2018 DIEP Surgery
Comments
-
Daizy07 - doc B hands down!
Parachutes — you are walking half a mile?! That is great .. I’m barely managing around my house 5 min each hour — my aching back!
I did have the home Health nurse come by yesterday to do drain care and she helped me use a pillow held against my abdomen when walking which does actually help with the back pain. My abdomen incision line is about 3 inches below my new belly button - pretty low I am happy with it. The pain ball is empty this morning and so far no pain in the incision. Breast drains are barely producing anything <5 cc all day. The addomen drains were over 200 cc yesterday. And i agree that my breasts are bigger and firmer than expected but I’m told they are swollen still. Pain is under control with just ibuprofen.
My biggest concern is my left upper arm began swelling and aching this week- this is the lymph node removal side. I have been wearing the sleeve I had for preventative during the day. Today it is particularly aching which worries me because I Feel the fullness .. doing lymph drainage massages twice a day hoping to get in with an LE specialist next week. Anyone else have issues with lymphedema onset after the DIE surgery?
0 -
Lula73 - could you post what you can tell us about the tummy incision? Why are some higher than others? How is an incision lowered in stage 2? What to ask about? Thanks! Lanne
0 -
Hi Amy...yes, oh my goodness. Rads seemed like a cake walk while I was going through it but just didn't realize what all was happening underneath. My skin died and I ended up having the TEs removed and have an open wound that is still healing 10 weeks later. My radiated side is a mess...such hard scar tissue (I guess?) underneath, painful ribs, and limited range of motion. PT is helping with all that, and now I'm looking forward to natural feeling breasts with the DIEP flap procedure. Not excited that it's a more complex surgery/recovery than implants, but I just look forward to having some boobs again! Good luck with your surgery in July and keep us up to date on how you are doing.
0 -
Lanne- there are typically 2 reasons why the tummy scar is placed higher than bikini line or just above the pubic bone: the location of the perforators were on the high side or it’s the PS’s preferred method/how he trained.
If you are looking at the surgeon’s before and after photos and the abdominal scar is high on all of them, that’s your clue that it’s the preferred method he uses. This is where asking about what all he does in stage 2 comes into play. Some PSs don’t address anything but the breasts after stage 1. If you’re seeing high scars and he is telling you he doesn’t address anything on your lower half after stage 1, it’s time to look for someone else.
They lower the scar by opening up the healed incision, removing additional tissue below the incision then pulling the skin down...so basically what they did during stage 1 minus the blood vessel harvest. Which begs the question why didn’t they just do it that way in the first place. This is one of the things I really like about NOLA-they are very concerned about those scars being low so you can wear even a skimpy bikini and no one will be the wiser.
If you’ve already had stage 1, have a high scar, and your PS says he can’t/won’t lower the scar, I urge you to get another opinion.
0 -
Lanne2389, Runrcrb, mustlovepoodles, Lula73, and Teaberry11, thank you for your responses! I appreciate you taking the time to give me some input. Lula73 you brought up some very insightful questions.
PS #A is Dr. Frederick Deleyiannis in Colorado Springs, CO, and I was unable to find any information online about any of his experience with breast reconstruction. There were other surgery accolades but nothing pertaining to DIEP or reconstruction. When I asked about any further revisions he said he would take care of those issues as well, but nothing specifically was spoken about.
PS #B is Dr. Tae Chong is in the Denver area and he works with Dr. David Mathes. Majority of the information I could find on both doctors was positive and directly related to breast reconstruction to include DIEP. Many positive reviews. Dr. Chong did address possible revisions needed after DIEP and that yes, it would be covered by insurance. It did impress me that Dr. Chong explained they perform DIEP on a wide range of patients, and they have successfully been able to complete DIEP on women that had been previously denied this procedure.
