DIEP Flap Reconstruction 2017
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Oh wow Lula!! Thank you. I have some great questions for the doctor that never occurred to me.
I am planning on going to Huntsman Cancer Institute in Salt Lake. This doctor was a 2nd opionion and was like day and night compared to the first doctor I saw an Idaho. All he does it all for reconstruction surgery due to cancer where is the first doctor I saw does it all and only expanders for cancer reconstruction.
I just don’t know how to find some one that can stay with me after I am released from the hospital. Going to have to work on that part.
Expanders would be easier...just a few short trips. I just am Worried about a foreign object in my body and one implant one regular breast. LOL I can’t imagine having one implant is going to feel OK if I want to keep my remaining breast.
For all of the liposuction, I’m assuming your sedated for that? Just an out patient surgery?
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Lula73- I am wearing an abdominal binder like I used after Stage I. I am not sure what you mean by a girdle. I am going to talk to the surgeon about it when I go back Wednesday. The binder doesn’t cover the whole area that I had lipo. I was overweight before my DIEP surgery in June. I’m not sure how much my body shape will change until I take more weight off. My stomach is smaller where I had my tummy tuck. After Stage 1 my pants would fall down to where my incision is lower on my stomach. I had a bulge above my incision and below in my pelvic area. I don’t really have a waist. The surgeon said he would not be able to do much about it but would take some fullness out above and below my incision. I don’t expect to come out looking slim and trim but would like my pants to stay up. I’m sure they can only do so much and have it fall under my insurance coverage. I am just hoping to feel normal when the swelling goes down. I think after dealing with this the last 6 months and not sleeping well that I am just discouraged and tired. Then I remember those who are dealing with so much more and am ashamed for feeling the way I do. Thanks everyone for listening!0
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Rlsteadman - Sorry your are discouraged from Stage 2 surgery. Unfortunately, 7 days is not enough time to get water retention out of your system. Try drinking Gatorade or other drinks with electrolytes to help remove excess fluid in your body. The anesthesia causes our body to retain lots of fluid. The nurse told me the fluids given during surgery are not hydrating. My doctor told me to drink Gatorade and the fluid started coming off my body. I was drinking too much water thinking it would help, but once i drank at least one electrolytedrink per day, I was able to shed 20 lbs water weight gain from Stage 1 surgery. Are your ankles swollen? That is one way to know if you are retaining water.
My Stage 2 was more difficult for me. My nerves were more impacted in Stage 2. I had an itching, burning feeling in my abdomen area. It would move around and drove me crazy. It lasted about 5 days, and then just stopped. It is the nerves in the skin and abdomen area trying to rejuvenate. I did not have this after Stage 1. I had a Stage 3 on Oct 20, and the nerves did the same thing again. It lasted about one week. I hate that feeling. Keep wearing a binder and girdle (I bought Marena LGA2 online) because you might notice more swelling after 14 days. I’m still wearing mine for at least 6 weeks post surgery.
Good luck and I hope you feel better soon. Stay positive
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Greeneyes: After Stage1 DIEP my breasts felt awesome! No change from original feeling. Only numb.
RISteadman: I had Stage 2 on 10/2 and I am still recovering BUT only because my body takes time to heal for a variety of reasons. This weekend I finally feel good. For me, the stitches would not dissolve so each week they had to be manually removed. I love my results. Just have patience. Stage 2 surgeries vary for each. I am sure you look great and I hope you recover as soon as possible
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I’m having DIEP 12/8. I’m currently a D but since I don’t have a lot of tummy tissue the best I can be is a B. I can’t do a TUG because one thigh has placque in the artery. I’ve seen posts that talk about breasts dropping in size post surgery. Is that because of swelling? Or will I wake up to a B and then see them drop to a A? That would really disappoint me. I’m okay not being a D again but dropping to an A would be way too dramatic.
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Good questions FaithWalker. I am/was a DD and the doc says I would be a C. I'm good with a C but would not want to wake up smaller either.
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I had my consult for DIEP but didn't quite understand where and what shape exactly my incisions will be, I know it might vary a bit but I was wondering if there is somewhat of a typical pattern. I had skin and nip sparing BMXbut Dr said because of rads I would most likely need to lose the nip and some skin for the best outcome. I know he said the bottom incision would be just below the old BMX incision just under the breast I just don't understand how the upper part might look. I've looked up random DIEP photos and I even looked at a few of the Dr's previous surgeries but it really didn't register while I was at the appt, too overwhelming I guess. Also, do most of you feel like your surgeon gave you a legit tummy tuck or just a means to get the tissue needed for the reconstruction? I mean, can that really be a perk? I'm having trouble with that part of it, just seems like more recovery and no benefit.
