Topic: Ready for Stage II DIEP - Need Advice

Forum: Breast Reconstruction — Talk with others facing decisions about whether or not to have breast reconstruction, and if so, what type and when.

Posted on: Jan 22, 2008 04:13PM

Posted on: Jan 22, 2008 04:13PM

Deleted Member wrote:

Well it seems I am finally ready for Stage II DIEP -- it has been scheduled for the end of February -- my original surgery was on 10/24 --   I had some complications with my original surgery so while I am anxious to get the second stage behind me, I am nervous as well --  I had a hematoma and an infection last time -- am hoping all goes well the second time around. 

I definitely need stage II however -- have to fix the dent from my infection and reshape one side -- will also get rid of dog ears on the ab incision.  Nipple, if I want it, will be done in third procedure after everything else settles.   PS said surgery should take about 1.5 hours and will be done as outpatient -- would like to others' experiences with this stage -- was told I probably won't get a drain -- but what else do I need to know?

I was also worried about risk of lympedema -- PS said no -- he is not going near the lymph nodes which are in the armpit, but just having surgery again makes me nervous -- I had 6 nodes removed in my sentinel  node biopsy and all is well -- 12 weeks post-op I have no problems at all with my arm and range of motion and I would like to keep it that way.

Any advice?

Thanks,

M.

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Sep 30, 2009 10:36AM Callygee wrote:

Hey puppyholic,

I'm having Stage 2 this Oct 14, original DIEP, May 28, 08. I waited because I had rads after uni-DIEP. I'm so happy with my foob & I healed so quickly. Now I'm feeling quite nervous about stage 2: remove some fibrosis & make foob smaller, create nipple. I think he's going to use lipo & I hear that it's harder to hela from lipo than incisions. He will also fix my dog ears & I have decide whether or not to reincise my stomach scar. It is a bit thicker in the center as I was pulled so tightly.

Is it true you were good to go after 4 days? It;s amazing how long I've been away from it all, so calm, now the jitters knockin' at my door. Any help will make me smile. Thanks, sister of the DIEP... 

Why did the patient go through treatment? To get to the other side! Dx 8/8/2007, IDC, 5cm, Stage IIB, Grade 1, 1/3 nodes, ER+/PR+, HER2-
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Sep 30, 2009 11:49AM dlb823 wrote:

Calleygee ~ I'm having Stage 2 two days before you -- on October 12.  I had my original surgery along with my mast in May or last year (5/08), then had long delays between surgery, chemo and rads, which I finished in 2/09.  Like you, I'm nervous, but also excited to get it done.  I'm not having my nipple made yet, but am having scar revision, a lift to the "good" side, and dog ears on my tummy scar removed.  

Good luck, and I'll be thinking about you ~  Deanna

Deanna "The soul would have no rainbow if the eyes had no tears" Native American proverb Dx 2/1/2008, 1cm, Stage IIA, Grade 3, 1/16 nodes, ER+/PR+, HER2- Dx 1/3/2014, Stage IV
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Sep 30, 2009 02:55PM Trishia wrote:

Here's my Stage 2 recap, copied from the NOLA in September thread.  My Stage 2 was 9/11.  And I feel fantastic!!! 

 I had ordered silicone stick on nipples back in May getting ready for stage 2. I haven't had nipples in 17 years, and I wanted to make sure that I would be happy with the placement and size, since I really had nothing to go on. I wore those to my pre op. Dr. Sullivan LOVED them!!! He had Dr. D, Liz, and Jeanine all come look at them. I emailed the company I got them form to Liz. He even had me wear them to surgery. I wouldn't be surprised if they start offering them to their patients who need them.

After that Dr. Sullivan started marking me like CRAZY with his blue marker. My sister said he looked like an artist! I agree with her 100%...he takes one look at your body and knows just what to do to make it look superb, but still like you. My dog ears on my hips were pretty big, so he asked me if he could excise them surgically instead of lipo them to get the best result. He told me I'd have additional scarring. Same thing for the fat under my arms. Of course, I said yes. I trust him completely. He circled all the areas that he would lipo and really focused on my upper abdomen. I was pretty uneven from stage 1. He was going to inject a lot of fat into the hallow area above my left breast (the radiated side). He also injected something to flatten out my scars that are starting to cord and keloid. We talked about my ab scar widening and decided to inject there too and not re-open it. So no ab drains! Wooohooo! Only breast drains.

Liz came in (the first time I met her!) and explained the lipo procedure and that I would be extremely swollen afterwards. I guess they inject the lipo sites with a mixture of saline, lidocaine, and heparin to help prevent complications and clotting. So between that, the bruising and the IV fluid, you are pretty swollen up! She said it takes a good month or two for you to see results and most ladies can't even fit into their pants right at first. It was a good heads up.