After reading your responses, it really helped me to identify the areas that are important to me. I want someone who is experienced but also is familiar with the unique characteristics of the breast and how that relates to each individual. Thank you for reminding me this is about my well-being and I deserve to have quality, compassionate care. I've briefly looked at NOLA, but was a bit overwhelmed thinking of the travel, surgery and insurance coverage, might be worth a call to discuss this option.
Again thank you for the input 😊
0 -
Daisy- I'm glad it helped! Since it got brought up yesterday by parachutes, make sure to look at the location of the abdominal incisions in the PS's before and after photos. If they are all high (can't be concealed in a pair of bikini panties), you may want to ask additional questions or expand your search. It's more than just appearance as a higher scar can interfere with clothing choices.
Honestly, NOLA makes it easy to go there. They have a wonderful lady who handles travel if you'd like her to and you get special discounts at the hotels they've partnered with plus upgrades in many (i.e.club level for less than price of regular room giving you access to breakfast, snacks, beverages, parking perks, handheld shower head in the shower, bigger bathrooms, etc). You can also opt to stay at Hope Lodge which is free for women coming to New Orleans for BC surgery. Since my surgery was right in the middle of Mardi Gras finding a room was the hardest/stressful part. The travel itself was not a big deal at all. Their patient educator, Liz will walk you through everything and you'll email pics of your torso via their secure email server for evaluation. After that Vicky checks your insurance coverage and tells you what you will be responsible for. Then you schedule your surgery. There is no cost to you until you decide to set a surgery date and you're 10 days out from the date.
0 -
Hello all,
I was on the 2017 DIEP thread - but my surgery was in December and revision just last week. It seems to have quieted down on the 2017 thread so I should hop on over here. In case I can offer any advice, please give me a shout!
I had BMX in 2011, with expanders and implants. Decided to go for the big DIEP surgery as the implants had become deformed over time, and uncomfortable.
I was offered a new technique developed by my surgeon called "Delay of Flap" which significantly cuts down on pain. So I had a pre-surgery 2 weeks before DIEP, had drains for those two weeks.
The DIEP went okay, was in hospital 3 nights, (Hospital of the University of Pennsylvania) went home without drains, went to my husband's company holiday formal at day 10, back to work in 4 weeks.
Not all peachy keen: I had some fat necrosis, a significant reaction to surgical glue, an open wound for 3 months, and a failure of the ab repair.
Just had my revision last week and all went pretty well, have to wait and see if that was "it" or not. I will copy over my post on the 2017 thread about the revision, for fyi.
Best wishes everyone
Michele
0 -
My surgery is in early July. My daughter is getting married in mid-October. When is the second surgery typically scheduled for and how long is the recovery? Will I look/feel ok by October? I'm assuming I should wait to try on dresses until at least a month after the first surgery or should I wait longer? Would appreciate any advice
0 -
LMichele, I'm glad to hear the journey is almost over for you. An open wound for three months must have been pretty darn uncomfortable. Thank you for coming onto this tread and lending some advice.
I think my body weight is a very important factor in the high low abdomen incision topic. I'm 5'3" 117 lbs. I had an "over 40 pooch" but really not much to give and was happy I'm pretty small up top (small
. I think the surgeon took my tissue where the blood vessels were located. I can't see a revision happening because I literally have no more tissue to give or skin to pull down. It was the nurse that told me the scar could not be fixed. I don't have an appointment with the surgeon for another week. So it's not until then that I can hear it straight from the horses mouth and have a full understanding of the reasoning but I'm pretty sure my weight will be mentioned. 0 -
hello Ladies
Introducing myself here as I'm scheduled for a bilateral mastectomy with immediate DIEP reconstruction. Needless to say I'm a bit scared and overwhelmed. I've been trying to learn about this issue I have and reconstruction but my brain sometimes is overloaded. I'm finally accepting that this is happening.
