DIEP Flap Reconstruction 2017
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Thank you so much for your thoughts on recovery everyone. I should also point out that I now think I will have a unilateral mastectomy so that should help recovery a little bit. I will meet with my PS next week and will ask her thoughts. I’m worried now about getting the support I will apparently need. I have one girlfriend that will stay with me in my house for a few days, and maybe I can get another girlfriend to do the same so that the week my husband is gone will be covered. I’m hoping this works.
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Surgery 8 days away, BMX and immediate DIEP flap--now that it is real, I find I am more sad and scared than I was before. Holding together okay, but have had a cold since last Wednesday. It is finally subsiding, but for a few days I was super scared as my surgeon's PA kindly but very clearly let me know if I needed to be on antibiotics from a complication of this cold (sinus infection, bronchial infection) I have to postpone surgery. Have now waited three months to have all calendars on board--and it has been four months since diagnosis.
I wish so much that the people who are sending prayers via social media were coming over to visit me--my husband has not been able to be supportive, we have had better moments of talking and caring, but his standard reaction is always to put me in defensive mode, every day. I know he doesn't even see what he is doing, but causing me to bend back and doubt myself or defend myself (today he worked on one of our household appliances that broke down, I noted he fixed the appliance, was in my own land not thinking about anything but the upcoming surgery and what I needed to still buy, clean, organize, or bring to the hospital. Somehow he decided to tell me "he didn't nap all day as I did."
OMG, I am at a loss here. I was finally able to get out of bed from this intense cold today, ran around getting things handled for my mother, with the annuities I need to withdraw from to be home and still financially solvent for recovery, got my hair cut, had paperwork notarized, did lots of stuff....and crawled back into bed at 1:30. All this happened at 2:30 when I got up
I don't actually know what to do....alternating crying, angry, scared, and honestly have no idea how to ask someone to be with me in this, in fact I have no idea who in my day to day life could even handle listening to me talk right now. I am grateful for here, it has helped me so much through this. Odd how it now is hyper real, all of you are so strong, and your strength has helped me all along. I am praying that I will feel better when I wake up, physically and emotionally. Peace and again thank you.0 -
I guess I honestly can't believe I have to have a mastectomy, that I have cancer. Odd--I knew it, have known it for months, have done all this legwork, and right now in this moment, I am dumbstruck by the reality that I have cancer and am having a mastectomy....it is like deep parts of me which aren't so strong finally get it and those parts of me are having a hard time today with the realization....
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rdeesides - It's difficult to predict how much support you'll need - the experiences of people in this board vary so much! But I'd like to chime in with a "best case" and hope you are toward that end of the spectrum. I had very little pain and was walking around the house with a walker the day I came home, with a cane by the end of the week. I had a wedge pillow and bed rail and never needed assistance getting out of bed. I wouldn't have wanted to cook the first week, but could have made do with frozen meals if I had to. But you'll definitely want to have someone you can call to do errands or to take you if you have complications and have to go back in to the hospital. You won't want to drive for at least a few weeks, as it requires abdominal muscles to lift your legs from the pedal.
Whether you can shower while drains are in seems to vary from PS to PS. I had 2 for my DIEP - one said yes one said no. Fortunately, the one who said yes was the senior PS. I couldn't have borne 4 weeks without a shower!
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Going to have Stage 2 on November 16th. Will have nipple reconstruction and some more revisions to my breast lift on other breast. Will have liposuction and fatgrafting from upper stomach above stomach incision and some below incision. Shouldn’t have any drains. Getting nervous about how long recovery will take this time. Will be having Thanksgiving at my house the next week.How was recovery for everyone who has had Stage 2? Any suggestions you can give me?
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I am day 5 out from stage II. I posted details of surgery a few days ago on day 1 of the surgery. This is very doable surgery. I drove to Walgreens day after surgery. But that was definitely a mistake. I wasn’t really in pain and did not pain meds but the anesthesia must still have been floating around my system as I was unable to focus clearly on driving - so I headed home as soon as possible.
The oozing from lipo hole ended in a few hours after surgery and had none by bedtime on first day. Really only noteworthy pain is from the inner thigh bruising where doctor took fat. But wrapping in 6” ace bandages helps; although I have to keep rewrapping because the ace bandages do gradually slip down when I walk.
