2018 DIEP Surgery
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Hello everyone, I am new to this site and have learned quite a bit since reading through this DIEP blog. I am in the middle of a botched reconstruction job as a result of the BMX I had in March 2017 and am looking for a new reconstructive plastic surgeon. I found out a couple weeks ago from a surgeon I consulted with at Mayo Clinic in Jacksonville that due to thin skin on my right side I am not a candidate to have another TE installed on my right side as I had previously been advised by my Orlando plastic surgeon so now I am researching the various options.
Since my BMX in March of 2017 I had 3 additional surgeries on the right side, 2 were to debride and reclose the vertical portion of my anchor incision and the 3rd was to remove the TE, debride and reclose the incision. The 3 extra surgeries were the result of unsupervised ancillary personnel performing all my post op visits after the initial BMX surgery which was combined with the TE installation. After the 4th and final surgery by my former plastic surgeon, I am left with a TE expander that is partially inflated on my left side, huge globs of skin under each arm which are always sore and bruised feeling that were formerly part of my side boob area, and a deep pit on my right side where I can feel my ribs along with severed and detached muscles, nerve damage, muscle spasms, stabbing and burning pain, phantom nipple pain and PMPS.
At this point most of the flaps are out of the running because they would damage more muscle tissue and restrict mobility which is out of the question as I have lost 40-50% of right side mobility and 30-40% of left side mobility. So it appears the only option I have is the DIEP. I can't afford for the surgery to be a failure so I need a doctor that really knows what they are doing. NOLA sounds like the best chance to take for DIEP surgery, but I have Blue Cross/Blue Shield PPO and can't afford to pay out of pocket if they don't take my insurance. I remember reading somewhere, I think it may have been this blog, the names of some other doctors that have trained at NOLA that now practice at different clinics/hospitals. If anyone knows the names of any of these doctors I would be grateful if they could reply to this message. Sorry this was a bit long winded, but figured I should get my story out there. Thanks again.
Cheryl
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Hi all!
I just wanted to provide a quick update since I had my Phase II procedure yesterday. It really only consisted to fixing the dog ears on my abdomen scar, fixing the size of the circular scar on my reconstructed breast and fat grafting to get some volume into reconstructed breast.
It ended up being a 90 minute outpatient procedure and I was lucky to recover well and get home pretty quickly. Since my reconstructed breast is numb, I am not experiencing pain there, but the areas that were lipo’d in my abdomen are pretty sore and swollen today. I was told to expect that for 10 - 14 days post-surgery. Despite the soreness, I am able to get up and around with no issues.
I cannot wait to see the real results of this once the swelling is gone and am hopeful it’s the last procedure I am going to need.
I hope everyone else out there is doing well. If there are any questions I can answer for anyone, let me know.
Carin
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90% sure of DMX and DIEP with PRMA on August 9, 2018. I still haven't had the MRI, but I'm not sure there's anything they could say to convince me to do the lumpectomy with rads at this point
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OCDAmy- good luck today!! See you on the flap side!
Ziggyrox- I went to NOLA and highly recommend them. The before and after photos of ladies who had botched recon elsewhere tell quite the story. If the out of pocket is too high there with your BCBS, the other docs you're asking about are Dr Craigie in Charleston and Dr Massey in Charleston (2 separate practices). Dr Blum who used to be with NOLA until just recently is in Charleston now but not sure where/if he's practicing. He's from the Charleston area and needed to move back closer to home for family reasons.
MinuteAtATime- I’m pear shaped as well and worried if there would be enough tummy tissue. There was plenty evidently. They like to use the hips/thighs for fat grafting harvest sites during stage 2. Have you set up a consult anywhere yet?
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Ziggyrox
I have BCBS when I was looking into NOLA I found out you can apply for a PPO waiver to try to get them to cover it even though they are out of network. I only have health insurance until DEC and I am currently battling cellulitis which seems to take forever to resolve. So I'm pretty sure I won't be able to do this surgery anytime soon.
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Ziggyrox,
You may also want to check out PRMA Plastic Surgery in San Antonio, TX. They are in-network with BCBS and are one of the top practices in the world performing DIEP flaps.
