2018 DIEP Surgery
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Thanks WC3! I don’t have a problem with the fat thing as I’m 4’9” & no place for it all to go but out. In fact I could give you some. 😯😉 I don’t look like I’m obese but I am. I had lost a lot & kept it off but then I think my Thyroid did a number on me. Obviously with the CA.
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Thank for the added info 2002Chickadee. Wow - a cadaver nerve - I had to go look that up! I'm pretty sure my PS won't be doing that, but it sounds like it was highly successful for you. This does sound like a type of nerve reconstruction (that I had read about on the PRMA plastic surgery site, which I came to through a blog called DiepC I think). None of that really applies for me though since I live in Canada.
Thanks for your other info too about recovery and all. I agree that I think this will be harder up front, but better later on. I have heard so many stories of implants going wrong (though I'm sure there are lots of success stories too, but these other ones stuck in my head).
My current dilemma is whether I should take this surgery opportunity to add in a contralateral prophylactic mastectomy on my remaining breast and then have a bilateral DIEP. I am really afraid of losing all sensation in both breasts, but I will need a lift on the 'healthy' side afterwards to create more symmetry so am wondering if I would lose sensation anyway, so why not add the extra mastectomy. Also, I had ILC stage 3 (so node positive) and I keep seeing references to ILC as 'sneaky' - whatever that means - and keep asking myself if I should take the more aggressive path here. The thing is that I don't see this notion about invasive lobular cancer in the academic literature, or anything solid anywhere else - just anecdotal accounts. My MO says it is not necessary to have a contralateral prophylactic mastectomy, that a Bmx is overkill, that the stats don't bear out that this improves outcomes (I've already had chemo x6 and rads x28).
I have looked at the studies and everything says only about 4% chance of a return on the contralateral side..... But with so many people mentioning this 'sneaky' thing I don't know how to make a rational decision about this.
If anyone else has any thoughts or experiences they feel like sharing in relation to this I would appreciate the input.
TIA
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Deaelle, i had ILC and did not remove my healthy breast. In my opinion it was unnecessary and doubles the risk of surgical complications. There’s also the risk that your DIEP fails on the “good” side. I had a lift on the good side 8 months after my DIEP surgery.
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Runrcrb, you make a good point about possible failure, which I never thought about. I agree that adding the extra mx and DIEP would also make for a really long surgery, which raises risk. Thanks for sharing too that you had ILC and chose this sensible path.
How did it go with the lift? Do you have sensation in that breast /nipple? The timeline sounds about what I am expecting too.
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Hi. Leatherette, i know this post is from a while ago but I haven't heard of many people having an expander and then diep. I have an expander now and I'm trying to decide between implant and diep. Did the expander allow for less of a skin flap and less scarring? How was the overall process
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stansie - i had an expander for 15 months. Carried me through chemo and radiation. Hated it for 15 months! Radiation did a number on me. My DIEP breast is belly skin starting an inch or so below the nipple (nipple and skin sparing mastectomy). The scar has faded nicely and for a minute or so one morning 1 months after surgery i had to think about which one was the Diep breast.
Deaelle - yes I have sensation. Happy with the lift as it was more for me than anyone else. Very happy with the surgical path i chose.
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I also had expanders for a year through chemo and rads and like Runrcrb, rads made an implant impossible so I went with DIEP. Almost all of my breast is my tummy and tummy skin.
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Standie, I had TEs for 13 months and then was offered DIEP as an alternative to implants. I had large beasts so there was enough skin there to accommodate TEs and later DIEP using only breast skin. Had 500 ccTEs during radiation, then afterwards filled to 600cc. My radiated side has not flourished as well/much as my non-radiated side so is smaller and I think I may have a lump of necrotic tissue in that side underneath. I am putting off phase 2 surgery to give that radiated side some more time to fill out more if it can. My good side is really good - really really good - too bad radiation took it's toll on the other side. My scars are underneath in the fold and out to the sides.
I had Aetna for all my BC and recon treatments and have to say I didn't have one problem and they even covered PT, lymph transfer,and rexus muscle repair during DIEP. I had some surprise complications with DIEP (handled superbly by my surgeon) and the hospital bill was over $150k. Luckily I'd signed up for 90/10 insurance coverage so my copays etc hurt but didn't bankrupt us. Sadly I had to change plans this year and amnot getting anywhere near that coverage (another reason for stage 2 delay), I'm very happy I made the switch to DIEP even though things are dragging out. I just was not comfortable with implants.