Doctor also took fat around stomach and flank area and now I have slightly more defined waist! This part doesn’t hurt so much. I did wrap with 6” ace bandage.
My main advice is not to use your arm - follow instructions. I felt great after surgery and must have still had pain meds in system because I was doing everything with no restrictions until I saw blood soak through guaze on lift breast side from stressing the stitches. I stopped using that arm and bleeding stopped.. after that instance, all seems to be ok.
My lifted breast pretty much matches the Diep breast (minus the nipple). Diep breast is slightly larger but I think some of the fat grafting and swelling are expected to be reabsorbed should go down a bit.
My first follow up doctors visit is on day 8 - will provide an update then
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Starlitmommom, I just wanted to let you know that it does get better... After you get your plans in place and start it will get better! Your diagnosis seems early stage so this may be a blessing in disguise that you caught it early.
I wish you peace and healing in all your decisions. We arerooting for you!
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I feel better this morning, jeanwash. The CAT I had to have for the vein/artery mapping required an Iodine contrast, as I am sure most know. I had that done a bit over a week ago. The hospital premedicated me as I have a sensitivity to iodine, steroids for a few days and double on Benedryl for a few days. I did have soft tissue edema the next day at work. Had to rush out to immediate care where I got a mega shot of steroids, 80mg of Prednisone, swelling went way down in neck and is now gone completely. The steroid caused my mood and the PA for my surgeon said it probably weakened my immune system so I also got the miserable head cold as well.
Vein and artery mapping went very well, cold is on the way out of my body, I work all next week so that should take my mind off the minor stuff. Had to stay home with the cold for 2 1/2 days b/c I was ordered to bed rest to avoid a secondary infection. Too much time on my hands, not enough people in my life who know me well enough to realize I look very strong--talk very strong--am quite strong, but do need people right now. I think when I am through the surgery and initial recovery, I will join the LiveStrong group near here so I can meet others who may also help me on this road.
My worry barometer is like at a 8 or 9 right now. Oldest daughter is delivering my newest grand daughter on November 8th. That will be five grand daughters
I am 56 and in a few days at most (she is having a c-section) I will be grandmom to five little munchkins. I do wish I could be more help to her, i usually am for her babes, but a blessing her c is scheduled for the 8th and I will have five days to know she and newest baby are fine. I have many blessings in my life.....0 -
I've scheduled Phase 2 for Dec. 18 - 6 months after DIEP. I'll have fat grafting to fill in divots, breast lift/reduction (D cup to C cup), small dog ears removed. No nipple - I want to wait until the DIEP scars fade to decide on tattoo vs reconstruction. I'm most anxious about the surgery on the good breast, because I'm not clear on what is involved and what I'll end up with. If it's simply moving the nipple up to match the other breast and removing tissue from the bottom, I think it will end up looking somewhat unnatural - wide and flat. That's sort of what the DIEP breast looks like, but I'm OK with that - with 3 lumpectomy scars and a DIEP areola patch that's several skin tones lighter than the rest of the breast, I'm not going to win any beauty contests anyway :-). It looks natural in a bra - that's the important thing to me.
If anyone is willing to provide some grisly details of what is done in the breast lift/reduction and how satisfied you were with the outcome, I'd appreciate it.
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just checking in - 3 days out from stage 2 DIEP and doing well. I’m all trussed up in a high waisted girdle that goes down to my knees 23/7 for at least 2 weeks. Plus the surgical bra. Lots of purple-green bruising from the lipo. Divot above right breast appears to be gone, Breast size reduced and the heaviness is gone. Feels like me again. Reduction, lift, fat grafting, lipo, scar revision, and hysterectomy. Other than gas pains from the hysterectomy (laparoscopic procedure) I’ve not really had any discomfort from it. Mainly pain from the lipo. Handling it with just Tylenol at the moment. No way on the driving though
don’t know why every PS has a different protocol on bathing. Perhaps a clarifying question would help. It was made very clear to me no tub baths, swimming, hot tub, or anything else where I’d be submerged in water for at least 4 weeks or until all wounds are healed whichever comes last. Showers are fine though. Clean towel, clean washcloth and bath/shower gel are a must - no reusing linens between washes and no bar soap. Pat dry and use betadine swab on the drain sites. would go absolutely nuts if couldn’t shower for 2 days much less weeks on end. Can’t even imagine how that would be considered hygienic after surgery anyway.