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CTCA in Zion, Illinois is also in network for BCBS PPO. That is where my bilateral DIEP will be on Tuesday morning
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Thank you ladies for all the referrals, looks like I have some homework to do....have a great weekend!!!
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My pre-op appt was two weeks before my procedure-just a quick check of BP,O2, look over belly\squeeze to make sure the fat was still there, and basic labs. I wasn’t drawn on until the morning of. They put a pink band on my left wrist, but I had to keep reminding people to use my right side. I had my mastectomy over a year ago and have not had lymphedema at all-it’s just precautionary.
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ziggyrox,
North Florida Plastic Surgeon’s, Dr. Fallucco and Dr. Desai are with M.D, Anderson in Jacksonville. I can’t say enough about their work. They are right up the road from you so it may be worth a consult. I think they take BCBS PPO because that is what I had last November/December when I started my cancer journey
I couldn’t be more pleased with my end result.
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surgery is over and I'm in my warm room. So tired will catch up on here soon. With the nerve block I'm amazed I have no pain. Being checked every hour and so far so good. Thanks again for all you encouragement.
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Congrats OCDAmy, keep us updated! I think I am next. I don’t know if I am getting a nerve block. I think I will be hoping I do. When you guys get to the afternoon of day 3 after abilateral DIEP do you think you could strip your own drains If you had to? Do you think you could handle walking to the hospital cafeteria to get food for meals? And carrying a tray to a table and sitting in a chair to eat? How about getting to the bathroom, showering, and getting dressed? Getting a bit nervous as to how I will get by. Any insight into what I will be able to do would be much appreciated.
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SadieSue, am I reading it right? Did you only get a UMX and no lifting of your other side during phase two?
Also, can someone tell me what the heck do "dog-ears" look like?
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carmstr-yes to walking, no to carrying a tray full of food (no lifting over 5lbs for 4 or 6 weeks), maybe to drain stripping (it’s not that difficult, placement of drains and your flexibility pistol will determine that), bathroom maybe but definitely by 5 days, no on showering by yourself (you really need someone there to at least make sure you don’t pass out or slip in the shower), maybe on dressing (by the time you get out of the shower you’ll be exhausted).
Parachutes-dog ears are where the 2 sides of the incision line not quite meet properly. You typically see them at the hip in skin/nipple sparing DIEP. Typically the upper side of the incision is puffer and may flop over the bottom side.
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Congrats OCDAmy!, I like the sound of that nerve block. Still waiting to see if I can keep my July 31st surgery date, the imaging will be there Monday morning,,, only 24 days after being requested. This is a journey for sure! Take good care, and let us know how you are doing.
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parachutes - you read it right. I considered doing a lift/reduction to the unaffected side during phase 2, but it was going to be more scars for not a ton of gain. I am only 42 and i’ve never had children/breast fed. My boobs were both in pretty good shape naturally before all of this started.
As for the dog ears, they are just small pieces of skin at each end of the abdominal scar from phase 1 that stick out. In phase 2, they smooth those down if you need them too. Mine were really small, but it varies from person to person.
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Hello All!
I had my CT scan on Monday and my pre-op yesterday. My DIEP flap surgery is July 18th (Hawaiian vacation before surgery for a last hurrah). I’m excited to have have the breast implants removed and use healthier tissue from my abdomen. The 18th will be my 5th surgery since my BMX in October. This discussion has been helpful in relieving my anxiety.
I know some of you are looking for surgeons. Here’s more information on my surgeon in Spokane, Washington. My PS is Dr. Emily Williams at Plastic Surgery Northwest. She’s amazing! Despite the complications that I have had with the implants and my skin, Dr. Williams has been encouraging, kind and I know that she will continue to take excellent care of me as I begin the DIEP flap journey.
OCDAmy - Glad your surgery went well:-)
Twills - You can officially add me to the surgery list.
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ziggyrox, I have BCBS andwent to Dr Klein in Orlando and would highly recommend him.
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Hi TWills,,
I have heard good things about Dr. Klein and going to Orlando would be easiest since it's where all my previous surgeries were done, but I can't in good conscious let them touch me again in their plastic surgery department as their lack of aftercare supervision is the reason why my chest is a train wreck and my only options going forward are flap type surgery or going flat. Also, the doctor that performed my 4 surgeries is no longer part of their practice.