My diagnosis is not terrible: DCIS in left breast but it's "high grade" and the lump is significant size and there is another area involved plus other spots showing up on the MRI (don't know). Mastectomy was recommended and I decided to make it a double with the reconstruction and be done with it. I'm confident this is the right thing for me but sometimes I find my thoughts saying "I can't believe this is happening". It's bothering me that on other sites there is a lot of suggestion that DCIS is overtreated. Many comments are downright nasty about people getting mastectomies for DCI
0 -
Hi Justkeepmoving - sorry for the disrespect you are experiencing. I always knew w/o hesitation I would go BMX (family history of BC). But when my BS, PS and Radiologist all recommended a lumpectomy, I agreed but was in knots for days about it. Two days before surgery I told them I changed my mind, had the BMX, and have never had a minute of regret. Only you know what's best for your peace of mind.
The one thing I do regret is not learning and asking more about lymph node removal. I've been doing more reading on lymphadema (my affected arm has slight swelling) and it can be a lifelong and painful side effect. I didn't really understand what it was all about when my BS gave me the option to take out a much smaller number of nodes and I opted out. Each decision we make always seems to be a catch 22. Lanne
0 -
Thanks Michelle,
I'll be starting my estrogen blocker in a few weeks, I have heard/read about the joint pain and have to say not looking forward to that or going back to hot flashes, I had those when I took tamoxifen. I am a little over 3 weeks post op and feel much better than I thought I would although still waiting for my energy level to get back to where it was before the surgery. Each day I do feel a little better and am able to do a little more so I know I am moving in the right direction. I do think choosing to have the DIEP surgery was the best decision, and joining this community was a BIG help, I can't thank all the women who posted and shared their experiences and stories enough, they truly helped me prepared for the surgery and what to expect after surgery
0 -
OCDAmy- 2nd Surgery is usually no earlier than 12 weeks after the first. Stage 2 is much easier surgery with approx 2 week recovery time provided no infection or healing issues. 12 week’s would put you at stage 2 just before the wedding. I personally would wait to do stage 2 til after just in case. I would browse dresses, but wouldn’t buy one til about a month out from the wedding because there’s often still some swelling still going down between weeks 8-12. You’re having the surgery at NOLA, right?
0 -
Thanks Lula! I appreciate the feedback. I am having my surgery at Washington University/Siteman Cancer Center in STL.
0 -
OCDAmy - like Lulu said, at least three months after first surgery but it can be driven by you. I will have some work done but decided at my three month follow up to discuss it at six months. So i go back in July and don’t know when we will schedule part 2. The surgery will be easier to schedule (less OR time) and i will determine when it fits my schedule. Plan to do it after the wedding.
0 -
I agree Amy, I was also told the revision would be about three months, best case scenario, but alas, they don't schedule it until after the DIEP at the one month out follow up, and by then it was way too late to get onto the surgeon's schedule at a convenient time for me (was traveling in May with my high school senior). I lived with the slightly uneven boobs and ugly incision scar and lumpy belly for almost 6 months but I was very active and feeling good.
My revision surgery was two weeks ago tomorrow. The first few days it was hard to move around much but then again I had my abs muscles heavily stitched. Anyway. you won't want to have surgical tape and lipo bruises, and whatever else comes up, right when you are trying to celebrate! Just wait till after. Sorry to hear you have to go through this! but you will feel good again eventually Michele
0 -
JustKeep Moving: sorry for your diagnosis, it is a hard thing. Even worse by know-it-alls giving unsolicited advice. If you trust your doctor that's all that matters, he or she is there to do what is right for you. If anything doesn't seem right, maybe you aren't sure, why not ask another doctor to review your case, people do that all the time. Another breast surgeon, as well as another plastic surgeon. Good luck keep us posted, Michele
0 -
Parachutes:
Actually the open wounds were not painful just SHOCKING, iccky, and a pain in the butt). Also left me with a nasty scar, thick, dark and lumpy. I am mentioning this because my incision was basically totally redone at the revision it still has tape on it so I haven't seen but I can already tell it's totally different. I can't imagine what there is about your scar that makes it unfixable. You will be pleasantly surprised that in the next few months the tightness will ease up so much! I eventually started to do some gentle yoga stretches (up dog: lifting head and chest off floor, looking up, it really feels good!) Also the revision may involve a little lipo, my doctor took a little from my hips (kind of around towards the back) and a little from the front of my armpits. Let us know how the consult/follow up goes
Michele0 -
Thanks everyone for your feedback regarding my daughter's wedding and the timing of the second surgery. I was hoping to have the second surgery done as well before the wedding because he will be replacing the tissue expander with a pre pec implant on my non cancer side during the second surgery and I wanted my breasts to match as much as possible. Oh well, it is not about me, its about her so I will jut wait on the second surgery. I don't want any complications to possibly interfere. Have my pre-op appointment tomorrow so this is getting real now. Trying to get my office and staff ready for me to be gone for another month. They did fine last year when I had my BMX but I always worry.
