2018 DIEP Surgery
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OCDAmy,
Congratulations. Can’t wait to say the same
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Congrats OCDAMY!
It does feel good to be done! The nipple tattoos make all the difference
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YEAH AMY!!!!!
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congratulations OCDAmy🎉🎉. I have my surgery scheduled for May with your same breast surgeon at Barnes in St Louis. Had my consultation with Dr Terry Myckatyn and really liked him. Encouraging to hear you are so pleased. Happy 2020
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Love Florida, he is an amazing PS and so kind. I have been very pleased with him and the entire team. Best of luck to you.
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Hi all,
Hope everyone's 2020 is off to a good start. I'm hoping someone might have some advice for me. I was recently diagnosed with DCIS, but because I'm BRCA 1 positive, the surgeon is recommending double mastectomy. I don't want to do implant reconstruction, because I also have a history of non hodgkin's lymphoma from 18 years ago and don't want the silicone to cause my immune system to act up. The plastic surgeon is recommending a DIEP flap, but several people I've talked to mentioned issues with bloating when eating and pain because of the abdominal incision. I have a 25 years history of Crohn's diesase (an auto-immune intestinal disorder) which causes me a lot of abdominal pain and bloating and is very hard to manage (can't be managed by diet). I'm worried the DIEP will present a lifelong challenge with eating and pain (I already get pain from eating because of the Crohn's alone!). Anybody have experience with Crohn's and DIEP?
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wintnt - I had a double mastectomy and DIEP 13 months later. I didn't experience bloating and no pain specifically caused by eating with either of them - with DIEP it was more like tummy swelling. There is obviously pain from the surgery, incisions, and regaining your posture from the tummy tuck aspect - plus any pain specific to how your body tolerates the surgery and healing. The tummy incision does not cut into the muscle layer. If you read through this topic, you'll get good advice and learn what others have dealt with, how to optimize your hospital stay and questions to ask your dr. If you ease your Crohn's disease with exercise, know that you'll have to scale back quite a bit for several weeks.
Take care - Lanne
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I second Lanne. No digestive issues whatsoever and cant say I've heard that before. DIEP only takes the fatty tissue layer, so not sure how it could cause bloating or pain associated with eating. I have not experienced that. I had significant abdominal muscle pain for about a week or two following surgery but it healed pretty quickly. I did have muscle pain when I started exercising again at 8w but only in the spot that they dissected the vein from the muscle. I gave it a rest and it's better now but I notice it when doing situps. The abdominal part of the surgery is not that different than a c-section, but the incision is wider and a little higher.
Best of luck to you!
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For those of you that had delayed DIEP with TE’s placed after mastectomy- were they prepectoral? Or under the muscle? My mastectomy is in a couple weeks and my plastic surgeon is not willing or probably able to do DIEP, so I want to just have my mastectomy and then go to a different PS for my reconstruction. The surgeon says she will not leave skin if I’m not reconstructing right away. She also said my scar would then be much larger from my sternum to my armpit! I do want to reconstruct- just not with her PS who doesn’t have much experience, so I was thinking of having her put in the expander so she would do a skin-sparing mastectomy, and then getting another opinion for DIEP. Advice
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Deedee - my tissue expanded was under the muscle. I had DIEP 15 months after mastectomy. If you need to have the mastectomy without having found the right plastic surgeon, have the TE put in. I think it always goes under the muscle as the purpose is to stretch the muscle to make a pocket for the implant. My plastic surgeon wouldn’t do my DIEP until after I’d healed from radiation and I’m glad as radiation was a bear. Private message me if you want pictures. And start looking for your DIEP surgeon. It’s never too early and since the surgery is so long scheduling takes a while.
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DeeDee, I had TE under the muscle but that was because I was anticipating have implants under the muscle at the time. I had chemo and rads after and like Runrcrb am glad I had the TE because rads did a number on my breast and afterwards my PS said she thought I might have trouble with an implant. She did not do DIEP and referred my to a colleague who did. So, he removed the TE, repaired the muscle and I had DIEP. I am not certain if you are doing delayed DIEP if you need a TE under the muscle or not. Seems like you wouldn't because they are not going under the muscle and many implants now are over the muscle (I have a pre pec implant on my other non-cancer breast). Maybe they can put the TE under the skin but not the muscle...I honestly don't know.
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DeeDee - good question. Please consult with a PS, but your BS may not be willing to place the TEs, idk. No reason why you couldn't have the (inexperienced) PS placed them if your BS won't, unless you're not comfortable with that. I would even say - maybe consult with a new BS/PS team so you feel more confident with the longer term plan?
I think over the muscle 100%. First of all, even implants are mostly done over the muscle now. Not trying to offend anyone here, but under the muscle hasn't been the preferred/best practice method for implants for 3-4 years. I think all immediate DIEP flaps are over the muscle...arent they? There's enough trauma with mastectomy. You don't want to mess with your pectoral muscles if you don't have to!
