2018 DIEP Surgery
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Hi Teaberry:
I also had delayed DIEP 2 weeks ago today and my surgeon used the mastectomy drain site but my mastectomy was over 3 yrs ago so not quite the same situation. I have had no problems with pain. Actually, I haven't had problems with any pain since I left the hospital and stopped pain meds. I have found it extremely helpful to drink a lot of water (hydrate, hydrate, hydrate) as others have pointed out and walk, even just around the house every hour or so, just a little bit helps. I've worked up to walking in the park every day 1.5 miles. I can't believe how much better I feel. And use that breathing thingee they give you in the hospital, it really works. Good luck!
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Teaberry11, my drains were in the same place as BMX and the TE’s. I was still tender as well but my drains weren’t uncomfortable. Well, any more than they should be. Good luck, we’ll all be thinking of you!!
Bella, I hope you can get in with your Dr and get some peace of mind. I also have a lump that would scare me under normal circumstances but it’s necrosis.
Shalaea, I hope you get some relief soon, these things that pop up can be so frustrating.
Primrose24, hope you are still doing well!
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Hello ladies,
I leave to the hospital (PRMA) in an hour. I'm more anxious to have the TE removed than anything else. Teaberry11, I asked my surgeon to put the drain in the same spot. I'm still tender too but I figure why have a third sorespot. Thank you y'all for sharing your experiences. Because of you I know I can get through this.
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good luck today, parachutes!!🍀
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Hi Everyone,
I am interested in DIEP Flap surgery in NY. I live on Long Island and am dreading more surgery. I have long horizontal scars from a bilateral mastectomy that look awful. I have TE’s in place.
Are there any surgeons in NYC who can help me look normal? I’ve been to several plastic surgeons and they are unable to get rid of the scars.
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Hello, I am new to this forum. I was diagnosed with stage 2a breast cancer in 2016 while pregnant with my second child
After surgeries and chemo and radiation I am looking forward to reconstruction. My PS has suggested DIEP flap. I was asked to lose a little weight before scheduling my surgery- I am approaching that goal and see him on Friday. How long typically between consultation and surgery? I would like to have stage 1 done before my daughter goes back to school. We can all dream, right?
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Hi Casey!
Welcome to our community! We hope you find this to be a supportive place. The time between consultation and your first surgery can depend on so many factors, but we hope your appointment on Friday goes well and you can start your journey toward reconstruction!
The Mods
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Casey83. Welcome. The answer is it depends on the surgeon's schedule. Also, you may want a second opinion. Take your time as you want the best outcome. Easier said than done! Hang in there
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Hello Ladies. I haven't been on for a little while and was so glad to see how well everyone is doing.
Stay well and happy healing!
Cev20
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Hi ladies.
I just realized that I hadn't posted lately, but I have peeked in from time to time. It is 16 days post op for me. 2 drains were removed yesterday and I still have 2 in. My nurse practitioner was very impressed with my healing and outcome (so far) . I had a setback...a coughing fit in the night caused a couple of intesutures to open up. Pain pain pain. I called nola without the expectation of getting a response, as it was memorial day weekend.
I was shocked to get a call back within 20 minutes. They gave me new rx and the next day pain was subsided. I'm now super careful about coughs, burps, etc. Still have drain discomfort. can't wait till these little buggers out!!
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nanpop, I am in a similar situation. I had my TE out in December. The horizontal scars have faded somewhat, still there. Just know more scars from DIEP, at the donor site and at the breast (they will probably add a piece of skin to the breast to make it a natural shape vs unnatural TE or round implant shape). And it might be worth it, like for me. I think DIEP looks amazing after nipple sparring mastectomy, it looks real. that is not my situation, so got to prepare myself for lots of scarring, maybe it will look like the breast is made of pieces, but at least will feel ok (down the road, like in a year or two).
I am still thinking of DIEP, that's why I am hanging out here... 6 months after exchange of TE for permanent silicone implant, still uncomfortable. It's better, but that feeling that something is wrong is 24/7. Done my CTA, read the results, no clue what the results mean. talked to my husband about going to NOLA (still sounds crazy), he says "maybe we can". Asked my PS about DIEP APEX, they said its not available in Boston.