0 -
Forgive me for not remembering, OCDAmy, but are you thin and getting a stacked flap on the one side?
0 -
Lula, from the beginning I had hoped to just get implants. After rads, it was clear that an implant on that breast was not going to work. When I met with my new PS about DIEP he could tell I was nervous about the procedure, length of time for surgery and being under anesthesia, and the long recovery time since I had take a lot of my paid time off for surgery, chem and rads. I asked about just putting an implant on the non cancer side and he said he thought if we did a pre pec implant he could get good results. I felt good about that at the time but have gone back and forth about just doing both.
0 -
OCDAmy- I am on the flap side so it's easy for me to say, but I'm going to throw this out there for your consideration...
if you're going to have to do something to the other breast anyway (racking up more time under anesthesia just on a different day), I'd just do them both DIEP. The surgery isn't that much longer, the recovery time is the same, and you'll have a matched set that feel (from the inside to you and from the outside to others), look, and age the same. They can't do DIEP again if you're unhappy with the implant and they're just going to dispose of the harvested tissue you're not using for that breast at the time of the surgery, so it is in effect, wasted.
If you are otherwise in pretty good health, statistically, longer anesthesia is not that much riskier than shorter anesthesia. People tend to fear it because in our non-medically trained mind we think it makes a huge difference. In reality, the same stages of going under and coming back out of anesthesia still happen no matter how long or short the surgery/time under anesthesia is. It's those stage transitions that are the times when risk for adverse events is slightly elevated. And mitigating those risks/keeping those risks as low as possible is what the anesthesiologist went to school so long for and trained for.
Infection is another complication that can be affected by length of surgery, however it has to do with length of time time the surgical site is open. In this case, the abdomen is open for a similar amount of time either way and each individual breast is open for the same amount of time as the other. So 3 different surgical sites each with their own “clock/timer". This is different than say an open heart surgery where 1 surgical site is open for 8 hours and that 1 click shows all 8 hours.
Just some things to consider...
0 -
Hello! I wanted you to know I had delayed DIEP flap surgery at PRMA. I had my mastectomy in my hometown in May '14, delayed DIEP flap December '14 at PRMA (traveled 800 mile to be there), and went back for the 2nd phase revision 4 months later that was all covered by my insurance. Phase II for me consisted of fat grafting to achieve symmetry and scar revision. It can include nipple reconstruction but that was not the case for me since I had skin sparring, nipple sparring mastectomy.
Let me know if you have any questions and I'll be happy to help.
0 -
Thanks Lula, I called my PS today and left a message to discuss further. I'm so scared of this procedure but I hear all the pros of doing both breasts.
0 -
you’re very welcome. Any surgery can be scary. Once I literally tried to bolt from the pre-op room they had me in. But when I tried to get out of the bed, the pre-op relaxer meds had kicked in and standing up much less walking/running was a no-go. Since then, I have mentally placed surgery in a different box - it’s now relegated to what I call ‘the next step to defeat (insert the cause)’ or ‘the next step in my plan to not let (insert cause) win.’ It changes the context mentally and allows confidence in the decision to be established and lessens the worry (at least for me) as it’s now something I have decided to do vs something that was pushed on me/something I was left with. More of a proactive stance vs a reactive one. Hope this helps!
