIEP Flap. I like the fact that there are no implants ( have been athletic in my past cycling, skiing, rollerblading, hiking, but not so much now at age 55). Also like that there is minimal cutting into the muscle. My plastic surgeon thinks it will be the best visual outcome matching my other 55 year old breast, and I just learned there is a microsurgeon at John Muir Walnut Creek, CA who can assist my plastic surgeon. But it will be a 10 hour surgery which is scary, and probably a week in the hospital.

    I have a second opinion scheduled with Dr. Kind in SF, who is very well known for his success using DIEP, just to get his opinion if it's even an option for me.

    Questions: what if the DIEP fails due to lack of blood supply? Do I have a second option? Am I making the right choice regarding staying away from an implant and staying away from moving my abdominal muscles (I was in a car accident 20 years ago with abdominal whiplash so would rather not mess with those muscles).

    I'm sure I'll think of more questions later.

    Other options for me are the Latismus Flap + implant and the TRAM Flap.

    Thanks,

    Catwalk62

    DX: 11/2015, HER2+, Right, 4.5 cm, Stage IIB, 1 of 7 nodes positive.

    Chemotherapy: 4/2016, Total Response.

    Surgery: Mastectomy, Right, Tissue Expander Placed.

    DX: 09/2016, Secondary cancer discovered in mastectomy slides, ER+, 1cm, Positive Margin, Found Post-Mastectomy.

    Radiation Therapy: 10/2016: Whole breast: Breast, Chest Wall, Clavicle (10 day delay due to redness).

    Hormonal Therapy: 05/2017, Arimidex (Anastrozole)

    Hormonal Therapy: 07/2017, Second Attempt, Arimidex (Anastrozole)

  • Lula73
    Lula73 Member Posts: 705
    edited September 2017

    catwalk- I would think your next best option after DIEP would be SGAP. When you go for your consults with the microsurgeon be sure to ask how many blood vessel they will ideally harvest. Some only take 1 period. Others will harvest multiples for best chance on outcomes. Dr Dellacroce from the center for restorative breast surgery in New Orleans (one of the top flap recon surgeons in the world) did a talk in England that you can view on YouTube where this is discussed as well as different types of flap surgeries. I've posted the link below.

    If you're wanting to avoid losing muscle anywhere those are the 2 best options. A quick rundown of the various flap surgeries (at least the most talked about ones): TRAM uses the abdominal muscle. Lat dorsi takes the latissimus dorsi muscle and flips it from your back to your front and usually requires an implant too-lots of talk about posture issues down the road without that muscle on the lat dorsi forum. PAP flap uses your muscle in the back of your thigh and leaves the back of you thigh pretty numb from buttock crease to knee-we really need that muscle and feeling in it as we age to stay mobile. TUG flap doesn't use muscle but tends to disfigure the look/shape of your upper thighs.

    Hope this helps!



  • Dunes
    Dunes Member Posts: 11
    edited September 2017

    Thanks,Falconer. The Excercise thread looks great. My pain is thoracic. I've been doing chest openers which feel wonderful. BTW, I've followed your successes all along!. My DIEP was 5/30, so almost the same

  • Honeybadger
    Honeybadger Member Posts: 51
    edited September 2017

    Hello Catwalk et al, Lula has PAP & TUG confused. PAP is muscle sparing and uses the Profunda Artery Perferator. (Pardon all spelling errors.) Usually scar is placed at buttock fold. Numbness can be very minimal. TUG is the Transverse Upper Gracilus muscle in the inner thigh. That is the method I chose. Not that I wanted to lose muscle, or desired a scar down my inner thigh & around my upper thigh, but my surgeon had done many more TUGs than PAPs & I couldn't face another complication after my TE failed on my radiated side. I am happy with my reconstructed breasts and my thinner thighs.:-)

    Its been almost 8 weeks and don't feel any change in my leg strength. I didn't have much abdominal fat at 5'3" 110 lbs so this was a better choice for me. Research as much as you can and consult as many physicians as you can afford until you feel comfortable with your decision. Wishing you & everyone here good health and swift healing. HB