Lanne
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I am thinking of getting the DIEP procedure. I am wanting to know great plastic surgeons that preform this on a regular basis.
Any and all advice....
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Are you happy
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Deaelle - I also have ILC and opted for the BMX. My mammogram 3 months before diagnosis said no issues come back in a year. I felt the lump myself randomly and after being told it was probably a cyst I asked for a biopsy and shockingly diagnosed with ILC - Doc sent me for an MRI due to higher probability of bilateral disease with ILC - the MRI showed a 2nd tumor on the left breast and 2 suspicious spots on right - I had both on right biopsied - one was a fibroedema and the other a complex cyst. At that point I couldn’t sleep knowing the imaging had failed me so opted for the BMX. Left had 2 lumps and 2 micromets in Sentinal lymph nodes- not seen on MRI! The right had several areas of LCIS. I am happy with my decision. I am also thrilled with my DIEP! My breast are very soft and symmetrical. I had nipple recon and look forward to my tattooing in the spring.
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Teaberry, good to hear from you! It’s been awhile! Happy to hear you are doing well!
((Hugs)).
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Hi Bella!
I have been on often always checking in on my friends even when I’m not posting! It’s so good seeing and hearing from everyone. Hope you are well! I think i read you got your tattoos recently? Are they what you hoped?
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rdeesides I have recently noticed scar tissue post DIEP 10/23. I also had radiation after the TE placement.
I have been seeing my PS monthly as a drain wound which has never healed since surgery has recently started to ooze and seems to be related to the hard lumps (fat necrosis). According to the doc, this is something that will be fixed on the 2nd surgery so for now I am just following proper wound care. But, the hard tissue definitely has gotten larger. I had the same thought, as it felt much like the tumor but I am certain that it Is all part-in-parcel for the fat necrosis and prior radiation.
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I would not do a tram flap. Is there another surgeon or center you can have look at your information for a second opinion?
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hi there, I just had single DIEP done on my right side on January 17. My surgical team consisted of a pair of brothers who specialize in Breast reconstruction and microsurgery in Colorado; they have done just under 1000 DIEP flap surgeries. After much research, I found their surgical time 1/3 of what other PS estimated with excellent results.
I cannot believe how beautiful my DIEP breast is shaped and placed. For reference, I had skin and nipple sparing mastectomy direct to implant March 2016 and radiation to the right side after recurrence in June 2017.
I am happy to answer any other questions you may have.
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Hey 123jkg123,
I had a stacked diep flap on my left side on Dec. 11, 2018. Dr. James Craigie of Charleston, SC performed my surgery. I am very pleased with the results. I go back for stage 2 in a few months. l was also very pleased Dr. Craigie would do the surgery. I have had a PE and blood clots and was turned down for surgery at NOLA. Dr. Craigie worked with me and my hematologist. He did a lot of tests. He came up with a plan. I had no clots. He and his partner Dr. Kline have probably a less than 1% flap fail rate. I had Dr. Megan Baker for my general surgeon. She was fantastic too, very skilled. I had nipple and skin sparing mastectomy. Charleston is beautiful and East Cooper Medical Center has exceptional care.
My only regret is that I didn't hear about Dr. Craigie first so I could have been happy sooner.
That was my experience. Good luck to you!
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Hello,
I had expanders removed and implants with R side Latissimus Dorsi flap 5/22/18. I had to have my implants replaced to a wider size with repositioning on 10/1/18.
I have numbness to both arms and now my Left side is drooping-the scar line now faces down, its also painful right in the middle. Saw the Nurse at my PS office, she took pics and said they would see me in 3 months. I am seriously considering the Diep flap. Has anyone went form implants with one sided LD flap to Diep?
Thank you for your time
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Teaberry11
Thanks for you note/sorry about this delayed response. I am currently in the hospital just 2.5 hrs out from my procedure. In the end I decided on just sticking with the single DIEP and not adding the contralateral mx + DIEP, but it was a long decision that felt agonizing...I am settled about this now but it took a while. If I ever go down this road again, which of course I trust never happens, I know I can live with that. I am reassured that the stats say only a 4% chance of recurrence contralaterally.
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Good luck Deaelle! We are all rooting for you!!!
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Hi ladies...I hope all are doing as well as possible. I've been away from the boards for a while but have tried to catch up with you all by reading the posts tonight. I needed a mental break - I've been disappointed with the results of my DIEP Phase 2 revision (December 12th) and had to take a break to keep from fixating on my lack of symmetry.