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Lula73 - I totally agree showers! My PS said I should shower each day to prevent infection, especially with my drains. I sometime used my hairdryer with warm, not hot, air to blow dry my incisions and belly button area. I found this info below on website that might be helpful for some.
“48 hours after your surgery please remove your dressing and take a shower with lots of soapy suds. In fact, we encourage showering to keep the area clean and dry. Allow soapy water to wash over wound like a water fall. Avoid directly scrubbing the incision and the JP drain exit site. After taking a shower, pat your wound dry. You can place a clean dressing over the incision and JP drainexit site if you desire, but leaving the wound open to air is OK at this point. Use a clean towel each time you shower and wear clean clothes every day. Take a shower once a day. The incision is held together with clips, sutures, steri-strips or dermabond. The JP drain tube is held by a suture to your skin. While showering, secure the bulb to keep it from pulling on the skin or becoming dislodged. Tie a nylon string around your waist to fasten the drain to while in the shower”
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Hi Starlit Mom,
Sorry you had such a crummy day. You sure sound like a Go Getter and people probably rely on you for alot (and take it for granted??). Age 56 and a crew of grandkids, wow! hope they and their parents are there for you. You just go on hiatus when you need to heal and surely people will notice it's time to focus on you! Best wishes for the new baby and for you, sorry for your diagnosis and for having to lose a breast, it is a sad time and it's normal to be a wreck. Hang in there. Michele
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Tomorrow is my day for phase 2. I'm looking forward to this hopefully being the end of my surgeries. Got lots of butterflies in my stomach. Luckily it's early. 7:00 am. It's out patient. I will be so glad to have this behind me. Just have the usual pre-surgery nerves.
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good luck tomorrow cwayman! The best part of tomorrow is you don’t have to lift a finger and you get to sleep right through all the hard work for the day🙂
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would like to hear of any PS recommendations for the DIEP flap in the NYC / Long Island area.
Thanks!
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i am contemplating bilateral DIEP surgery in Feb., after an emergency explant due to infection. I would love to hear specific recommendations for Pos in the NYC / LongIsland area! Thanks You
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who is your PS? I identify with your frustration.
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infreyred, it sounds like you have been through a lot. Post-op infections are not fun. I learned here that DIEP flap surgeries are micro-surgeries which are only performed by specially trained surgeons typically at larger teaching hospitals and specialty health practices/centers. You might try posting your note to the diep 16 thread as well. Good luck with your search
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Infreyred- ditto what suburbs said. Most of us end up traveling for natural tissue recon and it's worth it. I traveled from central NC to New Orleans to have mine done at The Center for Restorative Breast Surgery. Most of their patients travel to NOLA so they have a travel coordinator on staff that an help with flights and accommodations. They have contracts with several hotels in the area that work with them and have given better rates and extra perks (like complimentary room service breakfast daily, discount on parking, etc). The piece of advice I'd give you is to be sure to thoroughly review the surgeon and his group before deciding to go with them. Just like anything else, Practice makes perfect and a picture is worth a 1,000 words. You definitely want someone who is doing at least 1 natural tissue recon a week (if not more), has excellent before/after pics that you would be thrilled to call your own (make sure you're looking at cases similar to your before to see the expected after), and who has satisfied customers (you can typically find plenty of us here). I am thrilled with my results from NOLA and would do it again in a heartbeat. Let me know if you have any questions!
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Hi Infretred, I agree with Suburb and Lula that you really need to do your research. First person on on this Diep 2017 thread is Maya15 in New York. She may be able to give you recommendations.
Just to provide another perspective... I heard great things about NOLA but for me traveling out of state was absolutely not something I would do. I found an EXCELLENT plastic surgeon, trained and experienced in microsurgery. I am beyond thrilled with my results and care. I reviewed so many different photos that I am confident my results are absolutely the best possible. I do think DIEP surgery is now becoming standard. If you are not inclined to travel I am sure you can find an experienced doctor, especially in the New York metropolitan area. Just do your homework. Good luck to you!