  • Falconer
    Falconer Member Posts: 801
    edited September 2017

    Catwalk, my PS ordered an MRA of my abdomen to be sure my veins and arteries were good. They were, and I had the DIEP at the end of May. Ask your PS if he/she will order this scan to check in advance. They hooked up one of each- vein and artery because the nurses were using a little Doppler to listen to their flow while I was in the hospital. All good now! I have a warm, fleshy boob. No nipple yet

  • Falconer
    Falconer Member Posts: 801
    edited September 2017
    Dunes, sorry to hear of the thoracic pain; hope yoga will help you feel better again! Where did you have your surgery? How does your abdomen feel?
  • Lula73
    Lula73 Member Posts: 705
    edited September 2017

    honey badger-thank you for the correction-I'm still struggling with the memory issues from the tamoxifen and got those 2 backwards 😀😜

  • tnd22
    tnd22 Member Posts: 39
    edited September 2017

    This thread seems to be getting quiet. However, I have my DIEP flap tomorrow so I can still use support. i am a little nervous about the surgery, but will be fine.

  • Lula73
    Lula73 Member Posts: 705
    edited September 2017

    good luck tomorrow tnd22! Keep us updated when you can

  • Doglover32
    Doglover32 Member Posts: 4
    edited September 2017

    I go tommorrow morning for a first appointment with my plastic surgeon. Looking at doing unilateral mastectomy and immediate DIEP flap reconstruction. I've looked at a few websites with tips on things to ask, but do you ladies have any questions you wished you had asked before surgery, but didn't?

  • Doglover32
    Doglover32 Member Posts: 4
    edited September 2017

    Good luck tnd22! I can relate to the nerves. My surgery isn't even scheduled yet and I'm a bundle of nerves now.

  • mmcmom
    mmcmom Member Posts: 26
    edited September 2017

    good luck tomorrow tnd22!!

  • Falconer
    Falconer Member Posts: 801
    edited September 2017
    Dog lover good luck tomorrow. I would ask about an MRA of your abdomen to make sure your arteries and vessels look like they can be transferred to your chest.
  • Dunes
    Dunes Member Posts: 11
    edited September 2017

    tnd22,best wishes. This time tomorrow you won't have cancer breast!!

    Falconer, my surgery was at Virginia Commonwealth U hospital, Richmond. Loved my surgeons ( and all care)! My abs are fin. I'm reminded of the old joke. Me - "Dr, will I be able to do a plank after surgery? " "why yes, after a while", she says. Me- that's good cause I've never done one before" 😉(Ok, they're not THAT good) And my back is great tonight. Long walks on the beach all weekend. Life is good!


  • jeanwash
    jeanwash Member Posts: 43
    edited September 2017
    Tnd22, I cannot tell you how nervous I was the night before... wasnt even sure I would be able to get up in the morning and actually go. The ladies here gave me a pep talk for which I am very grateful!! When I saw my surgeon at 6:30am, I actually I felt quite calm because I knew no matter how I was feeling he knew what he doing. I woke up from surgery with a beautiful new breast. The recovery was just fine. I am very glad I went through with it!!

    Trust your team and get yourself to surgery! You will be fine. We will be rooting you on and waiting to hear back from you. Good luck!!!
  • MichCali
    MichCali Member Posts: 44
    edited September 2017

    tnd22--- best wishes tomorrow!! I had my Diep on July 22. I had a single mastectomy last November that I feel now was more painful. The recovery from the Diep takes time, but I'm so glad I did it. I was in the hospital for 5 days-- 3 in icu, then 2 on a regular floor. ( just what my Dr told me. ). Once home, I only took a muscle relaxer, no pain pills. I slept when tired and tried to walk around my house, even for a few minutes hunched over. I feel like ever day got a little better. Don't push it and lift or,do anything you shouldn't even if you start feeling better. You don't want to hurt the stomach stitches. Good luck!!!

  • kellychameleon
    kellychameleon Member Posts: 48
    edited September 2017

    tnd22 - good luck as you're going through the surgery. I hope everything is going smoothly and that your recovery is non-eventful.