I just don't get it, why women are getting TEs when they are going for DIEP? That damages your pec muscle forever. I have asked if my muscle will contract to its original shape if I do DIEP and they said no, the PS and the physical therapist.
Thank you for all the ladies who have shared your experiences
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Had anyone here had a hematoma or seroma post Diep that needed to be drained? I am heading back to the hospital tomorrow so that interventional radiologist can place another drain in. Breast is very swollen and bruised. 3 weeks post op today. My surgeon has done over 400 Diep procedures and has never had this happen. I am nervous about the flap getting disturbed and surgeon is out of town so I cannot ask him about risks. He has been in touch with nurses and has ordered this. I know it has to be done but would feel better hearing from someone who has experienced this.
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aliceko- i am confused by your doctors telling you the pec muscle will never be the same (my interpretation of your note above). I had a TE placed at mastectomy and it was in place for 15 months. post diep i am doing push-ups, swimming and a variety of other activities with no problems other than simply regaining strength.
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shalea- I'm part of a DIEP forum elsewhere and yes it happens. Sometimes caused by drains being pulled too early. Sometimes it just happens and a drain is already in place which usually means surgery is required to correct it. Hoping radiologist and new drain will help!
AliceKO- TEs do stretch the pec muscle and for many it does not shrink back to original size. When this happens it can result in what they call animation where the muscle buckles under the skin on the outer and/or inner curves of the breasts. They can't fix it. I know NOLA typically recommends rads after DIEP if rads are needed to help prevent this from happening. It's easier to deal with shrinkage/contracture in stage 2 DIEP than deal with pec muscle animation.
On going out of state for surgery, it only sounds crazy til you do it and see the results. My two girlfriends and sister supported my traveling to NOLA 100%. But it wasn't til they asked if they could see the results that it became clear they supported me because they loved me, not because they agreed it was the right thing to do. When they saw the results without clothes on their response was, “Noooow I understand why you went all the way to New Orleans!" I had shown them the before and after pics on NOLA's site but I think they thought those pics were the cream of the crop and not NOLA's standard results (those are NOLA's standard results, just for the record). I think a lot of people think that but you really don't understand til you go & experience it just how different NOLA is and what mx and/or recon should be like. All the other medical centers could learn ALOT from NOLA.
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AliceKo
If someone would have told me a year ago that I would travel from Chicago to new orleans for major surgery..I would have laughed my a** off! They really are at the top of the restoration community. I'm 2 weeks post op and feeling great. My ps here in Chicago looked hard to find anything negative to say about the work and couldn't find any. They really have destination surgery down to a science. Don't dismiss it!
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Hi there,
I just wanted to share an update with everyone. I'm getting discharged from the hospital today. Yippee. Three nights wasn't too bad. They must have a great cocktail drug recipe because I've been really comfortable the whole time I've been here. I woke up from a 7.5 hour surgery with the worse pain in my inner elbows. I guess from the way they were positioned but that was it. Walking and getting out of bed are getting easier everyday. I will say I am quite surprised that my left arm does not hurt at all and my range of motion was not affected. It's tough remembering not to use it though. I'm a little worried my noob looks bigger than I hoped for. But at this point I am nothing but grateful. I'm headed home so today is a good day.
I pray everyone's healing is going smoothly.
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so happy for you, parachutes! It is weird what endsup hurting that isn't involved in the surgery. For me it was my neck. I swore the little neck positioned thing they use during surgery had imprinted itself on my tissues. Don't worry if it looks bigger...it likely is. But bigger is better for tissue survival at this stage of game. They can reduce it in stage 2. Plus you likely have a lot of swelling and fluid retention as well. Outcomes are better going big and reducing vs going small and doing fat grafting or same size and dealing with tissue loss from necrosis then ending up in the too small category and relying on fat grafting.
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One thing I neglected to ask was where the abdominal scar would be and I'm shocked as to how much higher it is then my bikini line. Yup, an important question I forgot to ask. I'm sure he has good reason but sure would have been nice be mentally prepared. I'm also wearing a wound vac. Maybe to speed healing since I'm from out of state.
