2018 DIEP Surgery
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Welcome mrslaariz! Just my perspective, but DIEP is kind of like having a baby. In the thick of things during labor you're all like what have I done? Why did I do this? Then after it's over the memory of labor is not as intense and starts to fade and the reward was worth it. We are early into 2018 yet so a lot of us are just starting our DIEP journey and you're not getting to hear the other side of things yet. And we get very real on this thread right there in the thick of things. I am on the other side and for me it was all worth it. 6-8 weeks is the usual minimum time out of work for stage 1, and 2 weeks is the minimum for stage 2.
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kahnartist: I am so sorry to hear about your bump in the road. This process is different for everyone, and I havehad many bumps since 2013. Trust your instincts. Sending lots of prayers and good thoughts!
Thinking of everyone and their healing processes! I am here for all questions. Best, Lisa
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Welcome mrslaariz.
I have diep surgery scheduled in nola in may. They assure me I will be up and about in 4 to 6 weeks. Yea it's a scary procedure. But so is mastectomy. Ditto for chemo. The difference is, this procedure will bring you closer to your normal pre op condition. I just watched a you tube video that was great. Cathy golden discussed her diep surgery.
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Hello Everyone!
I am new here. This is my first post, though I've been lurking for a week or two. I am so impressed by your courage and your support of total strangers. Thank you so much for being real and for sharing your experiences -- both the good and the bad. That kind of support is one of the real silver linings I've found as I process this whole breast cancer mess.
I was just diagnosed on Feb 12. My mammo showed an area of calcification, and my U/S showed a mass -- both in my right breast. Biopsies revealed that they were both malignant. I had an MRI a couple of weeks ago that found two other "areas of concern" also in my right breast. Left breast looks OK as do my lymph nodes.
Due to the multiple tumors, I've been advised that a UMX is the way to go. I will be meeting with plastic surgeons today and tomorrow to discuss reconstruction -- one has expertise in DIEP and the other in implants. My husband and I are leaning toward DIEP, but I had a few questions that I was hoping someone who has gone through the process could answer. I am not one of those women who is not attached to her breasts. My breasts made an entrance at age 12 and have been a pretty defining part of my sense of self since then. I am working on the whole "I am a soul, I have a body," but it is a work in progress and I'm not quite there yet.
Anyway, here goes...
- I've read several accounts of women being happy with their results. Are you "Absolutely happy," or is it a qualified happy?
- I am assuming that any back fat or love handles are still there after surgery. Does it look/feel strange to have new boobs and flat belly, but still have other areas that didn't change?
- Do the scars really fade?
- Has anyone had stretch marks in the transplanted skin? How do you feel about that?
- How long were you unable to drive? What is up with the no driving thing anyway?
- I'm still making my way through this thread, so please forgive me if these questions have already been answered elsewhere.
Thank you all again for your support. I hope I can pay it forward.
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Welcome mrslaariz and cev20 to our community.
You may find some helpful, additional information also here:
We are happy you found this incredible group who will help guide and support you on this path.
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welcome cev20! I finished my DIEP journey in Nov 2017. Your post was timely because another woman going through DIEP that I know was just asking these same questions and we looked pretty similar post stage 1. I was reassuring her that they will even out those other areas (waist, hips, thighs) and make you proportional again in stage 2. Please note though that not all PSs who do DIEP offer this and get it covered by insurance so be sure to ask. (If you go to NOLA, they do get it covered.)
We exchanged before/after pics and it wasn't until then that I really looked at my before BC photos and my post stage 2 photos and realized how much better my breasts look after this whole ordeal. I am definitely very happy with my results! Just hate I had to get BC to get them.
Yes the scars really do fade (I'm 1 year out from stage 1 & 4 months out from stage 2 and the tummy ones are not very noticeable at all and the breast ones are still a little pink but mostly faded.)
I tried driving at 4 weeks post-op. I could do it but it was not comfortable. Who knew you used your tummy muscles so much to just drive the car?!? The other parts of the no driving is if you're on pain meds druving is a no-no, and slower reaction times if you're still having any upper body pain especially when using the chest and arm muscles.
If you are eligible for skin and/or nipple sparing mx, definitely go that route. That way you don't have to worry about that stretch mark question. They will basically scoop out all the breast tissue and then restuff the breast skin with tummy tissue and connect the blood vessels (that's a very simplified explanationn just for the record). Have they said if you'll do chemo or rads?