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Green Eyes: I am here on this thread cause I am going thru this to get rid of my implants. If you are having a uni I would especially encourage you away from implant, if possible. They really aren't that similar to a natural breast. Also: the tissue expander under the muscle wall is no walk in the park it hurt alot after the surgery. The expansions don't hurt much, but they make you feel like you're in a vise. The muscles never really like having something underneath, I feel tight and pokey feelings all the time. Also: I wound up in PT last year with shoulder pain, turns out my tight pecs had rotated my should cuff forward which took a lot of work to correct. I know you are going through alot but take it from me I really wish I had done the flap in the first place.
best,
Michele
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Faith,
hi again! I don't know if you did/could/would consider. My doc is doing a dual thing: DIEP on top of implant. The smallest implant they make I think he said 150 cc. this will be ON TOP of muscle wall, held up by some kind of a mesh product then the tissue transplant on top. My current implants are 550 (SO READY TO GET THEM OUT from under my muscles). I don't even mind having an implant still since it will be onto top so I won't feel it. The 550 implants are approximately a C cup. I haven't worn a bra for years! one of the best benefits of sub-muscular implants to be honest! I am 5'8" and about 175 lbs. I kind of let my weight go up this year due to the impending surgery. He said if I am okay with doing an implant I can be about the same size and he doesn't have to be so aggressive in the tummy. Ugg. It's all so crazy. I am relying on the many many many stories of women who are happy with their results, to get me thru. That and ativan.
Michele
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Thank you LMichele- I think I am trying to talk myself into the implant as it's "simpler" and I think I am scared of the recovery/time in surgery. I also am not sure how I can manage to have someone help me for close to two weeks between the hospital and local hotel stay. The closest doctor, which I like thankfully is six hours away. It's the logistics!
It dawned on me today I would have a one side "feeling" of implant with a "normal" breast. That seems like it would be more odd with one sided than having implants on both sides.
How long is the DIEP from begining to end on average? If I got started say end of January, would I be done by the end of the year? Don't really want a 3rd year meeting a $7000 deductable. lol I understand crap happens, just average time frame.
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Rlsteadman - Yes I'm in a full on girdle - high waisted hitting just under by breasts and extends to just above my knees. I thought they were pretty standard after any lipo to cover any areas that were addressed for 6 weeks. My post-op instructions state I can go to spanx type girdle after 2 weeks, but my body and spanx don't get along very well - they roll up on the knees and down on the waist so not what I need right now. The one I'm in now that the PS gave me is made by Design Veronique. The girdle helps with swelling and getting your skin and underlying tissue to heal properly together now that they lipoed the fat from in between. As far as the abdominal issues you mention with the bulging above and below it may have some to do with the technique your PS used. He may well be able to work some magic. I can say for me, I was 168lbs at 5'5" with 36C breasts and carried most of my weight in my lower tummy, hips and thighs. My tummy is completely flat (and has been since stage 1), my hips are nicely sculpted and thighs were sculpted to match in stage 2. If you go online to www.breastcenter.com and click on the before & after photos link for DIEP flap, the pics are pretty accurate. If they are remarkable different from what you have and you are similar in size to me or any of the ladies on the site, I'd ask your PS why you're not seeing similar results or can you expect to see similar results. Or better yet, that you expect to see similar results.
Faith - They could also do a stacked flap to achieve larger breast mounds closer to what you have now. Stacked flap is often DIEP + SGAP. The other thing to remember is that during stage 2, you'll likely get a lift which will increase fullness to some extent (provided you don't opt for reduction). Stacked flap would also mean you would have 100% natural feeling breasts as no implants are involved. As far as shrinkage...you will wake up very full of fluid and swollen. They will shrink from what you see when you wake up, but not beyond what the tissue is. So you may wake up a size larger than what was projected by your PS and shrink to the size he projected. I hope that makes sense.
TWills - You're going to Moffitt, right? It seems like every PS that does flap recon has a different strategy. I could show you pics of my chest and abdomen/hips but how they do things is NOLA is not necessarily how they do things at Moffitt. Do they have a website with before & afters that you could view from home? If not, perhaps they will let you come in and just see the before and afters again with no copay since you're not seeing the doc or the nurse. I'd want that peace of mind well before surgery so I could ask any questions as they may pertain to me.
Greeneyes - Stage 2 is outpatient for some docs and a 1 night stay for others...just depends on their protocol. About doing a uni vs BMX, I also think it would be strange to have feeling in 1 but not the other. Also, you can only do DIEP once. So if you do uni and decide/need to have the other breast removed down the line you'd have to do a different flap surgery for it or do an implant. I obviously went with BMX and glad I did (I'm kind of a symmetrical gal mentally.) Yes, DIEP can be completed in a year. I started Feb 14 w/ stage 1, finished w/ stage 2 Nov 2. Minimum 3 months between stages. You may or may not need additional fat grafting down the road beyond the year, but no one can predict that. I would follow up with your PS in Salt Lake to make sure what his timeline is.
