DIEP Flap Reconstruction 2017
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CAdrmn - welcome! I'm here doing the same. lol
FaithWalker22 - for my mx I got one button up after reading on here. I never did were it. I ended up just wearing large stretching pj tops. I had a pant/top set from costco that was super comfy. I just lived it....I also work from home... lol I pretty much wore what I wanted, just nothing tight. When I had problems was when the bandages came off....the skin was unbelievable sensitive. I ended up wearing a tanktop under my shirt and sewing a little pillow for in the car. the seatbelt was too much...this was only for a couple of weeks then good to go.
Does anyone know if insurance covers flights/transpertation to Nola if you have zero doctors in your state and most surounding states able to preform DIEP? Also, does Nola take payments/sliding scale ect? Or want the full amount up front? Trying to find the right insurance for the new year...nothing in my county has less than a $5000 deductible...and they basically pay nothing until that is met.
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BBB18: DIEP vs implant, single vs double is very much a personal decision. I had breast cancer in the right breast, no signs of any thing in the left. My breast surgeon and the well regarded plastic surgeon he referred me to both had a bias toward double mastectomy with implants. When I asked about flap, the PS gave me a recommendation for another who does this surgery (she doesn't). After much discussion, reading and soul searching, I settled on single mastectomy with DIEP flap reconstruction. Once I told my breast surgeon my decision, I felt 100% better which told me it was the right decision for me.
Due to needing radiation, I had a tissue expander put in at the mastectomy in Sept 2016. My mastectomy was tissue and nipple sparing. My DIEP is in 11 days and my plastic surgeon plans to go in at the same incision - in the breast fold. I'm in my mid 50s and active (swim, run, bike, yardwork, etc) and I have been aware of the expander every day that it's been there. I realize that implants can't possibly be this uncomfortable but ... flap is the right answer for me. I did consider a double mastectomy with DIEP flap but I would have ended with significantly smaller breasts (closer to A than my current D) and honestly, I wanted to retain the left breast for feeling.
Good luck with your decision - and any additional cancer treatment you may need.
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BBB18, Sorry about your diagnosis. It is tough time to decide on plan. I will share my story in case it helps... I had breast cancer in one breast. Almost decided for double mx but it seems so irreversible and drastic to me. I felt I could always have second surgery is needed. So last minute I decided for uni mx. It was, by far, the best decision! I have loved having at least one of my original breast all these years. Finally I had Diep reconstruction and now have pretty excellent match with good breast. I wish you peace in all you decisions and healing in your journey.
... also, best wishes to all the ladies getting ready for surgery and in the middle of treatment. I am sending you allhealing thoughts!!!
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CAdrmn- i had BMX w/ immediate DIEP recon at NOLA in Feb with stage 2 Nov 2. I will try to answer your questions but it can be different for everyone.
“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?" When I woke up they felt heavy and like they were just laying on top of my chest/ribs. Over the next few weeks they felt more like a part of me vs. just laying there. By 12 week I was good to go and thought I was back at 100% as far as them feeling like me. Did stage 2 Nov 2 and boy was I wrong-I was probably more like 75-80% feeling like me and now I'm 100%. No it does not feel like a boob shirt. Pressure? Yes (like they're laying on your chest-at least for me in the beginning). Feeling in them-no, (operative word being 'in') but most of the skin has feeling so you can still feel touch. No feeling 'in' the breast is true for all MX w/recon no matter the type.
I know I won't have nipple nerves anymore, but will I feel a pinch? No you won't. But they do respond to cold and touch.
Also are you happy with how your nipples look after reconstruction? yes, but I also had nipple sparing mx so they are my originals.
Feel free to ask additional questions or PM me! Who is doing your DIEP at NOLA
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greeneyes- here’s what I have researched regarding your questions:
Does anyone know if insurance covers flights/transpertation to Nola if you have zero doctors in your state and most surounding states able to preform DIEP? Maybe. Depends on your level of coverage. Mine did not but I’ve heard of others whose insurance did. You’ll have to read your policy or call & ask. If they don’t, save your receipts so you can submit it for a possible deduction on your taxes.
Also, does Nola take payments/sliding scale ect? Or want the full amount up front? Yes they do have payment plans. You just need to ask Vickie about it. They will likely want at least 1 payment up front.
Trying to find the right insurance for the new year...nothing in my county has less than a $5000 deductible...and they basically pay nothing until that is met. Vickie should be able to tell you which plans they’re accepting in network next year. Some are national plans like Cigna that they take where the center would be considered in network to help avoid additional costs. And if you go with one that’s out of network you can apply for coverage as out of area since no one local to you does the surgery. This would mean the insurance company would reimburse at a higher rate than out of network.
Hope this helps!
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Thanks Lula!
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LMichelle, tell me more about this nerve transplant! I'm so curious to what that might mean, feeling wise.