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I'm two months out from UX DIEP surgery and rather than the breast getting softer and more comfortable, it's getting harder and more painful. I can no longer lay on my stomach as it feels like I'm mashing a hard rubber ring into my chest wall. Is this normal, and just that the scar tissue from where the transplanted material was tacked down hasn't started to break down yet? Am I being impatient? I sent an email through MyChart to my PS but have not received a response yet.
Any thoughts?
Thanks,
Diane
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DeeDee - I had BMX with TEs and then DIEP 13 months later. TEs were over the muscle. My BS and PS performed the BMX surgery together. I had very large breasts so the BS/PS were able to save enough skin to create breast pockets big enough for the expanders, and the pockets were then used for DIEP - no tummy skin was used to create breasts. My scars run in the fold under each breast and out under my arms. PS used same incisions for DIEP.
Honestly, your BS sounds like a jerk! Pls consider getting a better team. You'll be putting yourself through TWO major surgeries only bcs your surgeon doesn't/can't do DIEP. The way it should go is - you tell the surgeon what you want and she does it unless there is a medical reason not to. No person going through cancer and breast surgery deserves to be bullied by her Dr.
Also, I had radiation btwn BMX and DIEP. Radiation did a number on the arteries/veins on my radiated side which caused complication during DIEP, and that side did not do so well after DIEP.. Something to discuss with your PS.if you’ll be doing treatments in the same order.
Lanne
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Diane - have you gotten a response yet? That doesn't sound right. At 2m post surgery I would think it would be soft. Definitely shouldn't be getting harder or more painful. Maybe you have a seroma?
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Hello, I have been reading through this board trying to gather info. My PS gave me several options regarding reconstruction after my BM. Initially, I was intending on getting implants but I am now really leaning towards diep flap. He said that he would still put in TE's to create a pocket and then instead of doing an exchange for an implant, he could do diep flap and use my own tissue. I see that some of you ladies have done this. What was your recovery like after the second surgery (the exchange/diep)? Was it as hard as the first surgery?
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mamags,
I suggest having another conversation with your plastic surgeon to understand more. DIEP is not an exchange surgery. My girlfriend had a double mastectomy with tissue expanders followed by exchange 5 months later. Exchange was simple, outpatient surgery. She was back in the office within two weeks. I had a single mastectomy with tissue expander and then all of my treatments (chemo, radiation). DIEP was an extensive 6 hour surgery followed by overnight in the ICU. I was an exception in that i was home after two nights. Drains were in just like my mastectomy. I will say that, for me, DIEP was easier than mastectomy.
Historically tissue expanders go under the muscle and are “filled” to stretch the muscle to create the pocket for the implant. While I’ve seen mention on these boards that more implants are going over the muscles that wasn’t offered to me, reason being that one wanted more than simply skin between the implant and the outside world. Regardless, the DIEP breast is built on top of the muscle. During my surgery after removing the tissue expander my doctor repositioned the muscle before building my new breast. Talk to your surgeon to make sure you fully understand the options and that plan. Also knowing your treatment plan will inform some decisions. My PS wouldn’t do DIEP until I’d completed and healed from radiation- I’m glad because radiation did a number on my breast.0 -
Run, I had the same course as you did. But I assume the TE, if you knew you were getting DIEP later, wouldbe placed above the muscle to stretch out the skin in preparation for DIEP later. My skin was pretty damaged from rads so my DIEP used the tissue AND skin from my stomach. Some women only need the tissue.
Manags, I found DIEP to be easier than BMX but that is not the case for everyone.
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HopeWins,
I have.an appointment with the PS in February, but no responses from others on the boards. The discomfort comes and goes some, without actually going away. It's worst around the outer edges of the breast and less so at the donor skin site in the middle of breast.. anyway though it's still rather uncomfortable. It doesn't feel like there's fluid buildup under the skin. I guess I'll have to wait for the PS appointment.
Diane
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mamags - as described above, I had BMX and DIEP in separate surgeries. I thought recovery for the first 4-5 days for each was the same but part of that was bcs my DIEP took longer than usual bcs of some complications thanks to radiation. And adding in the tummy portion made moving around after DIEP harder. But in the grand scheme of things an extra month or two of recovering from DIEP was well worth it.
If your surgeon is able to create pockets for you with TEs and not have to craft new breasts using tummy skin, you'll obviously have much less and mostly hidden scarring. I will say tho that for me, TEs were horrible and the main reason I switched from implants to DIEP but it was so so worth it.
If you are having lymph nodes removed during BMX, talk to your PS about a lymph node transfer to hopefully help stave off lymphedema.
Lanne
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Hi All,
One of our writers, Cheryl, would like to talk to people who has had a great caregiver they could speak on behalf of following a mastectomy with reconstruction. OR, directly talk with the caregiver themselves. This information would be so helpful to writing the piece she is working on. Please PM us if you are interested, or your caregiver.
