Post Diep Tummy Muscle Strength
Hi, I am considering the Diep procedure. I am still doing a lot of research on it. I just wanted to know from any ladies that have done this procedure, what your tummy is like post surgery
It is not a tummy tuck from what I am told. They do stretch the skin down. Does your tummy stay flat and tight years down the road. Can you strengthen the tummy to keep it looking flat after such a procedure, later on? Does it weaken the muscles to the point of having a bulge there forever?
Photos would be nice if anyone would like to show this.
Thank you.l
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Still nice and flat 7 years now. No muscle was taken in my DIEP.
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Almost 3 years out. I am active (run, swim, yoga) and my tummy looks amazing! No loss of muscle strength at all. I never had Stage 2 (I might this summer though) so I have a small “ridge” of fat under my scar line, but it’s not noticeable except to me. My surgery was very much like a tummy tuck, and even a withiut Stage 2 I’m very pleased with my results
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muscle isn’t cut with DIEP. Your mention of bulge makes me think you might be confusing DIEP with TRAM. TRAM is an older procedure that moved the muscle and fat up. My surgeon won’t do TRAM due to the long term issues of ab strength.
The exact location of your incision depends on your anatomy and where the best blood vessels are So when you are sewn back together, the skin is pulled down but you will likely have some pulled up For me the result was that my pubic hair is higher up than it was I would still do the procedure again
I swim, run, bike, yoga and strength train.
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As Runrcrb points out, no muscle is taken or used in DIEP surgery. Muscle is cut, though, to get to the blood vessels required to keep the flap alive when transferred. I can tell you exactly where my abdominal muscle was cut, I can feel a general tightness in the area. And my PS indicated hernia is a rare but possible complication (as with any surgery that cuts muscle) but I don’t know anyone who’s had that happen. The muscle strength is the same as before, no changes in that at all.
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Just wanted to say thank you for your comments, trying to decide on reconstruction, read an article on the TRAM flap that was not quite current and have a better understanding of the DIEP flap now. Being a larger woman, I have learned that implants are for smaller, thinner women, so trying to do some research on the flaps. All new words for me, but your comments have helped me. Thank you and I hope you are all doing well. Lisa
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Thank you for all the comments. I am from Canada and I am also on a Diep Reconstruction facebook closed group. From the comments of these women in that group, they have bulges on their tummies. The Admin lady on there, who has had this operation, said it is not uncommon for hernias. My plastic surgeon that I have had two consults with now has said it does weaken the muscle in your tummy. I could look like I was 4 months pregnant. This is more deterrent than the actual new foob area. Why am I getting different advice from these other ladies?
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I weighed 123 pounds 5' 3", I had extra skin and tissue on my stomach. It was all used my stomach is flat now, no ridges just a white scar line from hip to hip at bikini line. It feels tight even now, there is no muscle strength issue. Never had any bulges, looks great. What does your plastic surgeon say?
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My plastic surgeon has done 20 Diep surgeries. She said one had the strength diminsh and become mushy. They don't know why and it can't be corrected. I was surprised she had only done 20 of these surgeries. Does that sound low. I plan on losing another 20 lbs before this surgery if I do it. I will be 5 ft. 7 in at 165 lbs then. She said it would be better to lose my weight.
I also saw some photos on the other group of some women's tummy scars post op. One of the ladies had a fairly flat stomach before the surgery. After she looked 6 months pregnant. Her surgeon had to put mesh in and it looks better, but still a bulge there. Another woman's looks flat and great and another lady has a bulge too. I don't want a permanent bulge.
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What would cause a bulge? Are we talking about DIEP? The only thing I can think of is that muscle is being distrubed or removed, or maybe swelling. In a DIEP procedure no muscle is used.
Gingermiss, I would go to someone with more experience. My plastic surgeon does 1 DIEP surgery a week.
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Gingermiss - DIEP and TRAM are specialty surgeries; some surgeons do them from time to time, others specialize in them. My PS is a specialist, it’s pretty much all he does, and he’s amazing. His results are incredible. I felt this was my one shot to get it right and i wasn't going to take any chances so I did a lot of pre-surgical research before choosing my PS. I have a friend who had DIEP with a non-specialist, and she’s pleased with her results, so it is possible.
I hear concern in your post, and encourage you to seek out other surgeons, if possible, at least for comparison. Read others’ stories but know that results are also dependent on individual’s experiences - overall health, weight, age, diet, smoking, activity level, etc. And some things - like hernia or wound dehisence - can’t always be anticipated.