One thing you didn't bring up was UMX vs BMX. DIEP can only be done once. Should something start brewing in the other breast and it needed mx too you'd be looking at a SGAP recon or if not enough tissue there, an implant on that side. Something to consider.
I hope my answers help! Feel free to ask additional questions
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cev20,
A lot depends on your physical make up. Talk to the PS about physical concerns. I had single mastectomy and DIEP reconstruction. Am very happy. Single mastectomy with implant reconstruction will never match your natural breast as well as flap reconstruction will.
My recovery from DIEP was easier than mastectomy. I may be an anomaly. You can search on my user name to see an earlier post I made.
No driving while on pain meds or with drains is a good guide.
I am very happy that I went with DIEP.
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Hello all, I live in Boston and had bilateral mastectomy (left prophalactic - for DCIS in 2001). I had immediate reconstruction with silicone implants as at the time I had two small children who needed me and the DIEP reconstruction was relatively new and little tested. Over the years the implants have never been completely comfortable and there have been a number of infections on the left side with the most recent causing contracture. It is larger, hard and tender. The right too feels tight. I am looking at breast surgeons in the Boston area to perform the DIEP reconstruction but everywhere I look the breast centre in New Orleans NOLA breast restorative centre - seems to be the one of choice and THE centre of excellence for the procedure. I have Blue Cross PPO and the NOLA is out of network - I was told the maximum cost to me if the NOLA centre is out of network will be $7,500. - does this sound right.
I'd be so grateful for any help. I've only moved to Boston in August last year so I have little knowledge of this system here.
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Thank you, Lula73! That definitely helps. I'm so happy that you are satisfied with your results!
I just left the implant guy's office and he made a compelling case. His plan is staged mastectomy on the right to conserve the nipple, then reconstruct with implant; and reduction/lift on the left. He cited surgery time, hospital stay, and recovery to make his case.
My appointment with the DIEP guy is tomorrow. I'm hoping he is as compelling because I hate the idea of one natural and one implant.
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Cev20, did implant guy warn you about the implant being cool to the touch?
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Thanks, Runrcrb! Thank goodness your recovery was uneventful! My main concern is ending up with a matched set, so I'm very optimistic about tomorrow's appointment with the DIEP surgeon.
Also, you guys have me seriously considering investing in a recliner.
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cev20- purchasing a recliner is worth it-just make sure to get one that’s a power recliner and comfy too. DawnAnn also makes a good point about the implants. Cool to the outside touch and cool to the chest wall.
ColettePeter- Welcome to the group! if $7500 is the number Vickie quoted you, jump on it and get on the schedule! The amount you pay is the amount she quoted and they do not balance bill. The docs at NOLA are worth every last penny. Those before and afters on their site are the real deal-I’m living proof and no one does more of these procedures than they do. If you read my reply post above to cev20 that went on the board around lunchtime, you’ll see that I went to NOLA and they do it all. Their goal is that you look as much like your old self (or better) when all is said and done. That includes ensuring your lower half is taken care of as well. It truly is about restoring you.The center makes traveling for the procedure easy as well. If you have any questions, feel free to ask!
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Dawnann, no. He didn't.
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Thank you Lula.
Yes, I am wondering what I am getting myself into but good to know that it is worth it when it is all said and done.
I am now looking for an experienced PS in the Phoenix area.
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Hi TWills-
I have not been working while recovering from my reconstruction but I DID work all through my chemo and pretty quickly after my mastectomies. I don’t know why my chemo was not that bad. I only felt leg aches once in a while but I would go for walks in the hills and I would feel better. I have been a freelance hairstylist for the past 30 years so when I was diagnosed, I still took jobs flying to New York, and doing photo shoots, commercials and music videos here in L.A. I just popped on my wig and went about my life!! Weirdly enough, it’s almost like it’s hitting me backward because i’m having such a difficult time with pain from this surgery.
I’m always a very positive happy person and as my husband says, “the toughest woman he knows”...both which really helped me get through cancer. So I’m trying to be the same with this. I look forward to finally seeing my doctor on Friday.
SadieSue09-i’m Going INSANE not drinking coffee!! I think once they let me have coffee, I’ll be good as new!! Lol! I hope my PS is not one of those 6 weeks guys!!
Kahnartist-Good luck with everything. It’s hard not to be sad about it not taking but aren’t they going to try again? Let’s all hope and pray that it’s something easily fixable and it will take the second time. They will figure something out. And You can always vent in this group. This is why we are here. Sending you the warmest hugs on a second successful surgery.
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I'm boob shopping again today. Hope to have a final plan after today's visit!