0 -
Hello, I've been stocking this board for awhile. I am located in N. California and in the process of trying to schedule DIEP reconstruction at NOLA (hoping for early Jan '19). I've chosen them given their experience and the fact that my right side has been radiated twice in less than 4 years (only once on the left). I've had a UMX on the right in May 1017 and want a prophylactic MX on the left (also want to be smaller as I am currently a DDD). Based on my photo review NOLA is recommending the following:
- reduction surgery on the left; wait 4 months to heal and then
- a stacked DEIP on the right and a Sgap flap on the left
Has anyone here or does anyone know of some one that has had both a DIEP and Sgap flap procedure at the same time? I haven't gone into NOLA for an in person consult but am thinking that may be good idea. Also, since my insurance is Blue Shield and out of network, am wondering if anyone has had experience with any of the NOLA doctors performing the surgeries at a local hospital and not their own private hospital. I am still waiting on a quote to figure out if I want to pay for their hospital out of my own pocket, but may have to go with a local New Orleans hospital that is in the Blue Shield network.
0 -
Michelle- are you on the NOLA FB page? If it let me know and I can get you added. Plenty of women on there have had what your asking about and/or used an in network hospital vs the center’s hospital. I went to NOLA and would do it again in heartbeat.
0 -
Hi ladies,
4 weeks post diep surgery and checking in. I went back to work today. I had cabin fever and was doing more strenuous stuff around the house than working. All I can say to all of you considering this surgery, is there really is not a better way for breast reconstruction. Traveling to NOLA was maybe, no probably my best decision ever. 100% . My only issue is my brand new bellybutton is off center. I was told it would be corrected during phase 2, which is sceduled for Aug 23.
I was super impressed with the facility as well. Who ever heard of a 17 bed hospital?
My surgeon, Dr Trahan does 300 diep surgeries per year...he said every one is a little different. Their success rate is better than 99%.
Good luck to all !
0 -
hello ladies, wow I completely understand in net work verses out of net work and the cost. I did call NOLA just to ensure I could get pre-approvals. I did, with blue cross blue shield (out of net work)but also was hoping to find a doc up here in Michigan or close for another option( in net work) Any suggestions??
My chemo should end mid Aug18, so I figured I would start looking now. I tried in the city I’m having chemo but no DIEP option..
0 -
Hello Everyone,
Have any of you gone from implants to DIEP flap? Please share your experience with me.
I'm new to this website and have been stalking this thread, but can't seem to find much information. So I apologize if this topic has already been discussed. I'm starting my second round with BC & had a second mastectomy 6 weeks ago. My PS recommended DIEP, but I was afraid of the 10-12 hour surgery and the lengthy recovery. Six weeks with the new TE, I'm already over it! My other side has always been hard, tight, and occasionally painful, but now my whole chest feels that way. The old side is encapsulated, has changed shape, and has moved out of place. DIEP recovery seems tough, but I'm thinking once it's over, I won't have all of these issues. I also have some additional questions about DIEP recovery. Thanks in advance for any information!
1) How long until I can be at home alone?
2) How many surgeries are typically needed?
3) Is Physical Therapy required?
4) What are "dog ears" and what typically needs revising?
5) I've read about numbness in the abdominal area. Is it similar to the numbness after a mastectomy? Is your whole abdomen numb?
6) How does taking Tamoxifen affect the procedure and why do I have to be off of it?
7) For those who have had previous implants...My implant/TE are under the muscles. PS says he will put the muscles back where they belong during DIEP Flap reconstruction. Will the tightness go away after I am healed? I am assuming the tightness is from the muscle pulling.
0