If you’re planning to lose weight do so before surgery, if possible. I was thin to begin with with smallish breasts. I recently lost my last 20 pounds, and my breasts have definitely taken a hit. My recon is a little sad right now but I’m hoping to do some fat grafting to round it back out a little.0 -
I agree with others here. I have consulted about DIEP with a PS with lots expertise in that area and he reports bulge is rare, happening at only 1 percent. So, yeah, DIEP has a very low morbidity with an expert. And I am pretty sure if this rare event of hernia occurs it can be fixed via hernia surgery, but others here with more experience than me on hernia may want to comment on hernia serverity and repair.
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Hi. I know this is an old post but I wanted to respond. I am one of the 1 percent with loss of abdominal strength and an abdominal bulge. I had mesh put in to fix the bulge.
I am 3 1/2 years out and my muscle strength is very poor and I am so tight. I feel like I have weights around my stomach. I don’t know how to explain it. It’s super uncomfortable.
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Hi Pandabear. What did your plastic surgeon say was the cause? Because DIEP doesn't use muscle, from what everyone is saying? Was your PS a specialist, or just does them occasionally?
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Even 2.5 years out I have some tightness too, not nearly as much as right after surgery, I can sympathize. Yoga helped me stretch out much of that tightness. Most of its from the skin and tissue itself, although there is a small area of muscle tightness where the underlying muscle was cut to detach the blood vessels that feed the flap tissue. So it’s true that no muscle is removed in DIEP, but muscle is cut to get to that epigastric perforator
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My PS just says it happens to some people. Honestly I don’t think he knows what to do with me. I did have open wounds in my stomach after surgery and not sure if that’s a cause? My stomach is rock hard and I can’t get up from a lying position on my own.
I am in a FB group with people with the complication from Tram and DIEP.
My PS does the DIEP a lot. And he assists with a PS in Newport Beach.
I am just one of the unlucky ones
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Pandabear, Have you been checked for truncal lymphedema? I have it and what you're describing sounds similar. Sometimes my abdomen gets so tight (like braxton-hicks contractions) that I look like I have six pack abs. Which I don't.
Trish
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I have truncal lymphedema too. Trishyla you're the first person I heard that has it also. My physical therapist said it's getting more common with DIEP, APEX, surgeries I experience it more in my armpit area going down my right side. They also have suggested that I wear a sleeve also.
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That's exactly where I get my worst swelling, mstrouble16. Starting in my right armpit all the way down to about my hip area. Left side swells, but not nearly as bad.
The two things that help the most are manual lymph drainage massage, done either by my therapist or myself, and dry brushing. As long as I'm vigilant, and don't ignore early symptoms, I can usually nip it in the bud.
I do wear my compression garment (but not my compression sleeves) when it gets really bad. It's so attractive, and sexy, too 🙄🙄
Do you ever get the tightening in your abdomen? Like Braxton-hicks contractions? So far, I'm the only one I know who gets them. They're very weird and annoying.
You can PM me if you want to compare notes further.
Trish
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I'm 4 years out from a DIEP (Stage 1 only) with no bulges or abdominal weakness. Stomach is still pretty flat, but when I gain a little weight my scar gets tight and itchy. I also developed truncal lymphedema in the last couple of years. I've had to extend my lymphatic drainage massage to also move fluid toward my groin nodes to help reduce the swelling. Best wishes on decisions and outcomes!
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Trishyla - thank you for the suggestion. I have not ever been checked. My regular Dr thinks it’s a lot of scar tissue. How did you find out you had it?
I am in Burbank! We are practically neighbors! Who did your DIEP?
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Pandabear,
I found out about truncal lymphedema by reading these forums. My symptoms matched exactly, so I spoke to my oncologist about it. She sent me to a LE therapist for evaluation and treatment. I was lucky to find a very experienced LE specialist at Huntington Hospital Outpatient Rehab. She's amazing. Booked solid months in advance.
I get my care at City of Hope in South Pasadena. My surgery was at their Duarte hospital . Dr. Mark Tan and Dr. Sharon Clancy did my DIEP flap and Dr. Wei Yi Li did my revisions. I wouldn't reccomend any of them for their bedside manner, but they did an amazing job on my reconstruction. I'm very pleased with the results.
Where did you have your surgery? Are you happy with your results, other than the ongoing stomach issues? You may want to see another PS for a second opinion on what, if anything, can be done to address the problems with your abdomen.