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Lula, I didn't realize you were a NOLA alumni. Hearing the positive feedback from you and others has diminished any lingering doubts I had about traveling from chicago for reconstruction. Thank you all for your candor. I only wish I started this process last year. I wasted a lot of time for nothing.
Oh, and here's the deal maker...my insurance is an in network provider. This whole procedure is going to cost me $1350.
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that’s awesome DawnAnn! I think a lot of people in general find traveling for medical treatment daunting. It really isn’t. It just takes a little more planning than staying local. A lot of people wonder why you would travel so far if there was a closer doc qualified to do the procedure. My answer is just because they’re qualified doesn’t mean they’re good at it. When it comes to something like this going to the best pays off. Have they discussed dates or which doctor you’ll have yet?
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Lula, may 15th is my date. Dr Blum is lead surgeon. My ps in chicago, who does diep, (but not many) told me that the docs in nola will do a better job than he could. Of course this came after several revisional surgeries due to problems wirh t.e.'s. Oh, and of course steering me towards an implant restoration. I could write a book.
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Mitzi458-
I am so sorry that your PS is distant and isn't communicating with you. Interesting that he would think that wouldn't make it into the Yelp review. I am having my BMX with DIEP on May 10th after two failed lumpectomies and Bilateral breast reduction. Well, not failed, but we removed over 10 centimeters of tissue from right breast and we can't get 2mm of clean margin, so I guess it is a fail in my mind because here we are. My PS has been so wonderful. I can't tell you the amount of time he has spent with me answering questions about all of my options and what ifs. Honestly, if it weren't for him, I don't know that I could feel as comfortable as I do going into this surgery. I understand that these surgeon's are busy but they are getting paid, a lot! Clearly this is why they want Yelp reviews. Well, he is your surgeon and I am sure he is very talented and that matters more than a good bedside manner, but once it is all said and done, a nice honest yelp review might be just the thing that will help someone else make a decision on if they are ok with that level of communication. All of this is hard enough without feeling disconnected from those in charge of your journey! I hope you continue to do well recovering and hoping you get back to ideal asap! Wishing the best for you!
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Second stage procedure planning is coming up. I see the PS on April 9. I have some decisions to consider and would love some input from anyone that has been through this. A couple things to know about my initial surgery:
* I did have some healing issues with some necrosis but only as bad as thickening below the flap, red tissue which I know will fade.
* Overall shape is great other than just below the flap on the inside lower area the scar tissue area is a bit thicker and comes out a bit more than the flap, so it isn't a perfect shape. When I saw my PS last in January, he said in order to get rid of that area he would need to really reshape things a lot and reduce the breast by quite a bit which he does not want to do as the 'footprint' of the breast shape is so darn close to my existing breast on the right.
So hard to describe this without images but I hope you all know about what I am saying. I am unsure if nipple reconstruction is the way I want to go but maybe that would 'hide' the shape issue? I was told that when they create the nipple it is basically always 'out' and due to the fact that I only had a unilateral mx, wouldn't that look weird? Has anyone else had a unilateral mx and gone ahead with the nipple reconstruction and like it?
We are also looking at just adding some fullness to my right breast via fat grafting. Initially we had talked about a lift but both breasts sit the same and the only real difference I can see is the reconstructed one is just fuller. Can anyone offer what to expect from fat grafting? If you have had any? Just injections of the fat and not a new surgery. (I guess basically lipofilling is the best terminology for what we are doing)
i appreciate any thoughts! Thanks.
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Kahnartist, how have you been feeling? Did everything get resolved with your flap?
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Hello Ladies. I wanted to start by saying thank you for your guidance. I was able to ask questions that I would have never known to ask if it weren't for this group.
My husband and I met with the DIEP surgeon yesterday. He explained the procedure and the recovery times (which honestly seemed a little ambitious based on the experiences I've read about here). I knew to ask about plication thanks to you all, and yes, he does do that. In fact, he said he does it on two layers during DIEP versus one layer during a regular tummy tuck. He said he has even had some success reconnecting nerves, which would mean having sensation! The consult went great, or at least he told me a lot of what I wanted to hear.
We are moving forward. My preop has been scheduled for 3/28, and my first surgery (lumpectomy/reduction/lift) will be on 4/10. UMX/DIEP is TBD.
I'll share my experiences as they happen in hopes that they can be helpful to anyone else who is coming down this path.
Thanks again for your sisterhood.
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Hello everyone, I’ve gotten a bit behind so I’d like to welcome all of our new posters:) I hope every one is healing well from surgery or feeling prepared for your upcoming surgeries.