Many, many thanks!
The Mods
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Four weeks PFC and my fingertips are finally feeling much better. I was really starting to stress that the Taxol SE's would be permanent. I managed to do some knitting for the first time in several weeks. I had stopped because not feeling the yarn and needles was making it really difficult.
I also got some great news. My PS had a cancellation and they were able to schedule me for a March 11 DIEP flap surgery. Which is huge - I was dreading waiting until summer and having things drag on. Of course we had come to grips with the delayed surgery and started making plans and now all that is up in the air. But totally worth it!!
Hugs to everyone - it's sunny for the first time in days and reading everyone's progress is making me really optimistic for the new year.
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Hi All,
I am back home from my BMX and DIEP and they were not kidding about stomach pain. It definitely gets better, but wow. I made good use of the Valium for muscle cramps. I have question, not to be too graphic, after my lumpectomy my boob was deeply bruised so I expected as much this time. Now they are swollen and bruised and there are blisters. Did anyone else have blisters? I also have a hard lump, which I asked was a seroma but the PS said looks like a blood bubble. Yuck. I see my doctors this week so I am sure they will give me updates but I am hoping I am not alone in this.
Thanks!
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I had blisters along my mastectomy incision about day 6. I saw my PS and he immediately took me into his surgical area and cleaned me out. He said it was an infection. Yours may not be the same thing but I think you should ask if you need to be seen
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Thank you for the information jbdayton. I saw my PS yesterday and he removed my stomach tube (2 to go). He popped the blisters which I thought was always bad, but he said it is from the swelling and was unconcerned. He prescribed a cream to use on the blister area and darker purple bruises and said it all looks good. I see my BS tomorrow and then PS on Monday so hopefully they will notice if anything is awry. And of course remove the drains.
Cannot believe it has only been a few days since I left the hospital.
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Hi there,
It's been a little over 6 months since my surgery, and I was wondering if I need to pursue something else with my healing. Is anyone else still experiencing stiffness in their shoulder/back/chest area? This ache/stiffness/pain has been there since my surgery. I came down with the flu, so these symptoms appear to be magnified. Is this normal? I am able to do stuff, so it's not stopping me from living. Yet, it is always there especially when I wake up. It takes a while to shake off in the morning. I forget about it. But if I stay in one position for a prolong time like when I'm at my office job, the pain is there. It feels like I'm so stiff. Is this arthritis?
I also went skiing this past week, so that could have made it worse too?
It just feels like a loooong time feeling this way. When does it go away? What did you do to get rid of the pain. I try not to take Ibuprofen or Tylenol because I wanted to be nice to my liver after all that chemo.
Thanks for any insight.
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I went to PT at a location that specializes in breast cancer patients. They gave me exercises to do to open up my chest, strengthen the upper body and increase mobility. I still do them daily at home and notice the difference on days that I don't, since Im taking Arimidex.
I highly recommend at least a few sessions. I paid out of pocket and it was worth every penny.
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Thank you Magari. How long after your surgery did you start PT?
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Hi, ladies. It feels weird to be taking about something other than COVID-19.
I had a BX DIEP on the 11th, replacing them TE’s that had been placed during my BXM. They were over muscle and super uncomfortable. I hated them from day one and having them removed was almost as awesome as my last chemo.
It has shockingly been pretty good so far. The surgery went 8 hours and my PS said it was perfect to my husband. I didn’t have any rads, just chemo. I’m a BRCA carrier, so I went for the BXM to be done. A few hours post op I was a mess. It hurt. Once the drugs got me through that first night, I was pretty good.
I got up and shuffled around the first morning after. And again the afternoon. The goal was to get out at 48 hours because there were two COVID-19 positive patients in the building.
They ended up springing me at 48 hours post op. I’m in a binder and the girls are enjoying some air. I think they’re a little smaller than I was expecting. I had plenty of belly to use. As things settle they are looking a little bigger.
I’m living in my recliner and staying warm and trying not to kill my kids who are stuck home with me instead of at school.
How did y’all handle the binder chafing while drains are still in? It’s so uncomfortable but I can’t quite talk myself into taking it off because it’s providing so much support. I’ve got at least five days until the first post op opportunity for drain removal.
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Hello ACchaos
I just had bilateral Diep 3/9/20 at Johns Hopkins with Dr Manahan. BMX with failed tissue expanders over muscle 6/14/19 at another facility
I'm very pleased with my results but feel for you and your early discharge with kids at home too. I was in hospital 72 hrs and each day makes a difference--gets better and better!!
Each doctor is different. Mine did not prescribe a binder and I have no dresssings. I've read other posts that they used a t-shirt or cami to help prevent chaffing but you are so new post op and your doc may not want anything tight on the breasts. I would check with your surgeon about wearing a shirt you can tuck in the binder or if you can release the binder when in recliner to give you a break.
Will keep you in my prayers and here's to a speedy and corona free recovery for us!!
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