Feel free to PM me if you have any other questions.
Trish
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NancyHB - Thank you for the explanation about muscle is cut to get to epigastric perforator. I had my DIEP 8 years ago and I am still just as tight in my stomach as I was then. I seem to be in the minority though with the problem. I also have fibromyalgia and so my breast sites are also extremely sensitive.
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Pandabear I am in that 1% with you and I had a surgeon that had done a lot of them. Could you tell me the name of the FB group?
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I just had my 3rd consultation with my plastic surgeon and decided on the Diep procedure. Now the waiting game for surgery. I was mistaken, she does about 20 Diep surgeries per year. Apparently, she is at every bra day in our area, which I missed. I asked her how many she had done, and she said 20. That was all she said. My last consult, she said 20 per year. So, there was a bit of a miscommunication there.
I am still hesitant to do this procedure though. The 1% rate of your stomach complications, worries me Pandabear and Blondie. I had one failed immediate skin sparing reconstruction already. It became infected and apparently that is in the 1% for it to happen, as well. So, maybe I am susceptable to complications. I don't want to deal with hernias and bulges etc.
I may change course and go with the Latimmus Dorsal procedure. Less surgery time, less down time and the back scar seems less scary to me, than the huge stomach scar etc. I talked with someone that had that and one lady had capsular somethin, not sure how to say that and had her implant removed and replaced. So far, so good. The other lady has that procedure too and she is going on 10 yrs with no problems. Having to remove the implant and replace it, is really not that complicated either. I had the expander removed with the failed reconstruction and it was quick and easy. I just don't think implants are healthy. So, there is no perfect surgery here. You just have to make a choice, and do it. Or stay flat.
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There have been plenty of days that I wonder why I went to all this trouble with reconstruction when flat is so easy for so many reasons. Best wishes on making the choice that feels best for you.
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I am looking into diep surgery. I have the allergen textured implants and one has ruptured. I don’t really want to have implants put in but having diep and end up with permanent pain in the abdomen or muscle weakness in the area is Not something I can live with. My biggest fear is being on the table? Cut open and they find they have to cut the muscle to access my vessels. If apex flap was available in Canada then I wouldn’t have that fear. They would just switch to the apex method if diep would require them to cut the muscle.
For those of you who had diep, would you go through this again?
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Mantra, that's a tough question. Most of those who are happy with their results have skipped into the sunset and didn't look back. Many of the ones still here had complications or are unhappy with their results. It might be good to ask this on a DIEP thread from 2017 or 2018 where the full cohort is more active.
I had DIEP in 2015 after a complication from my 2012 SGAP resulted in necrosis and a shrunken breast. The SGAP blood vessels are smaller than DIEP vessels, so my breast did not get sufficient blood flow and part of it did not survive. The surgical recovery is long with flap procedures, but my DIEP results look very good. I have numbness in my breasts and around my waist, but I am more used to that now. My breasts are much larger than what I wanted (wanted C cup, got DD), so there are days when I wonder why I even bothered with reconstruction at all. It's a lot of hassle for these things that get in the way all the time. The upshot is that I am wearing a lot of strappy summer dresses without a bra. These decisions are tough! I wish you the best. Also, find the best surgeon. It matters.
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I had BMX and immediate Diep in 2013 and I still like my results. My muscle was cut on one side due to complications but otherwise the surgery went smoothly. I am active but not athletic so I do not notice a problem with the muscle. Unfortunately I have gained a little weight so my stomach is not flat. As with all surgeries, some people have problems and some do not. There are no guarantees. I am one of the fortunate ones who did not have problems. Good Luck
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Hi,
I've never posted before but just came here to look and see if anyone else felt like they were having contractions after DIEP. I just had my procedure last Tuesday at Moffit out in Tampa. Only a week post op but I swear I feel like I'm in labor. My stomach gets so tight just like Braxton Hicks and now my lower back has been spasiming like crazy from using the walker and walking in a cramped position. My stomach does look flat though. It's the wierdest sensation. My surgeon doesn't want me to wear any compression garments but it feels like I have a binder on that gets pulled tighter whenever I move around too much. I'm wondering if this will go away as I heal. I haven't even had my drains out yet so I'll have to ask at my post op in one week0 -
Went ice skating the other day, no problems. I hadn't skated since my DIEP. I am going skiing in a couple weeks I was afraid of falling but I am giving it a try. It has been almost 8 years since my surgery.
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