Should I consider DELAYING pedicled TRAM flap surgery if it means I can have a DIEP flap instead?
Hi All,
I'm scheduled for a delayed pedicled TRAM flap right breast reconstructive surgery on March 7, 2025. Should I consider DELAYING pedicled TRAM flap surgery if it means I can have a DIEP flap instead?
Here's the thing: everything is TOTALLY LINED UP for my current schedule TRAM flap for 3/7/25. But if we try for a DIEP flap, we may need to reschedule the surgery to allow for a longer surgery. That could mean a delay of one, two or more months! Is getting a DIEP flap *worth* screwing up all these details below**? Or is the TRAM flap a similar (sucky?) recovery? Or is it more about a DIEP preserving muscle and therefore one's abdominal strength isn't lost at all?
**Here are My Reasons for Wanting to Keep Current Surgery Date to 3/7/25:
1) It looks like the most amazing anesthesiologist I requested will be available. This guy has been my anesthesiologist for about 3-4 outpatient procedures before and every time I wake up feeling great. NO nausea at all. I spoke with the hospital and they told me there's an excellent chance he'll be assigned to my surgery. But there's no telling if a future date he'll be scheduled.
2) If it ends up being postponed to late March or early April I won't be able to keep me and my 10th grade daughter's annual spring break plans to go visit my sister in DC.
3) Speaking of my sister, she's already planning to come up to help for the first week. She took off the day of my surgery and the day after surgery from work, and will be remote on Wed-Fri. What if she can't get the time off for a future date?
4) Lastly, I am trying to make sure all my revision surgeries fall into this calendar year 2025 in order to hit my out of pocket maximum. If surgery gets delayed too much, some of the revision surgeries may not fit into 2025. But if a DIEP flap doesn't happen until May or June, all the subsequent outpatient reconstructive and cosmetic revisions like a left breast lift or rebuilding a new right breast areola and nipple may not fit into 2025. If they happen in 2026, I won't be able to afford them.
Thanks so much for input, ladies! It means a lot,
Jennifer
Comments
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jenzen,
I had DIEP in 2021. I’m very happy with my results.
Would the same PS that is scheduled to perform the TRAM be the PS doing the DIEP? Did your PS discuss both procedures with you at the beginning? Did you make your decision based on timing of surgery, which surgery you could get scheduled first?
I would not make a decision between the two surgeries based on having a specific anesthesiologist. I had 5 total surgeries with 5 different anesthesiologists and woke up feeling fine every time.
I think you really need to consider the possible complications due to muscle loss/weakness. That’s the biggest difference between the surgeries. Seems like the pediculed TRAM is an older procedure.
I do see that you have other reasons for wanting to go forward with TRAM. They all seem to be related to timing, getting surgery done sooner. Again, I personally would not make a decision based on those factors. I think you need to decide for yourself if preserving muscle is important to you.
I don’t mean to sound like those other factors are not important. They obviously are very important to you! They may be important enough to ultimately decide which surgery you choose.
It’s very hard when making decisions about reconstruction. I hope I didn’t add to the confusion.
Wishing you the best💕0