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I had my 2 week post Stage 2 follow-up with my PS Wednesday. Everything is going fine and my pain from Lipo is pretty much gone. We set February 15th for my tattoo. Then if need come back in 2 months if need to have any follow up if it fades. I am curious why the tattoos only last 4-5 years. I thought tattoos in general last a lifetime. My son has one on his leg and I have never heard that he has to go in every 4-5 years. I didn’t realize this would need to be redone every 4-5 years. What does everyone else’s PS say?
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My understanding is that medical grade ink fades faster than a tattoo artists ink, that's why a lot of people go to them instead. Sometimes they do better work, more realistic as well. There are a lot of threads on this site about that.
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Vinnie Myers is a legend in the 3D tattoo world. He has a partner now too who recently posted on BCO. I’d want to see the surgeon’s work and compare it to Vinnie’s. I literally could not tell Vinnie’s 3D tattoos weren’t the real thing.
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My Vinnie's are going away tomorrow
they were good. but not covered by insurance, next time will try the insurance covered tattoo artist!!
Twills I am not sure how long it will take till I can answer! i am a lucky gal to be under the care of a surgeon trying new techniques...
(Suhail Kanchwala - University of Pennsylvania)
I have nothing to lose! I hope it works but not sure how long it will take for the nerve transplant and the "delay of flap" procedure to be the standard of care.
tomorrow I lose my FAKE BOOB IMPLANTS! I am so ready!!!
Peace and health to all
Michele
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JBDayton: if you have time to edit the list: the surgery I had on 11/20 has a name, I hadn't realized! I think I am the 20th person but I guess it's a thing now...
it's called "Delay of Flap"
not sure if anyone will be searching for info anytime soon but I am hoping to be a resource!! actually to think of it as snipping a few blood veins turns out to be an understatement of course,
Peace,
Michele
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Good luck Michele, hoping all goes well for you.
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LMichelle- I thought they were removing your implant and replacing with a smaller one with flap on top? I would think it would be similar to skin sparing mx at that point. If you’re staying the same size the incision should run from bottom center of nipple to chest and maybe into intramammary fold. They usually try to reduce/limit the number of incisions on the “top side” of the breast. Hoping you end up getting to keep your Vinnie’s. Good luck tomorrow!
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Hi All.
I just wanted to introduce myself. I have been reading all your posts over the past few months and greatly appreciate your candor and willingness to share your experiences and knowledge with the rest of us. I just received the call Friday that I my BS and PS have received authorization for a prophylactic BMX with immediate DIEP reconstruction, and they have put me on the schedule for Dec 18! I have been contemplating a prophylactic mastectomy since my mother's death from Stage IV BC in July. My older sister was diagnosed with stage 1 at age 38, and my mother with stage IV at age 66. My maternal grandmother had died in her 70's of metastatic cancer (my mom never found out what the primary CA was). My sister tested negative for any BC genes, so the genetic counselor did not recommend testing for me. Due to my family history and dense breast tissue (I always found it ironic that my 34-nearly B's could be described as extremely dense
, I have been undergoing yearly MRI's alternating every 6 mo with yearly mammograms for the past 8 years, and just underwent my 2nd biopsy in Sept due to yet another new lesion on the MRI (which turned out to be benign). After watching my mother succumb to metastatic BC, and after realizing that at 43, I have at least another 30 years of MRI's with ensuing biopsies ahead of me, I decided on a BMX with reconstruction. I also have two sons, and I want to do everything in my power to ensure that I'm around to see them grow up.I'm sure I will have many questions and concerns as the date nears, so I wanted to establish roots here. I feel I already know some of you just from having read your posts. For those of you with approaching surgery dates, good luck, and please keep us updated on your recovery.
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Hello GagasDaughter, welcome! I hope you find peace with your surgery. I am sure just the "lack" of MRI's and mammo's ect will be HUGE! So glad you were able to find the best thing for you and your situation.
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Hi aquilegia,
I'm in the San Jose area with Kaiser insurance & I'm considering bilateral prophylactic mastectomy, possibly w/ DIEP flap reconstruction. Would you be comfortable sharing which Kaiser facility you went to, which doctor(s) you have, and how you feel about the results of your reconstruction? (Or I can private message you if you prefer.) Did they do the stage 2 phase that others in this thread describe, to revisit and improve some of the cosmetic aspects? Do you feel that you look pretty proportional as far as chest, stomach, hips, etc.? I know the main thing for all this is to be healthy and protect myself from cancer, but I have to admit the aesthetic side of things matters to me, too. I wouldn't have thought to even ask about all these questions about appearance till I read this thread. It sounds like some people have not been that happy with how they looked overall after DIEP, while some felt that everything flowed better after stage 2. Thanks so much for your help!
(I just joined and don't have a signature yet, but I was recently diagnosed with LCIS. Due to family history I did genetic testing. No mutations, but a variant of uncertain significance for NF1 and I'm being assessed by Kaiser genetics to see if I have neurofibromatosis type 1. I'm not sure if Kaiser will approve BPM, but I'm leaning toward requesting it because my lifetime risk is pretty high and I really want to stay healthy for my family, especially my toddler son.)