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Just checking in. My surgery on the 7th went well. I had a couple of problems but all in all, it's not as uncomfortable as I expected. I had to come home with a catheter in because I couldn't pee after surgery. Probably from the anesthetic they said. I have had many surgeries before this without that problem, so it was just a fluke that it happened this time. I think that the majority of my discomfort is from the catheter and not the surgical sites. I'm staying at my parents house till I get rid of it since I have 3 dogs in the house and don't need them getting caught in my tubing. That would really hurt. Monday is my recheck with my surgeon and with urology. I can't wait. I was wondering about how long I have to wear compression after this surgery? I'm sure she will tell me on Monday but I was just wondering.
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Help. I had my Stage 2 on October 2nd. I had dog ears removed, fat injections to my abdominal scar and right breast divot and lifts for both breasts. Both boobs went from D to B/C. Initially, stiches under each breast would not dissolve so they had to be removed manually. Now I have wound openings under each breast. The one under my left breast has grown from the size of a dime to now a half-dollar. I am using a silver dine cream (?). I am so scared. Does anyone have any wound healing advice? Thank you. Lis
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Hi all. Cwayman650, I hear you. I left the hospital after my BMX and DIEP with a catheter (plus 4 drains and a pain ball, wah!). The catheter is so uncomfortable that you do forget about any other pain or discomfort. Have a speedy recovery. I hope you get rid of yours soon.0
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Infreyred- below is a suggestion. I do not have personal experience with this surgeon but you might want to do some additional research on him. Like everyone else stated, do your homework and make sure your plastic surgeon is an expert in DIEP Flap surgery. I would think the NY area would have many options. Good luck
Joshua L. Levine md, facs
3 Columbus Circle (1775 Broadway Between 57th & 58th)
Suite #1410
New York, NY 10019Phone: 212.245.8140 | Fax: 212.245.8157
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LiLI-Ri I would call my surgeon about that tomorrow as soon as they open. Sometimes it is better to ask the doctor instead of the average person, even if we have had a lot of experience.
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Lili, I suggest asking about a wound specialist. I had a wound that I packed for over 8 weeks under my PS guidance. It did not really show much improvement until he finally ordered a wound vac and it was healed in about 3 weeks. My entire lower incision of my second flap opened up when my staples were removed.
Good luck and let us know how it goes.
I remember you from back in August 2014 when I was dealing with this wound.
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infreyred- make sure you are 100% happy with the before/after pics of DIEP/GAP surgeries done by whoever you choose. Not just happy with how they look considering you’ve had breast cancer. Going through natural tissue recon, you should be thrilled with the results. There are many surgeons out there that can give you that result. Look for online reviews of the surgeon too-and not ones that are on his/her site or affiliated with his/her site. You & your insurance company will pay the same amount for a “meh” result as you would for a “fabulous” result.
Cwayman- my stage 2 discharge papers state 2 weeks in the girdle 23/7 (1 hour out of it for showering). Then I can wear spanx with the same coverage range (high waist extending to the knees) for 4-6 weeks 23/7. I find spanx always roll up on my thighs and down at the top and are just super uncomfortable for me. So as much as I dislike the girdle I think I’ll stick with it the whole time.
Lis-definitely call the dr in the morning. Better to catch any problem associated with incisions early! Is it possible that your bra was rubbing the incision causing it to open up? I wear ABD pads across all my incisions under the bra and girdle to pad the area, keep the garments from rubbing and to avoid skin irritation in general. You can get ABD pads from your surgeons office or at a medical supply store
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Any suggestions on where to find online reviews of a surgeon? Are there sites that have them? TIA
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I just did google search “reviews Dr. John Smith Anywhere town" or “patient reviews Dr John Smith Anywhere town". It's amazing the number of sites that have dr reviews. This of course was after I had researched the dr and his/her qualifications, before&afters and practice to determine if they were a viable option to investigate.
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Ok, I've done that. I was hoping there was something that was a little more official. Gotta love the medical community.
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