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Hello Ladies ---
Just posting to give a shout out as I'm meeting with a plastic surgeon this week to discuss DIEP for my bilateral mastectomy
What question do you wish you asked when you saw your PS?
Thanks!!
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Hi Ladies - I just found this site after being on BCO last year for surgery. You'll see in my signature line I had Stage III IDC and underwent BMX 1/30/17. I was scheduled for temporary implant replacement on 4/20/18 after completing chemo and rad last year when my surgeon left the practice and the new surgeon discussed DIEP. I'm now scheduled for 9/10/18 - which seems far away but I'm sure will be here before I know it. I plan to mostly read from everyone to learn and prepare. I'll add input if I have anything to offer.
My surgeon is Dr. Kenneth Lee & Dr. Klein with Orlando Health/UF Health Cancer Center and I feel very comfortable with him.
Thanks so much for having this site!
Michele
(Shellybeans)
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Shellybeans, you will love the end result of the DIEP procedure. TWills had the same surgery at with your doctors back in March. She will have lots of info and good advice to share with you. I do know she was very pleased working with these doctors. She began this thread back in January. When you have time, read the discussions starting in January
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Thanks Bella2013 - I've been reading Twils'' posts - I noticed we have the same dr. I put on a few pounds since I finished treatment - it's not on my signature line but I also had my ovaries removed in November. I'm 48 and was put into full blown menopause. That, on top of the AI I'm taking has slowed me down. I'm trying to work out and exercise to keep myself active to offset the SE's from the AI's and reading everyone's posts tells me I need to be moving a lot between now and my surgery. I am not significantly overweight or anything like that - but losing a good 15 lbs wouldn't hurt. I know that I'll have to get small implants later so I'm already preparing mentally for that.
Anyway, that' probably more than you wanted to know but thanks for the welcome! LOL
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Justkeepmoving- from a previous post on this question request:
Sorry it's so long. I just cut & pasted...Note that they were put out there as an answer to a different question so please excuse how they’re worded...
If choosing UNX vs BMX: Did they tell you that if the cancer shows up in the other breast you can't go to your abdomen a 2nd time for reconstruction if you need to have a mx on the other side down the road?
Did they show you their before and after photos? (If no photos, keep looking for a PS, if you wouldn’t be happy to have the results you see in the photos - not just happy considering you had an mx/BC - keep looking for a PS).
How many of this exact procedure do they personally do every week/month/year? (They really need to be doing at least a minimum of 1 of these procedures every week for an average of 4-5 per month and 52 per year. Preferably more).
What is their personal flap failure rate? (National average is 10% -you want lower than that. For reference, NOLA’s failure rate is <1%)
Their infection rate? (You want this very low too-NOLA’s infection rate is <2%).
How do they address the changes to the lower half of your body that occur at stage 1 during stage 2? (This includes appearing more short waisted, hips out of proportion, upper abdomen larger than lower abdomen.) If they say they don’t/there’s nothing to address/they take care of it in stage 1/etc, keep looking for a PS)
Where will the abdomen incision be located? If you think it’s high, ask if they will lower it in stage 2 and if so, where will it be located then?
What are the reviews of this dr and their practice online?
Do you need chemo and/or radiation post-mastectomy and if so how does that play with the reconstruction you're planning?
Every post I've seen online where doctors hop online and respond to patient questions say to ask all of these questions before making the decision. After all, you likely would prefer to have the surgeon whose done over 1,000 of these exact procedures with a very low failure and infection rate vs one whose only done 50 with 10% of greater failure/infection rate. This is a major procedure combined with microsurgery that requires a lot of skill and patience mixed with a eye for artistry with the womanly human form. And like anything else, practice makes perfect.