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thank you for your reply greeneyes81!
I totally just deleted my post because I was embarrassed no one had answered and I thought I did it all wrong! I swear I feel like I don't no what I'm doing! I put my initials in the signature line and I can't figure out how to get back there to put my diagnosis! Lol! I'm a mess!
This reminds me of AA it's an exclusive club that totally sucks being a member but it will save our life and we are all family because of the bond we have does not discriminate; not age, race, income, looks or even sex.
Here I am, your new sister. I just want to say that I appreciate all of you for sharing your experience strength and hope.
I see my doctor tomorrow and a plastic surgeon for a consult tomorrow. I'm now thinking a lumpectomy lift and lift reduction on my good side (which is already a good half size bigger)
I will update tomorrow night!
Lov
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Lula....OMG!
Thank you for all the info!
If I have it done it will be Dr.. Robert Allen. From what I understand he is the founder of this procedure.
I keep going back and forth. I want to have it done for peace of mind more than anything but i always start thinking I'm not sick enough. I just do that, self worth issues etc.
Great news about the nipples reacting to cold! I didn't know if all the nerve function would be gone.
I read some older posts from 2012 discussing wether Tricare covers the diep flap on the unaffected breast or even at all. My doctor told me it is LA law that both breast are to be included as part of the reconstruction process if a woman chooses to do so.
Does anyone know where I can get more current info regarding Tricare? I have been around long enough to know to wait until I have the prior auth in my hand before doing anything. I just don't want to waste the doctors time if it's a no go. Plus curious about the auth wait times situation s etc.
Thank you so freaking much!!
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Hi everyone. I had my stage 2. It lasted about an hour and a half and included 1.) removal of a large lump of fat necrosis on the top pole of one breast; 2.) nipples reconstruction; 3.) reduction of flesh under right and left arms; 4.) Reduction of right dog ear; 5.) lipo on the Ken doll cod piece; 6.) and clean up of left dog ear where wound had not healed from drain to clear up an abscess. The pain was intense immediately after the surgery once I woke up, but is now under control. I have a few steri-strips on the abdomen line and my chest is wrapped with gauze and flexible rubber like tape. I can shower in two days.
I can't comment on the results other than the thought that this was the last surgery made me incredibly happy and gave me an overwhelming sense of relief. Yes, it's early and I could be celebrating prematurely; however, Iam very happy.
Special thanks to everyone that posted about stage 2 and sent messages on the topic which were very helpful. I will post comments about results soon.0 -
CAdrmn- where do you live? Dr Allen is s gem for sure!
Suburbs-do glad you’re doing well. That feeling you’re talking about is a good one - kind of hard to des ribe - but welcome to the post stage 2 club!!!
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LL99L - I sent a private message.
I'm not saying that Kaiser does shoddy work - it's just a big organization that puts a premium on efficiency. I'm fine with the results, and expect that the Phase 2 touch-up will solve most of the little issues.
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I'll be scheduling my DIEP surgery soon and want to make sure I have it early enough next year so I'll have time for Stage 2 and any subsequent surgeries within the year, for insurance purposes. Is that time frame doable? What's the General time frame between stage 1,2, and nip recon(if I decide to do that)?
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TWILLS - my doctor said we'd evaluate any touch up needs about 3 months post DIEP. Timing may be driven by complications or just regular healing. You should also consider the time between radiation and DIEP. My doctor wanted at least 6 months. My DIEP will be 8 1/2 months after my final radiation treatment.
Good luck on the scheduling.
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Runrcrb, that's about what my PS said for Stage 2. The earliest he will do the initial surgery after rads is 3 months, that puts me mid January.
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TWills - my PS said to wait 6 months, to allow the scars to become less pigmented so they can decide if fix-up is needed. I would not have been ready for Phase 2 at 3 months, as it took almost that long for a necrosis area to heal on the breast seam. Nipples or tattoos can be done at Phase 2 or any time afterward. I decided to wait, since I had UMX and want the aureola and nipple tattoo to match what the other breast looks like after lift/reduction.
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TWills- 3 months between stage 1&2 and if you need any additional tweaking to stage 2. About 2 months in between for tats.
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Thanks everyone:)
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Thanks aquilegia! That's helpful info. I'll respond to your PM.
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Looks like I will be joining this group. I had my first consult with PS today. I had already decided I wanted BMX, even though only one breast is affected. I’m only 40 and already had one scare with the other side earlier this year, I don’t want to be dealing with this forever and it’s not like my existing breasts are anything to look at. Originally I had wanted to go with implants, the idea of using natural tissue just seemed like more hassle and pain to me, but after meeting with the PS today I am realizing that the DIEP will have a better long term outcome for me. A few more weeks of post-op now will pay off in the long term. I’m still hopeful that we will be able to get it done this year, but thankfully my max out of pocket is pretty manageable so it won’t be the end of the world if I have to wait until January. We had already planned to meet that by Easter because of the annual tests I have to have for my ulcerative colitis.
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