DIEP Flap Reconstruction 2017

Houmom, hi, hope you are doing okay besides not standing up straight! that takes a while! You can't stand up too too much when you are still recovering, but I did go to my husband's christmas party at day 11, I never thought I would but i wanted to go for at least an hour and I found out the more you stand up the straighter you get. When I went back to work at 4 weeks, I realized that sitting at a desk was harder than standing up. Even a half hour of sitting would make me feel all crunched up again. I am now at 6 weeks out and it is really getting easier.

I wonder if I should go on 2018 thread. I am not done!

Just getting over an interesting 2 weeks in which I had a negative reaction to the adhesive glue on the incisions. I guess whatever remained at about 4 weeks, was just too too much for my system. It was very inflamed and throbby and itchy all over.

Got fat necrosis in one side, anyone have any experience with that?? Dr. is so casual about everything, no problem he can fix it... but it is really bumming me out and I am having a hard time finding info. I am massaging like crazy and all it seem to do is make me sore.

Michele

well all went well today at the plastic surgeon. Surgery is on for May 18th. Super excited. 16 weeks and counting. Surgery being done at Moffitt cancer center in Tampa by doctor Paul smith. Wonderful doctor

LMichele- the necrosis will be broken up during stage 2 typically with the lipo cannula. And yes they can reduce the flap breast. They can take care of the side boob and dog ears at your hips as well as car revisions. They make you bigger in stage 1 because that tissue is most likely to survive and stay vs trying to make you bigger using fat grafting which tends to get reabsorbed. The PA estimated I was a cup and a half bigger than when I started this process. Dr reduced, lifted, broke up some necrosis, got rid of side boob, took care of dog ears, straightened my belly button (mine is oval and it was tilted after stage 1), lipoed hips and smoothed transition from waist to hips to thighs, and used that fat to fill in upper poles of both breasts. As far as symmetry, talk with your dr about what option you’d like and what would be best in their opinion.

Hi friends,

This is my first post. Last week I was diagnosed with DCIS Stage 0 grade 2 and atypical ductal hyperplasia, L breast. I also had ADH in my right breast in 2016 with a lumpectomy. Because of my high breast cancer risk (37% before the DCIS diagnosis) and having the option of avoiding aromatase inhibitors and radiation with a BMX, I met with a PS yesterday at Stanford and am planning to have a BMX with DIEP. He also offered me the option of DIEP with implants in case there is not enough fat in my abdomen to make my breasts the size they are now, or if I want to go up in size. If there is not enough fat to make them the size they are now he would put the fat in there and then add a thin implant, under the fat but on top of the chest wall. He also said I could add fat later but some of it might get absorbed, or it might not take. Have any of you done DIEP with implants? I am a bit concerned about the implant needing to be replaced -- I am 58. Or any other complications of implants. Thanks.

I am having a lumpectomy Monday then will schedule the BMX with DIEP to be in about 6 weeks or so. The doctors at Stanford are telling me my breast cancer risk will drop to 1% with the BMX, which is great. Question: How long did it take after your BMX with DIEP to feel "back to normal" in terms of your energy, range of motion, and pain? Thanks!

Thanks suburbs!

CyberCathy my plastic surgeon offered me the option to add implants to my DIEP but I was happy to be going much smaller. It is still an option down the line for me, it did not have to be done all at once.

Hello All,

I had unilateral mastectomy with immediate DIEP flap reconstruction in August of 2017. I wish someone would have a book or a blog of the monthly..'what to possibly expect' so that when things happen I am not just sitting and worrying or wondering. I cannot always seem to find my answers because most people only communicate when they have had horrible experiences.

I am hoping to ask a couple of questions and if this has been done and the answers are within this thread of 41 pages, my apologies.

I did have lots of issues after the surgery as my onco surgeon was fairly aggressive and I had some necrosis (nothing that went completely black...dark blues, lots of seeping from the skin and peeling). Anyway, I have some redness below the flap now and hoping that will shrink in time. I have not had the stage 2 surgeries yet. But, I was told I might have to leave the lower part of the breast below the flap the way it is because trying to remove the scar tissue would make for a really irregular shape.

Here are my questions:

Last night and today I have some cramping going on above the reconstruction - feels like along the route the drain had been in and soreness near the one lymph node that was removed. It has had moments here and there of some pain from nerves regenerating but this also feels like I am puffier - maybe some fluid retention but looking at it I cannot see it is puffy - just feels it. Can we still get inflammation these many months out? Is cramping just nerves regenerating?

Second question, due to the amazing 'footprint' that the plastic surgeon made of the reconstructed breast, we are really just looking at some fat graphting for my right breast (no cancer in that breast). Initially we thought I would need a lift to the right breast but the two really share the exact same outline and look, aside from the reconstructed breast being fuller near the top. Has anyone had this process? Any thoughts on that?

