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Upcoming DIEP Flap

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I was initially diagnosed with a small DCIS. The plan was a lumpectomy with radiation therapy. Genetic testing, BRCA2+ gene mutation, strong family history, and the size of the DCIS measuring 65mm - the plan changed! A BMX with immediate DIEP Flap was the plan. Still a 'Stage 0'. The Plastic Surgeon changed the plan to a delayed DIEP.

The margins and the Sentinel node were negative; the Left breast was clear. The Pathology showed a "small area" of invasive cancer within the DCIS. The stage is now 1A

The Oncologist suggested Hormone Blockers. The % of life expectancy would increase by 2%! I didn't feel this was worth the side effects of hormone blockers.

DIEP Flap will be done in June 2024. I would like to know some post-op expectations.

Comments

  • moderators
    moderators Posts: 8,185
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    @cmhwilkins, welcome to Breastcancer.org! We're sorry you have to be here for this, but glad you found us!

    As you prepare for your DIEP flap surgery, here are some links with information and tips that might help:

    What to expect with any surgery

    Questions to Ask Your Surgeon About Breast Reconstruction

    Shopping/packing/to-do list for surgery + recovery

    After Flap Reconstruction, Complications More Likely in Women With Higher BMI

    We hope this information is helpful! We look forward to hearing more from you.

    The Mods

  • mavericksmom
    mavericksmom Member Posts: 1,200
    edited May 22
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    I had a single mastectomy with DIEP in 2019, less than three years later I was Dx with cancer in my remaining breast, so I had to have an implant on that side because DIEP is one and done.(I was refused a prophylactic mastectomy in my right breast!)

    Recovery starts with a number of days in the hospital to make sure the tissue "takes" and gets a good blood supply in your new breast (s). My pain was well managed, I had a great team and while it was painful learning to walk hunched over for a while, that was all done while I was in the hospital. I had a slow healing process but like every surgery, some of us heal faster.

    I had complications, but that had nothing to do with the surgery. I had skin healing issues due to the radiation I had the first time I had breast cancer, almost 16 years prior. You shouldn't have those issues.

    Plan to have help for the first week after you are home, meals, laundry etc. I made meals and froze them to help make things easier. I slept on my recliner as it was more comfortable than my bed, an adjustable bed would be great, and many people have those now. Unfortunately, I don't.

    Make sure you have something to attach to your drains for when you can shower. I think showering was off limits for a week, but honestly don't remember. I do remember having a device that went around my waist and I could attach all the drains to it. The drains need to be emptied several times a day, so you may or may not need help with that. Again, they will show you how to empty them in the hospital. I had three drains, only one for my breast, two for the abdominal incision, and never needed help emptying or recording the amounts.

    MOST IMPORTATNTLY: BE PREPARED TO SEE YOURSELF IN THE MIRROR THE FIRST TIME AFTER THE SURGERY! No one told me about the huge amount of swelling that took place, again, each person is different and I don't know if it happens to everyone or not. I literally cried my eyes out when I saw my body for the first-time post-surgery! I looked hideous! I didn't realize that someone could look that much worse but I sure did! PLEASE KNOW THAT THE SWELLING WILL GO DOWN AND YOU WILL LOOK GOOD AGAIN! I am not sure if this happens to everyone, but it happened to me so if you are prepared and it doesn't happen for you, that's awesome! If it does, you will know you won't look like that after fully healing!

    I am very happy with my DIEP surgery and I am sure you will be too! Just don't push yourself and accept any help family/friends can give you!

    Wishing you the very best recovery!

  • cmhwilkins
    cmhwilkins Member Posts: 2
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    Thank you for the information. I have already had bilateral mastectomies! I had drains then, the were in for 2 weeks. My husband and I handled them together. I just used lanyards we already had around the house to hold the drains for showering. Following the mastectomies, I was permitted to shower the next day (though I waited until I got home). I was in the hospital for 2 nights. It was uncomfortable - but well—managed pain.

    I had purchased (from Amazon) a set of 6 'incline pillows' of varying shapes, and sizes, that I used in bed. I do not have a recliner or adjustable bed. I had to sleep ONLY on my back — for almost 6 weeks, then was allowed to 'tilt' and gradually was 'released' from back sleeping! That was the best!

    Mine will be a bilateral DIEP Flap.

  • mavericksmom
    mavericksmom Member Posts: 1,200
    edited May 22
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    I think you will do well, you have already gone through so much and have past experience to draw from. I don't remember having any issues with pain, it was well managed, and I didn't need any potent pain killers once I got home, just extra strength Tylenol. I hope others share their thoughts with you.

    As for what I said about the belly button, just ignore. I was misinformed by my doctors, and I am going to edit my post about that. I reached out to the mods and they were able to better explain it to me. That is what I like about this website, there is so much information available.

    Again, I wish you well with your surgery and hope you will post on here afterwards!

  • waves2stars
    waves2stars Member Posts: 131
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    Don’t plan on doing house work for a few weeks. I loved having a toilet riser and it was pretty cheap. I would stay away from long showers because I suspect having the scabs get too wet increases the risk of infection. Make sure to have plenty of fiber like pineapple on hand to deal with the constipation (it’s also good for tissue repair). I was glad I had suppositories on hand. I used men’s undershirts that I cut down the middle to layer between my skin and the binder to keep the binder fresh. Like Mavericksmom said, do not freak out that your body looks like a very exaggerated version of what you were hoping for! It took three months before my breast was close to the finished size, and if you have wound healing issues it will take longer. Don’t be a hero and try to do housework before they clear you, not even loading dishes in the dishwasher. No one is going to remember how much dog hair collected in the corners or how you laid around in a robe for a week, but do it right for yourself and enjoy the results. Did you know tissue repair is generally from .5 to 5mm per day? Just be patient!

    If you could possibly borrow a power recliner from a friend, you will rest better. I had a hospital bed (borrowed from older relative) but I got sore laying in it. One night I got in a recliner and was stuck because I couldn’t really use my core to get out of the fully reclined position. I think I caused some abdominal problems from getting in and out of the hospital bed. You just want to think of it as a marathon, not a sprint, and really baby those abs the first three weeks. The plastic surgeons seem really good about informing you about caring for the breasts but not so much about getting the best and strongest results from the stomach. There are a lot of good tips on realself if you look up tummy tucks.