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Hi all,
Well, things were going suspiciously well after my DIEP on Monday....I don’t think anything is horribly wrong, but I have two issues:
1. On the right side of my abdominal incision, I am getting a burning sensation, usually when I move, sometimes when sitting still, then a feeling of ripping, like a stretch mark is forming. I look down, and...nothing. The tape is still on the incision, no extra blood visible, no visible stretch mark. It causes a “take your breath away” pain briefly, then goes away.
2. On the point of the football shaped flap, near my armpit, I am suddenly very aware of a stitch or something poking, and it’s constant. I see a couple of stitches poking out on the top of my flap, but they don’t feel irritating at all.
I just want to sit perfectly still and do nothing until my post op appt on Monday afternoon! Things were going so well! Anyone have these types of sensations and know what they are?
thx,
L.
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Thought I would check in. Feeling really good so far. The stomach is a bit more uncomfortable than the breast. I couldn't eat or drink any thing yesterday and today I'm able to have have clear liquids. Looks like I can start eating tomorrow, I'm starving Not getting much sleep because ever hour they use a dopler to listen for the blood flowing through the artery. The nerve block was awesome and I felt very little pain. The catheter came out this afternoon and finally went pee. Hoping to be able to go home on Monday. I honestly feel better now than I did with the mastectomy. Fingers crossed I have no complications. The only other bummer is how hot it is in my room plus I have a Bair Hugger, kind of like a heating pad.
Also I can' have any caffeine including chocolate! For how long?
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OCDAmy,
No caffeine? Oh my, I sure hope my PS doesn't say that. I can't live without my coffee all day long! glad your doing well.
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My doc is not concerned about caffeine. I only have 1cup of half caff a day, though.
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I think I just got great news from my insurance company. They have approved 7 days for my DIEP surgery. I believe that means 7 days in the hospital so I don't have to worry about taking care of myself for days 4-7. At least that is what I think it means. I have been a little bit worried about how I was going to manage when the discharged me to the hotel room.
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Leatherette- Hoping its just an internal stitch pulling a little that you're feeling. Have you said something to the dr or nurse about the pain? In the meantime try to keep still and stay hunched over a little at the waist to keep stress off the incision. When you’re in the bed, be sure to lift the bottom portion of the bed up and/or put a couple pillows under your knees to help relieve stress abdominally as well. I know I wanted to stand up straight but didn't so there would be as little stress as possible on the abdominal incision. I used pillows under my knees any time I was in bed or in my recliner until after stage 2. The feeling of a stitch poking you in your breast could well be justthat. There are internal and external stitches, so one may be poking you but you can't see it as it's on the inside. Hopefully it will dissolve quickly.
Carmstr- that's great news! And it will be a big help! Forgive me for asking, where are you having your DIEP done again?
OCDAmy- so glad things are progressing nicely!
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OCDAmy, glad to hear you are doing well. I hope that your recovery goes smoothly! Just curious...why is your room warm (is there a reason or is it just hot) and why no caffeine?
Sonia
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Leatherette, I too had what I thought were stitches sticking out. Much to my surprise they were the microphones that allowed the medical personnel hear the blood flow in my breasts. They came out at my first post-op appointment with my PS. It doesn’t hurt at al...it was just surprising. I thought they were loose ends of my stitches!
As far as the abdominal incision is concerned...there are multiple layers of stitches in your abdomen. It is going to take a few months for that area to heal. Protect that area. Do exactly what your doctor’s tell you to do.
Wishing you the best recovery
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Sonia, the room is kept at around 85 degrees and I have this warm blanket that blows in hot air. I keep that on my breast. It's supposed to help your blood flow better. They also inserted a small wire into the breast and my doctor is monitoring my blood flow from his cell phone! The nurse comes in every 2 hours now to check the blood flow as well. I don't know why no caffeine. I'll have to ask when doc comes in. I felt way more pain during my BMX thanI do now. Getting up and down is the hardest part but I'm doing it. I'm starving, can't wait for breakfast when I finally get to eat real food.
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I think caffeine restricts blood flow - don’t want that
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Thanks for the responses! I feel like I have been very careful, but maybe I can be more so. My back is hurting from hunching over. Maybe I should use a walker.
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