I’ve been thinking of you Kahnartist and I hope all is well.
Bella, are you feeling any better? I hope you’ve found some relief.
I had a blood clot scare earlier this week but it ended up being a hematoma at the site where they gave me a shot during my hospital stay after surgery. I also have a small area under one side that is slow to heal, they don’t seem to concerned yet and they’ve told me how to deal with it. This is when I’m glad I don’t live too far from my Dr. I also very ungracefully slipped while getting out of bed this morning. First thing I did when I landed was grab my boobs, lol, like they were going to fall off. My poor husband had no idea what was happening, what a way to wake up. I said some bad words for sure.
I’ve noticed how different all of our recoveries have been and I’m sure it’s because we are all at different stages. I had my BMX just over a year ago and then Tissue expanders put in and then one taken out so I’m really numb from those surgeries so I’ve had less pain because of that. Also, if you’ve had radiation and you have to have the skin replaced as well adds another layer to the recovery. Same with skin and nipple sparing or not.
I guess my point is that there are so many factors that contribute to the healing process so keep that in mind.
Let me know if I need to add you to the top or change a date!
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cev20 - what type of recovery time did your DIEP surgeon quote for you? One thing to keep in mind is recovery times and experiences vary wildly from person to person.
Based on the stories i had read, I was worried about recovery time as well. I had a UMX with immediate DIEP reconstruction on March 12th. I feel like I really turned a corner about 8 days out from surgery and now I am starting to feel much better each day. I have no doubt i’ll be back to pre-surgery shape (minus the cancer) by the end of 6 weeks.
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I believe there is a difference in recovery time for someone having BMX with DIEP Flap reconstruction verses someone having a UMX or having a mastectomy at a previous time and then having DIEP Flap at a later time.
I am one month post op from BMX with DIEP Flap reconstruction. My journey is similar to those who had the same surgery and somewhat different from those who had mastectomies previously and are now doing DIEP Flap reconstruction. At 4 weeks post op I am not driving yet because my abdomen is still weak and my reaction time is not as sharp. I think age is a factor in recovery time also. I am 61 so I won’t recover as quickly as someone in their mid thirties or early forties.
Blessings for an excellent recovery and miraculous results
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Hi Camstr835,
I'll be in Boston having my surgery on the same date (4/17), stacked DIEP. I'll likely end up an A cup - was told to try to gain weight just a couple weeks ago when we decided on this, but of course when I'm supposed to gain, I am losing (lol -anxiety). Anyway, I'll be thinking of you and everyone else...and have so appreciated all the advice, support and encouragement found here. Thank you all.
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Hi Colette,
I’m getting my stacked DIEP in Boston at Beth Israel Deaconess 4/17. Their Breast Care Center is excellent, and my PS and oncologist have been amazing. I also have BCBS PPO and BID is in network. My partner is a physician and has helped me source and assess care hereand he is fully on board. I suggest you check them out before you make a final decision. PM me if you want specifics.
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Good day, as most have mentioned, healing depends on so many factors including type of surgery, phase, approach and our surgeon’s technique.
At over 2 weeks post op, I am feeling stronger each day. Had 3 of 4 drains removed so am driving though I usually have someone with me when I do. My stomach and breast area still feel tight but my PA says the more I move, the better this will feel.
I’ve been to the gym for a slow walk on the treadmill since the drain removal and that has helped loosen up my stiff muscles and relieve some of the soreness and bloat.
I alternate sleeping in a reclining chair and bed. Just worried that I will roll over and pull my drain out at this point.
There is a glue strip on my stomach that will be taken off along with the last abdomen drain next week and I am so looking forward to that.
Have a good weekend everyone
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Good morning!
TWills, how are you feeling today after your fall? I hope everything is intact.
SadieSue09, he said recovery time for first procedure (lumpectomy/reduction/lift) would be about 2 weeks, and 4 weeks for UMX/DIEP. I think it would be more prudent to plan for the worst and hope for the best, so I'm adding another 50% to each of those in my head.
Bella2013, thank you for your words of wisdom. This will be my first procedure and I'm 44, however, I am sorely out of shape. To give you an idea, the PS looked at my belly and exclaimed "Oh yeah! There's LOTS of good tissue to work with here!"
My 11 year old son is not too happy about the DIEP -- he loves my "squishy belly." Opt4life, that's awesome! I hope my recovery is as swift as yours.
Here's wishing EVERYONE uneventful procedures and speedy recoveries!
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