    I'm 3 weeks out from surgery and am feeling pretty good. My main complaint is that I just can't get comfortable while sleeping so I wake up a million times a night. I'm naturally a stomach sleeper and hate sleeping on my back, which is part of the problem. Other than that, recovery is moving along as planned. I went to my daughter's soccer game yesterday and felt great. Today was the first day I was cleared to drive, and I dropped the kids off to school. I'm relaxing right now and am going to go get a pedicure in a little while. Tomorrow I'm going to go into my office for a couple hours. I'm planning on easing my way back into working.

    There's definitely still some pain, and I'm moving pretty slowly, but overall, I feel like I'm doing pretty well for 3 weeks.

  • Lillanysan
    Lillanysan Member Posts: 2
    edited September 2017

    I can't get a reconstruktion until a year after radiation. So I have plenty of time to think about it.

    How does a diep work when I have stretchmarks after having babies? They arn't massive but they are located around my bellybutton.

    Have you been able to have the operation even with stretchmarks or is there other better options for surgery

  • Falconer
    Falconer Member Posts: 801
    edited September 2017

    image

    Hi Lillanysan,

    I snapped a photo of my abdomen. The scar below my new belly button was from a previous hernia repair (2013). The hernia was above my belly button. When I had the DIEP and new belly button made, the scar ended up below. Not sure if this answers your questions about stretch marks, but they are scars right

  • aquilegia
    aquilegia Member Posts: 54
    edited September 2017

    Wow, Falconer, your abdomen looks great! I had DIEP about the same time, but the scars on my bellybutton and flap incision are still maroon colored. Very different from the scars from breast surgeries, which faded very quickly. I have such fair skin on my abdomen that the patch on my reconstructed breast looks like a headlight, lol. Oh well, underwear covers them up just fine.

  • Encee
    Encee Member Posts: 8
    edited September 2017

    Hi all;

    Obviously new to this forum & a little overwhelmed with the information overload and posts, but good overwhelmed.

    Diagnosed 6 years ago, and living life well after chemo, radiotherapy and Herceptin. Had immediate reconstruction which encapsulated, had revision reconstruction 4 years ago which also encapsulated. Had DIEP flap 2 months ago that I’m still recovering from. 2 small concerns: my abdominal surgery site has 2 cm of wound breakdown - is being monitored by surgeon and managed by simply changing Aquagel dressing myself every 2 to 3 days. It’s not heneious, just small bit of gloop and blood on dressing when changing. No pain or odour which is good. Just wondering how long it has taken for some of you for complete wound healing & any tips/suggestions?

    Also, my abdomen is still really tight and feels like I have a small baby in there! Have the sensation of a string tied around abdomen and anything below it is fine but anything above it is prevented from moving below the “string” - does that make sense? Any thoughts?

    One final observation - if I had known then what I know now moment - scar tissue is the spawn of Satan... it probably contributed to most of my problems and reasons for surgeons going in and repairing/revising/re-doing reconstruction. I have started going to a physiotherapist who works a lot with post-mastectomy patients and she is doing magic with scar tissue breakdown. Am I the only one who feels that the surgeons should be focusing greatly on advising patients to keep on top of this? If I had been told or read up more on dealing with this as important part of recovery after last 2 surgeries then I wonder where I would be now. 🤔

  • jeanwash
    jeanwash Member Posts: 43
    edited September 2017
    Encee so sorry to hear of your challenges. After being on this site for years, I found the exchange of information within this community instrumental in preparing me for my Diep surgery and after care. The doctors do give their general instructions but very detailed examples of issues etc are not always proactively provided... exactly why I find this site so valuable. I do know others here have greatly benefited from physical therapy and wound care.

    Just weighing in to wish you continued healing ...
  • Dunes
    Dunes Member Posts: 11
    edited September 2017

    Hi Emcee. Welcome! So sorry to hear of your troubles, but it sounds like you're in good care this time. I had some pretty significant necrosis on my breast. My PS and wound nurse decided to allow the body to heal itself(with the help of all the wound care), no grafting. They promised if I was patient all would work out-about 3months. Almost 3 months to the day all was clean and healed and scarred! I was amazed as I kept thinking things didn't look right. PS will be fixing the scar with phase 2. Hope you find the same to be true!

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