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Lula73, I'm actually going over to UF/Orlando Health in Orlando with Dr Klein, he used to be at Moffitt years ago. I thought I'd do as you said and ask to come in just to look at the photos again, I have to drive over for the CT scans week after next so I'll ask if I can do that then. The no coffee thing is a bummer! I haven't decided exactly when I'll schedule my surgery, mid Jan would be the earliest, but I know I'll have to wean myself off prior. Dreading that
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TWills-how much coffee do you drink? I don’t do coffee but I do drink Coke-at least 1 a day in the morning. No problem according to my docs in NOLA. Maybe you could just do that 1 “Get me going” cup of coffee. It’s worth asking!
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TWills and Lula73, I missed a post or two.....what's the concern about coffee pre-surgery?
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Hi. Was diagnosed September with breast cancer in my right breast. The way it was found was a miracle & life has been pretty crazy since. After biopsies &consultations, I need to have a mastectomy & I want to do immediate reconstruction. A friend of mine had a diep flap 10 years ago. After speaking to the PS, I’m nervous about choosing the diep flap over an implant. I like the idea of my own tissue but he made the implant sound a whole lot easier. I would really appreciate some input.
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I drink about 2 cups at the most every morning, not a lot but I need it! LolThe nurse told me at my consult that I couldn't have coffee for 6 weeks after surgery, not even decaf since it can still have as much as 3% of caffeine still. It's because of blood vessels and healing. She said it's just not worth the risk. I think I'll be fine not having it after surgery because I'm always very sick after and it takes weeks to get back to normal sometimes. I wouldn't try to stop cold turkey so I won't get headaches. I'm definetly going to ask again and make sure though.
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TWills- Got it. I switched to decaf post diagnosis. I think I'll take that 6 week no coffee advice as well. Thanks for sharing!
BBB18- My diagnosis was in September as well. While none of us want to be here, I must say welcome to a wonderful group that will help you as best we can. My first PS was really pushing implants too because it takes less time in surgery. He said he'd recommend implants to his wife or daughter and he even went on to say if I don't like the implants I could always do DIEP later-- as if I would willingly want to undergo another surgery. I am now connected with a BS who is also a PS. I'm having BMX and she's happy to do DIEP because she knows its what I want. Your recovery time will be longer with DIEP. Since I am single that made me nervous but then I decided to do to not fear overtake me. I made a plan to have the surgery I wanted even if it meant I'd have to get a home health aid to help me. Whatever the case, do what's best for you. Someway, somehow things will work out.
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Wouldn't want to put any undo suffering upon anyone, lol, it's just was my Dr suggested to me. I'm sure it's an over abundance of caution and some Dr are totally fine with a little. It's in my head though and I feel like it's not worth the risk. It's all of the little things that can make each step so much harder! Grrr
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BBB- shorter recovery time with implants but satisfaction with end result and how they feel is more important. What's another few weeks in the big scheme of things. No worry about capsular contracture, leaking, having to replace, etc. Natural tissue recon breasts feel, look, move and age just like the real thing. I say that as my 44year old self sits here typing with boobs that look like they did when I was 20! So maybe with the recon they do have the ability to dial back the clock a bit. So i guess that means when I'm 80, I'll have the boobs of a 56 year old! Worth every penny & extra week of recovery!
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I just got my stitches out today from my stage 2 which was done on Nov. 7th. I'm really happy with my results so far. My dog ears by my armpits are gone and so are the points on my hips from the ends of the abdominal incision of the stage 1 surgery. Plus my belly is fairly flat. Still swollen but no more muffin top. Looking in the mirror I finally feel like I look like a woman again without clothes on. Even with the healing incisions on all the parts that are still bruised, swollen and reddened. My plastic surgeon told me that I won't have the final results for about 6 months. She also told me that after phase 1. Rlsteadman, I'm a couple weeks ahead of you and I have the same problems as you're having but it is getting better. Some days worse than others and some days better. Just hang in there. It should just keep getting better, and be sure to tell your surgeon how you are doing. They should be able to give you some suggestions. I have found that if I just stand up slowly it's a bit better. I just stand or walk a bit bent over but it doesn't last very long.
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Cwayman650, very happy to hear things are getting better and that you are moving along with your recovery. I find that moving slower helps avoid pain as well. My stage 2 is scheduled for next week. I am trying to keep my emotions under control. Thanks for keeping us posted. This board is a life line.
