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Am I crazy to consider a DIEP this far out?

outfield Member Posts: 235
edited January 2023 in Breast Reconstruction

My bilateral mastectomy was in 2010 when I was 44. Not skin or nipple sparing - wouldn't want to have "spared" any of the breast with the worse problems, that's for sure. Back then, I was adamant I did not want to discuss reconstruction because I was so afraid of dying and I did not want to miss an extra minute with my kids (2 and 3 when I was diagnosed) by giving time to a surgical recovery. I also didn't think I'd mind being flat, which for the most part I have not.

But now I'm finding myself wondering. I'm finally off the aromatase inhibitor and feeling more like an adult woman again. It's almost like going through a second, milder puberty being off that thing. I think I might want breasts. I would not consider implants, and I'm really not keen on the idea of losing a chunk of muscle because I'm fairly athletic. I'm also not keen on the idea of big breasts - I'd want someone to respect my wish for small ones. I was super skinny back in 2010, but I have a little belly now. Is this sounding like a situation where a DIEP is an option? Am I nuts?

And second part of my question, does anybody know a surgeon who does a high volume of DIEPs and would respect a woman's wishes about wanting small breasts who is in Phoenix, Denver, or Texas? I'm in New Mexico, and while we do have a lot of good doctors here, we have a skeleton of a healthcare system and few choices compared to other places. I'm not sure I trust the surgeon here who was recommended to me. How did you choose your plastic surgeon if you are in major metro area and actually have choices?


  • ratherbesailing
    ratherbesailing Member Posts: 124

    Outfield, no, you're not crazy! Of course, I can't gauge your situation, but can say I didn't have much of a stomach, and had to go to two different plastic surgeons to find one who said it could be done. You definitely want a surgeon who has extensive experience in DIEP, as it is challenging technically as well as aesthetically. I have no ideas for plastic surgeons in your area. There is a group in New Orleans that has a lot of experience in DIEP, and often treats patients out of state. Wishing you the best...

  • veggal
    veggal Member Posts: 261

    Check out Dr Nicholas Haddock at UTSW. He is the “king of flaps.

  • anniepnw
    anniepnw Member Posts: 23

    I have my DMX scheduled for 02-07. I have been agonizing over a reconstruction yes/no decision since my diagnosis in early December. To opt for DMX was so easy compared to flat vs reconstruction! I am very heavily leaning towards going flat with an AFC, but a small part of me wonders what if......

    I have two appointments with two different plastic surgeons, both recommended by my breast surgeon, this coming Mon and then Tue. I think I want to see if they can sell me the reconstruction, even down the road. I've done a TON of research, and everything so far sounds like, No, AFC is it. I don't want implants (foreign bodies), and flaps feel like an extremely involved series of surgeries; when I hear that some ladies had to go through 7 or 8, I am like, No frigging way.

    The biggest question, though, that I want to ask both PS is if I can do a flap reconstruction later in life (i believe they will say yes), and what issues they may think of down the road. From my research, the tissue expanders and how uncomfortable they are will fall into that bucket, but also my size - I am 5 2" and 128 lbs with lots of muscle mass and want to go back to my normal 122. I was talking to a patient coordinator at PRMA, a well known clinic in San Antonio that does nothing but flaps, and the way she put it was, Look at your tummy and try to grab a handful of tissue; your new breasts will be around this size or slightly smaller. Well, I have an almost flat tummy, so here goes this idea... The next area they'd focus on would be the insides of the top of my thighs as this area usually has some fat (yes!), and the skin is most similar to the breast skin. For what it's worth.

    I am on the West Coast and was referred to PRMA by a lady who did a DIEP flap with them when she used to live in Houston; she runs a DIEP group n Facebook, that's how I found her. She highly recommends them.

  • meow13
    meow13 Member Posts: 1,363

    Go for it, my friend had her DIEP 16 years after her mastectomy. I had mine and she saw my results and said I want that so she could wear a bathing suit on her trip to Hawaii. She was in her early 50s.

  • outfield
    outfield Member Posts: 235

    anniepnw, I had to look up AFC because I hadn't heard that term - 12-1/2 years ago I wonder if it was even around. I did not have one, although from all the photos and chests I've seen over the years, my surgeon didn't do a terrible job. I'm similar to you in size - 5'1-1/2" and right now about 120, not as muscular as I used to be. I'm curious about how your appointments went.