After that my sister and I spent the evening walking the Quarter. Had to have an iced coffee and beignets at Café Du Monde, of course! Had a tarot card reading. And then had the most fabulous dinner and Bayonna! It was amazing!!!

I had a WAY harder time with the actual surgery for stage 2. I had extreme nausea for the first 16 hours or so. They had to give me IV nausea meds every 4 hours, and I still felt wacked out. This didn't happen with stage 1. I only had 1 bout of nausea and that was it. I had the nurse take the catheter out and got up about midnight. I am one of those patients who HATES lying in the bed. I need to get out as soon as I can. I don't think the nurse agreed with me, but oh well! Another difference in the two facilities for me.

My girdle was twisted, so we had to undo it and fix it. This was HELL!!! I have a really high pain tolerance, but when she was clasping it up and digging her knuckles into my sides, I about threw up and started crying. The next day, my new nurse showed us how to do it so that didn't happen. Thank goodness!!!!!!

I was finally hungry and able to keep something down at about 8 am. Almost a full 24 hours from surgery. I felt much better after that and walked up and down the hall a couple of times. The pain, to me, was worse than stage 1. I felt tight and worn out after stage 1, but I didn't hurt or ache. I actually hurt with stage 2. The pain pump was my friend!

For lunch I walked down to their little dining area and sat to eat. I was nice to move around. After lunch I had my first shower. Now, I was scared to see myself! I wasn't expecting much difference after Liz's talk. The first time I saw myself naked, I was like "Holy Sh*t!!! I look AMAZING!!!!" LOL!!! I seriously did. Yes, I have about 4 feet of new incision and the bruising on my hips and under my arms was ugly....but my mid section and upper stomach were transformed!!!!! I have no rolls or bulges and a beautiful hour glass shape! I said right there that it was worth the pain and nausea!!! And I had nipples!!! For the first time in 17 years!!!

I got out of the hospital about 2. My IV had infiltrated into my muscle. So my left hand and forearm was twice the size of my right arm. My nurse assured me it would go down, but it freaked me out. In all of my surgeries (this was number 13 I think); I have never had that happen! They asked if I wanted to stay another night, but I was ready to get out of there!!!

They gave me percocet for pain. The nurse gave me one right when I was discharged. I took one more 4 hours later. I have had percocet before, but it had been years since I took it. Well, it totally wigged me out! I was shaky and easily startled and couldn't sleep! I decided to quit the pain meds and switch to 2 tylenol every 3-4 hours. I know, I am crazy right?!?! Lipo is one of the most painful things. But like I said, I have a really high pain tolerance and that is what I did for my first mastectomy, since I was pregnant at the time.

I was finally able to sleep the next day and night. That's why I didn't post much! Sunday morning I walked to Café Beignet for breakfast, walked the hall of the hotel and about 10 minutes on the treadmill for lunch, and then spent an hour an a half shopping in the Quarter in the evening. I was exhausted!! But it feels really good to move around. So make sure you do some walking every few hours after your surgery. I also drank a TON of water! It helped to flush all the crap out of my system quickly and keep my swelling down.

My sister unfortunately got sick. So I learned to do up my own girdle pretty quick. I took a natural laxative that kicked it on Monday morning! It was a prune and senna one. I had forgotten to bring my Smooth Move tea. You can urinate with the girdle on, but not have a BM. I am PRAYING I don't catch her cold! And I hope it's not the Swine Flu!

The rooms at the hotel were REALLY small! So even though I washed my hands and didn't touch or use anything she had, I was SO exposed! ACK!

My post op was on Monday. One of my nipples isn't doing so well. Dr. Sullivan said it is extremely rare to have necrosis of a nipple made from your own flesh, but it appears it is happening on the left side. We will have to wait and see. There is nothing I can do to prevent it. I am wearing the nipple protectors and keeping it dry. They look pretty freaky right at first! Then the left one is half purplish/black. I am hoping for the best. One of my hip incisions was a little red and inflamed, so they have me a shot of antibiotics...which hurt like hell! LOL!! He also removed my breast drains. YIPEEE!!!

The flight home was uneventful, but hard on me. I was in more pain that I had been. Sitting for long periods is hard on me!

My hubby couldn't believe how good I looked, even with the new incisions and the bruising. He was SO impressed! I will post pics on Tim Tam's site in my thread soon. I have a pretty good photo journal going, and want to keep it up.

Hope everyone is continuing to heal nicely!!!! My sister finally got to understand the experience we all have when we go to the Center for Restorative Breast Surgery. It is like nothing else. The sense of calm and the way they make you feel is amazing. The quality of care and their genuine concern for you goes beyond any other medical experience. It's so hard to explain unless you are there. I'm glad she gets it now.