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Greeneyes - for me, from first DIEP consult to last followup visit will be about 8 months (assuming Phase 2 results are good), so if you schedule it for January 2018 you will likely not have major expenses the following year. My PS wanted me to wait 6 months after Phase 1 for the scars to stabilize before doing cosmetic touchup and lift/reduction on the other breast. There will probably be a few followup visits afterward, and I'm planning to get nipple tattoos later, but most of the cost will be the first year. I didn't have to worry about cost since I have Kaiser and the cost for everything will be about $500, but that's definitely a consideration if you have a high-deductible plan.
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Agree on nixing the coffee for 6 weeks, also chocolate, Coke, etc. which have caffeine in them and antihistamines which all make blood vessels contract. You want to treat that flap really carefully the first few months, as it's establishing its new blood supply. Think how terrible it would be to lose the flap, which my PS said only happens to his group in about 3% of DIEP cases. Tylenol can help with the caffeine headache.
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wow, I need to figure out how to get Kaiser lol ty!
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Well, there are tradeoffs with Kaiser for sure. They have a center here in N. CA that is specifically for breast cancer, so the surgery goes smoothly and the PS are very experienced in the microsurgery techniques. I'm happy with the quality of care and results so far. But comparing my experience with accounts here from women having DIEP at specialty clinics like NOLA, Kaiser isn't as customer-oriented. I don't get the warm fuzzies that they care that much about the cosmetic appearance.
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i am pretty sure I'm going to do a bmx with diep reconstruction. My dr. Is in NOLA But what will my boobs feel like to me? Will it feel like I'm wearing a boob shirt, just pressure, or will I have feeling in them? I know I won't have nipple nerves anymore, but will I feel a pinch? Also are you happy with how your nipples look after reconstruction?
I go for my consultation next Friday. So here I am in the middle of the night again with questions running through my head! Lol
Also considering a lumpectomy with lift and reduction.. I keep thinking I'm not sick enough to choose a bmx.
I found this blog today and am so happy to read true experiences; not just facts.
Thank you
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How long did you wear button up shirts? Was it for the entire recovor until the drains were out? I’m trying to figure out how many I need
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Hi faithwalker22. I had one button down shirt dress and a button down tunic to wear to appointments. Until the last drain was removed after 4 weeks, I could only wear very loose 100% cotton button down pajamas or men's dress shirts around the house. Have a speedy recovery and best wishes.0
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After DIEP I did fine with tunics. I did have four nodes removed and dissected, but for some reason it did not affect my range of motion in arms, shoulders, anywhere.
I still made sure I had help getting the tops over my head in week one, didn't want to pull anything that could compromise the noobs--but, honestly, the larger tunics were already in my closet (was a Lularoe junkie for a while) and I had plenty of leggings/jeggings--so I belted the drains around my waist with string and safety pins, put on the leggings, tucked the drains into the leggings (I had three for almost three weeks) and put a large tunic over the whole deal along with a longer open front sweater (have three or four larger open cardigans) throw on boots and maybe jewelry and I looked okay--put the drains to the side and the sweater assured the outline of the drains was covered.Got through the Thanksgiving my daughters and their families brought to us and to a short time with my husband's family. DIdn't sit much as getting up was pretty painful those first two weeks. I bought button up shirts but I hate them, so I can't imagine myself wearing them. With the light dripping I had now and then, I don't think my husband wanted his shirts with those dotted stains, especially since I couldn't do laundry for over two weeks.
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BBB: sorry to hear about your diagnosis. it's a rough time for sure.
Well I am going in Monday for my DIEP flap and I can't wait to get the implants out!!! Yeah maybe the initial recovery was shorter in that I went home from the hospital from the BMX sooner but it was a BITCH having sub-muscular tissue expanders it felt like I was being squeezed to death. then the trips for expansions and the exchange for the implants.... I definitely made the wrong decision for me, a youngish (46) athletic person. Plus over time they became more uneven and misshappen and totally unacceptable. They were supposed to last 10 years I am having them out at 6 wish I had done it years earlier. So: my unequivocal point of view!
I had my (second) pre-op yesterday and I got some good news: My doctor is planning to do a nerve transplant! there is no guarantee it will work but if it does that would be amazing! I barely remember what it's like to have flesh on my chest and if it didn't have to be numb that would be great!
My office co-workers were just awful yesterday, my last day before being out for 4-6 weeks. They went on a "meeting" which I wasn't invited to and it was a "business meeting" at a new supplier: a local small batch vodka distillery. No lunch, no card, no good luck, no one was even there to say good bye. It stinks to be so wound up and upset right when I am about to under go this major thing. I should take this as an opportunity to re-think who I want to surround myself with on this journey called my life.
Peace~~
Michele
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