Those before and after pics will tell a very good story. If they give you any excuses on why they can't show you any (including HIPPA), move on to another dr ASAP. When you're looking at the photos, don't fall into the trap of comparing them with a mastectomy photo without reconstruction. Compare their photos with other photos of the exact same procedure from other surgeons. I can tell you firsthand that the really good surgeons have results where you can barely tell anything has been done if at all and the new breasts look 100% natural -even with nipple reconstruction and/or tattooing. If you need direction on seeing what excellent results look like for these types of procedures, check out the Center for Breast Restoration Surgery website at wwwbreastcenter.com. I'm living proof that those photos are accurate. And my recovery has been nothing like the many "standard" mastectomy with/without reconstruction stories or the "horror" stories online. I'm either the exception to the rule or the surgeons at the center are REALLY REALLY good (hint: it's the surgeons).
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I just wanted to post a quick note to say how helpful it is to read through your past posts with the information after your surgery. As someone who never expected this surgery to be and option and having it scheduled, it's really been a comfort. So Thank you!
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Shellybeans,
TWills had her surgery with the same team,so she will be able to answer better than any of us. I wish I had the opportunity to have diep reconstruction at the same time as mastectomy. That being said, better late than never. I have had an amazing recovery process. I had my surgery at NOLA same as Lula. My ps in chicago does deip infrequently, and didn't want to do the procedure. I am 3 weeks out and it looks amazing and I feel great.
No one is a better advocate for you than you are.
Ask questions... will there be just 1 surgeon or a team ? How long will surgery last? What is failure rate? As far as your extra 15 lbs, it may help them out if you gain weight on your tummy.
Good luck!
Ps NOLA is slang for the center for restorative breast surgery.
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Lula73, I'm saving your last post. You have covered some very important points. Thank you
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Thanks Dawnann - I've looked at NOLA and the appear to be the leader on this surgery. I'm comfortable with my surgeon as he's the chief surgeon and teaches this procedure. I wish I had thought/known this was even an option when I had my BMX with TE's - that being said, everything happened so fast and everything was so urgent, I am sure I wouldn't have done it. I was so worried about starting chemo and having positive nodes, I just didn't care about how my breasts looked. I'm glad - in a weird way - that I can approach this now with a much more level head that I had a little less than a year ago.
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Cindy, yes they are telling me my pec muscle, the upper one I think (there are 2 or 3, I need to check my anatomy!) will never be the same. Once the muscle streches this far, it will never go back to its original form. They said, we will staple it down to the chest wall and you are going to be fine. They said I was going to be fine with this implant and I am alive (thank you) and functioning, but not fine. We all know the body can be amazing in adjusting to all sorts of crap happening to it.
And that's what I keep hearing from women with autologous reconstruction is that the body eventually bounces back and they can exercise and move like before. I can move, but it's just feels like I am sick and disabled. Yuck
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Lula, wait wait. If we are talking recurrence (which we all know happens sometimes), we are not just talking the other breast, it could be the same side chest wall, not just the breast tissue which is removed. And what are you going to do then, not have any surgery because you don't want to disturb your new beautiful reconstruction? I just don't know that you can always prevent... What if the recurrence does not happen and she can keep one breast forever and maybe enjoy sex.
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Alice- The question is merely something to think about in addition to symmetry. Many women do not completely understand that its a one shot deal and think that they can just go back again and harvest more from the tummy if they need to. Understanding this may influence someone's decision in either direction when it comes to UMX vs BMX. You never want to hear, "They never told me that! I wish I'd known..." which then leads to regrets. The docs just dispose of that 1/2 of the harvested tissue if you don't have BMX...seems a waste. All the docs talk about how having bc on one side does not mean increased risk on the other side...however if that is truly the case, why do they do intensive monitoring for years after that with mammos/mri every 6 months? You can't tell me insurance would pay for it if there was truly no increased risk on the other side. Recurrence can happen in the same breast, and yes I'd let them operate. If I needed to lose that whole breast again, I'd opt for SGAP recon to replace it. There are many women who still enjoy sex after flap recon. I do. Without my ovaries and taking an AI, it takes a little more to get me going, but I enjoy it. There are some women who have said they think it would be strange to have one breast with full sensation and one that doesn't. They'd rather have the same or similar sensation in both. Its a lot to consider and the more information a woman has about the procedure and looking at it from multiple angles, the more equipped she is to make the decision.
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