Carmstr, Parachutes, and Magnolia...sounds like we all have similar issues with the radiated breast being so different from the non-radiated breast. I'm sorry that you have had disappointment and hope that you are able to have successful revisions. My radiated side is noticeably smaller (worse than it was prior to revision), about two inches higher, and has almost no projection. The non-radiated DIEP breast looks pretty good but needs to be higher. My PS says that he can fix symmetry by adding a small implant to the radiated side for projection and lifting the non-radiated side. I have to admit I'm a little untrusting since the revision did almost nothing to make my breasts look better (although he did get rid of my side boob and smoothed out my stomach).
Here are a few thoughts/questions for any of you ladies that might have some input:
If you were going to get a second opinion, wouldn't you want it to come from a PS who specializes in DIEP? All of the DIEP surgeons in Charlotte are in practice together, so to get an opinion from another DIEP surgeon means I need to travel. I could go to Charleston SC or Durham/Chapel Hill. My husband says just get a second opinion from any PS in Charlotte, but I think any doctor giving another opinion (and possibly doing revision) should be a DIEP surgeon. Would you agree?
Has anyone here had a small implant added to their DIEP breast? I don't want an implant...but more than that I want to be symmetrical so I guess I'm willing to do it, but sure do with there was another option.
Thoughts/recommendations on DIEP surgeons in Charleston SC or Durham/Chapel Hill NC? I have a consult scheduled with Dr. Craigie in Charleston but might cancel it. It's certainly easier to do another revision here in Charlotte and not have to travel.
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Hi Sonia, I’m curious, did your DIEP on the radiated size get smaller after initial recovery and swelling went down? I have wondered if the radiated tissue on the DIEP side will continue to shrink as it did with my implant. The time in between completion of radiation and DIEP was 18 months; I don’t know if that makes a difference.
Also, has your surgeon mentioned fat grafting as an option to add fullness and shape the DIEP side instead of an implant?
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Hi KJ17...I do think some shrinkage occurred during recovery, but there was a noticeable difference even right after the surgery. I was surprised and disappointed to see that but had hoped they would even up during recovery, but that didn't happen. The PS does not think he can graft enough fat to even them up, and he says that is because the radiated breast will always tighten up and be higher and smaller. He did some fat grating in the revision but it wasn't enough and I guess most of it was absorbed. I waited 7 months after radiation for the DIEP surgery. So do you have DIEP on just one side, your radiated side?
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ladies, my DIEP was 8.5 months after 35 radiation treatments. I had a unilateral mastectomy so was matching to a natural breast. The DIEP breast was fuller, especially to the side, than my natural breast. The lower half of my breast (from about an inch below the nipple) is made from belly skin. I had the fullness reduced 7 months after DIEP and a small lift on the natural breast. I have not experienced any additional tightening of the radiated breast. I’m 14 months post DIEP.
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Hi ladies! I'm starting to read up, in preparation for bilateral diep April 1.
Quick question.
My PS recommended adding a few more pounds to get two B size breasts. I'm really talented at gaining weight, so that was easy. However, I've gained weight in my thighs and rear too not just my stomach. Has anybody who lost weight after surgery felt like their breasts decreased a lot due to the weightloss? I'm not so psyched to end up A's after such a big surgery but i'd also like to get in my pre-chemo jeans again. TIA!
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Sorry Flynn, can’t help you there-haven’t lost any weight!
I’m getting my phase 2 tomorrow morning-lift and reduction on non DIEP side, abdominal scar revision, dog ear removal with a little lipo.....wavering between nervous and not nervous. Life was just getting back to normal, now I’m messing with stuff again.
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I hope your phase 2 went well! My biggest concern about diep is the fact that life will again be disrupted by my surgery.
I was overwhelmed when I searched on weight loss & diep but suddenly an old thread about it appeared:)
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Flynn, life will be disrupted. I think I’m in the minority but will share - the mastectomy was harder than DIEP for me. Hope all goes well for you
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thanks runcrb! That’s good to hear. I’m preparing myfor a rough go but hopefully i’ll be pleasantly surprised.
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DIEP Ladies,
Are any of you 70 or older who had DIEP? I wanted a TE with implant on cancer side and reduction on non cancerous side but read where implants are not very successful after radiation. I don’t know much about DIEP, and at my age, am wondering if it is worth it. Any suggestions from anyone but especially older ladies?
I pray for all of us!
Caro
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