Everyday I am thankful that I was able to be healed by Dr. Sullivan and his colleagues and staff. It was worth the 17 year wait.

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Oct 1, 2009 02:10PM DianneMS wrote:

Hi

I was thinking about having my Stage 2 done the Tuesday before Thanksgiving, but after reading this I'm not to sure.  Maybe I should wait until the week after Christmas.  I am not sure how much work she has to do.  I will have a better idea on Oct. 16th when I see her.  I will be staying in MI so I don't have to worry about travel.  My PS is only 1 hour away. 

Trishia it seemed like they did alot.  Was this all covered by your insurance? or were there additional charges?  I would love my PS to do some additional shaping.  Thanks for your details

Dianne

Dx 8/13/2008, DCIS, 1cm, Stage I, Grade 3, 0/0 nodes, ER-/PR-, HER2+
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Feb 12, 2013 06:43PM angiebaby1 wrote:

I have to reply to this subject...I am only 2 weeks out from my unilateral diep...right breast skin sparing mastectomy and left breast delayed(since May 2012 from radiation) reconstruction...darn that is a mouthful.

Mu plastic surgeon actually got a Little upset with me last week as he removed two of my breast drains because i kept mentioning having stage 2 done to fix to different sizes of my breasts...one is too large and the other is square.



I think I will be looking for a new doctor and he is one of the best but I guess he got Butt hurt when I was in the hospital under morphine drip because I said I thought everything looked like shit...LOL



I was pretty doped but he is now being a big baby. He says everything looks great and yes my flaps have survived but I am so not happy and will not leave my breast looking like this. How long do I need to wait to have stage 2 done? thank you

Angela

Dx 11/17/2011, IBC, 6cm+, Stage IIIB, 0/3 nodes, PR-, HER2- Chemotherapy 1/10/2012 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 5/29/2012 Lymph node removal: Left, Sentinel; Mastectomy: Left Radiation Therapy 7/8/2012 Breast Surgery 1/27/2013 Mastectomy: Right; Prophylactic mastectomy: Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Feb 19, 2013 12:44AM BirdyRobin wrote:

I will be doing stage 2 tomorrow. As always I am a bit nervous the.night before surgery. I hope I get nipples/ariolas tomorrow. I have one dog ear and I think tummy scar will need some work. I don't like my scars on the side of my breasts. Well guess I will see what happens.
Robin

Dx 4/15/2011, ILC, Both breasts, 6cm+, Stage IIIB, Grade 3, 4/10 nodes, ER+/PR+, HER2- Surgery 4/15/2011 Lymph node removal: Left, Sentinel; Mastectomy: Left, Right Chemotherapy 5/31/2011 Cytoxan (cyclophosphamide), Taxol (paclitaxel) Radiation Therapy 10/31/2011 Breast, Lymph nodes Hormonal Therapy 6/19/2012 Femara (letrozole) Surgery 8/19/2012 Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Feb 20, 2013 01:30PM BirdyRobin wrote:

I am tired, sore, achy, and having trouble sleeping. But, I am done with stage 2. I did not get nips, aris but my breasts are a bit closser together and filled in a bit. They used fat grafting and fixed the dog ear. Next stage will be 3 and then I get nips and aris. Then finally tats.
Robin

Dx 4/15/2011, ILC, Both breasts, 6cm+, Stage IIIB, Grade 3, 4/10 nodes, ER+/PR+, HER2- Surgery 4/15/2011 Lymph node removal: Left, Sentinel; Mastectomy: Left, Right Chemotherapy 5/31/2011 Cytoxan (cyclophosphamide), Taxol (paclitaxel) Radiation Therapy 10/31/2011 Breast, Lymph nodes Hormonal Therapy 6/19/2012 Femara (letrozole) Surgery 8/19/2012 Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Aug 6, 2016 11:42AM Teacher4 wrote:

Hello. I have just completed stage 1 anout five weeks ago with Dr. Sullivan and his team and they truly did make it a pleasant experience. I am now thinking about stage 2 and wanted to know how much down time is involved. How long before you were able to return to work?

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Aug 7, 2016 07:54PM moderators wrote:

Teacher4, welcome to our community. Glad that you found us! You may find this page helpful to you: DIEP Flap Reconstruction: What to Expect.

We are all thinking about you!

To send a PM to the Mods: community.breastcancer.org/my/...
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Aug 7, 2016 09:41PM meow13 wrote:

I found the 2nd surgery had more discomfort and pain. I had liposuction from my legs. I had mine done July it was hot and a bit uncomfortable. I had to wear a garment from just under breast to my knees. If you have this I would buy another garment to switch with. My ps said the longer I could wear the garment the better. He wanted at least 4 weeks. I would get sweaty and itchy, so I would take a shower and put the clean garment on and wash the other. It helped alot.

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