If I didn't make sense on something, please let me know. Sorry for the long read.

Thanks!

trhfbc2017, swelling can last for a long time. If you are not going for regular physical therapy, you might consider it with a seasoned expert in lymphedema. I have the same swelling but not cramping.

Faithwalker, glad to hear everything is going pretty well. It is fabulous to sleep in a proper bed. I spent a month on the couch before and after surgery. A pain free night of sleep is a slice of heaven. Good for you.

Wishing you both aspeedy recovery.

My stomach incision is feeling weird this evening at the far ends, it feels like the tape is pulling on it or something. I’m not sure if it’s because I’ve been able to eat more normally in the last couple of days after not eating much since surgery last week. It’s driving me crazy.

Rlsteadman, I had a large lump at the top of one breast. It was equidistant and matched perfectly the lump from my port on the other side. My breast surgeon looked at it about 8 weeks after my surgery. The plastic surgeon happened to be in the office and was called in as well. The spot was immediately checked out by ultrasound. It was deemed to be fat necrosis. The breast surgeon said to have it removed and be subject to pathology during stage two which was to be 4 months later. The plastic surgeon warned me there would be a line of stitches and scarring. It was removed during stage 2 and confirmed to be fat necrosis with no cancer cells. You might consider having your breast surgeon check it out. All the best

Hi Suburbs, Lula,

thanks for your info and I have more questions: do either of you know, what are the guidelines, how do they decide when the necrosis is able to be broken up, vs. having it removed surgically? mine is pretty large I would say a triangle shape with the bottom edge probably 4 inches across 2 inches tall at largest section. If they break it up: does the fat stay in shape? dissipate? does fat grating replace it? If it removed surgically, do they rearrange the flap and do the fat grafting elsewhere? What are the chances this can really all be taken care of in one more surgery?

I know these are questions for the surgeon but it's another 5 weeks till my consult and 4 months till my stage 2.

What is the recovery like in the donor sites? How long does the bruising and swelling last? Everyone including my PS says it's an easy surgery but I read someplace it can take up to a year. Are the areas smooth? do you have to wear compression garments? Will my 5/29 surgery take me out of commission /have me off the beach the entire summer?

Also: I am at week 7 tomorrow, the abdomen is still pretty swollen. How much longer do you think on average till I shrink enough to wear my pants?? Black leggings getting tiresome.

It is so hard to remain patient and optimistic. I already had 7 months from when I scheduled, to the DIEP date, feels like endless worrying.

On the upside, I have been increasing my exercise. Yesterday I actually added a VERY slow jog in little bursts, for a couple of minutes, I did 3 miles in 45 mins. Goals! gonna try for 44 mins tomorrow. Can't wait to run again.

I didn't go back to sleeping laying down till about a week ago, (tried a few times but I didn't like it plus my husband snores) I slept on the futon sofa with lots of pillows and a big ottoman. (and ROKU!) Now I have a big body pillow on one side I can lean against so I don't have to roll as much to switch positions. I kind of made a triangle of pillows.

Cathy sorry for your diagnosis and best wishes. I thought going into surgery, I was going to have small implants but it turned out I had more fat that they realized! All I know is I am glad to have the implants I did have, taken out from under my pectoral wall. What a relief.

Michele

Does anyone have any advice for my abdomen scar, it’s very itchy at one endafter they removed the tape yesterday.

Haha wonder if I can get my husband to pick some of that up for me I’ll give it a go though!

TWills - my PS told me ahead of time that this is not meant to be a 'tummy tuck' but they do their best to have a favorable outcome. Basically the same reason that jbdayton said, this was for breast reconstruction and DIEP flap and not a cosmetic surgery. I had also not heard of plication. That being said, I think my PS did an amazing job.

My PS also used the PICO bandage and for anyone just heading into this type of surgery, I would say insist on it. For anyone that does not know, it is a large bandage that applies a negative pressure onto the abdomen, it wicks away moisture from the wound. I was really well healed under that when it came off. The only downside, they tape it down and that tape has to come off. That was quite an experience.

My abdomen scar is about 95% perfect. It is nice and low if I ever did want to wear a bikini LOL. There is only one dog-ear but that is not that major. The only thing that happened to mine is a couple of hard lumps dead in the middle of the scar. He said he could remove those but I am only 6 months out and we are waiting until April to see if those go down. You have probably all heard the same thing, removing scar tissue can sometimes cause more scar tissue.

He did a great job on the belly button as well.

houmom- it’s both a waiting game and a revision. They can definitely pull the breasts in so they’re not so wide and they can remove the side boob under your arms. Hoping that lump you describe is just necrosis-they should be able to break it up or remove it in stage 2. It will take about 12 weeks for everything to have settled & adhered enough to go back in for stage 2. Plenty will continue to change between now & then.