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Topic: Physical Fitness limitations after a DIEP reconstruction

Forum: Breast Reconstruction —

If you've had or will be having a mastectomy (or in some cases, lumpectomy), you're likely facing decisions about whether or not to have breast reconstruction, and if so, what type and when. Deciding whether or not to have a breast reconstructed is a very personal choice. Take the time you need to learn about how breast reconstruction might affect you, both emotionally and physically, before you decide to have the surgery.

Learn about different surgical options and the medical and personal issues around breast reconstruction.

Intro medically reviewed by: Brian Wojciechowski, M.D.
Last review date: November 22, 2020

Posted on: Oct 27, 2015 06:17PM

personaltrainer1 wrote:

I am at a decision point in my reconstruction. I had previous radiation an lumpectomy so after re occurrence diagnosis I had to have a mastectomy. I chose to do a bilateral with tissue expanders. The radiated side got infected and the expander came out. I am a group fitness instructor and personal trainer and I am very leary about proceeding with the DIEP procedure as I am unsure how it may effect my physical activities. Has anyone experienced this that can offer me their story?

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Oct 28, 2015 01:46PM cloudynight wrote:

Hey personaltrainer1,

I am reasonably physically active, and had a unilateral DIEP construction at the end of April of this year. I'm overweight, but can run 4 or 5 miles at a time, and lift weights once or twice a week. I'm 36, and this was my first, and only reconstruction procedure. I did not have radiation. I was not in my top physical condition when I had the surgery, and I followed it up with 12 weeks of Taxol, so I lost a lot of strength there too.

I would say that my overall experience has been great with a DIEP reconstruction. That said, holy hell, it is QUITE a surgery. I'd had abdominal surgery before, a C-section, and this was much, much more serious.

Good things: I personally have no range of motion problems with my arms. I'd say my range of motion is 95 percent of what it is on the unaffected side. My pecs are almost as strong as they were pre-surgery. The cosmetic result is FANTASTIC. The surgeon actually sewed my abs together (they'd separated during pregnancy), so my stomach looks pretty darn good.

Bad things: My ab strength is nowhere near what it was before surgery. It's actually a loss of strength much greater than just the time off from the gym I took while recovering and doing Taxol, and I think it has to do with the abdominoplasty part of the surgery. Recovery was really a full six weeks until I felt like I could get back into things, and it was strange to try to do so in my new body. I lost a lot of abdominal skin in surgery, and my whole body just felt off. My abdomen was much too tight for a while, and it all just felt so weird: It was just really weird. Not too bad, and six months out, I'm pretty used to it, but the scar is huge. Short-term recovery is also pretty rough: I was in the hospital for five nights, and I'm not sure I could have come home any earlier.

I'm also facing the second-stage surgery next week, which I'm nervous about (but which is a much more minor procedure).

I've just given you some scattershot impressions of my experience. Am happy to say more if you have any more specific questions.

Dx 3/2015, DCIS, Left, 5cm, Stage 0, Grade 3, 0/1 nodes, ER+/PR-, HER2+ Dx 4/30/2015, IDC, Left, <1cm, Stage IA, Grade 3, 0/1 nodes, ER-/PR-, HER2+ Surgery 4/30/2015 Mastectomy: Left; Reconstruction (left): DIEP flap Targeted Therapy Herceptin (trastuzumab) Chemotherapy Taxol (paclitaxel)
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Oct 28, 2015 03:46PM jenn333 wrote:

I had my DIEP surgery in September of 2011. I agree with cloudynight - it's one hell of a surgery. Having said that, you front load all of your risk so once you're through it, you can pretty much forget about it and the results improve as time goes on. Very happy with my result. My abdominal scar is hardly noticeable and I have no range of motion issues. I started working out with a personal trainer about a year later and had fantastic results. I worked out with her for 2 years and ended up in the best shape of my life. I now work out with weights 3 times a week at my gym but no longer with a personal trainer and am just as strong and fit than before my DIEP surgery (stronger and fitter, for that matter). I had radiation too but that was after my DIEP procedure.

Happy to answer any other questions you may have.

Dx 8/3/2011, IDC, 2cm, Stage IA, Grade 1, 0/5 nodes, ER+/PR+, HER2- Surgery 9/14/2011 Mastectomy: Right; Reconstruction (right): DIEP flap Radiation Therapy 11/15/2011 Hormonal Therapy 1/28/2012
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Oct 28, 2015 07:12PM mary625 wrote:

I was never an athlete by any means. LOL. I wanted to interject to say that my abs have not been the same since I had surgery a little over a year ago. They really were traumatized. I had to wear compression like Spanx for months on end to try to keep the phantom feelings away. I've gone back to Pilates after both stage I and II, and it was a difficult transition. Doing the ab work doesn't feel good. Some days are worse than others. Today I was finding it difficult to sit up from lying flat, both at the doctor and on the Pilates equipment.
Dx 8/29/2011, ILC, 1cm, Stage IIIC, Grade 2, 10/16 nodes, ER+/PR+, HER2- Chemotherapy 9/26/2011 AC + T (Taxol) Surgery 2/6/2012 Lymph node removal: Left, Underarm/Axillary; Mastectomy: Left, Right Hormonal Therapy 3/12/2012 Femara (letrozole) Radiation Therapy 3/13/2012 Surgery 9/24/2014 Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Oct 29, 2015 06:21PM personaltrainer1 wrote:

Wow...this is very helpful! Thank you so much for taking a few minutes to share your experience. So 2 out of 3 have significant decrease in their core strength...and that is one of several concerns I have. Obviously the surgery itself is the first one, length of time, the magnitude of the whole thing etc...but my life after is a concern as well....of course, we'd all like it to be like "normal" what is that!

again....thank you and any other experiences out there I'd love to hear those too

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Oct 29, 2015 08:22PM caligirl3 wrote:


I had a bilateral skin sparing mastectomy with immediate DIEP reconstruction December 2014. Like the other ladies mentioned it is a long recovery, but in my opinion totally worth it! I was not in the best physical shape going into surgery, but now almost a year out I have no issues. I have resumed Zumba, Tae Bo, and have been doing Shred by Jillian Michaels. It is taking me a bit longer building up my core strength, but I suspect part of that is not having had a strong core to begin with. I did have limited range of motion immediately in my left arm after surgery which I attribute to the mastectomy not DIEP. After physical therapy sessions that has since resolved. Even having had that setback, I would definitely make the same decision again to have DIEP. The results are incredible. I am very happy with my choice. If you have any specific questions I would be happy to answer if I can.

Mammary Ca(mixed Ductal and Lobular) Oncotype Dx. 6 Dx 12/10/2014, Right, 1cm, Stage IA, Grade 2, 0/1 nodes, ER+/PR+, HER2- (FISH) Surgery 12/10/2014 Mastectomy: Left, Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Hormonal Therapy 1/12/2015 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 9/29/2015 Reconstruction (left): Fat grafting, Nipple reconstruction; Reconstruction (right): Fat grafting, Nipple reconstruction
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Nov 3, 2015 12:50PM NatsFan wrote:

A perspective from someone who is a few more years out out from surgery - I had a bilat DIEP in 2008. I'm not particularly athletic, packing about 20 pounds I don't need, and at the time of surgery I was 52, yet still came through it just fine. Today I'm pretty physically active (I just ran a 10K race this weekend), do Pilates and yoga, and lift weights, and I have as strong if not a stronger core now than I did before surgery. My scars have pretty much faded to the point where I really don't notice them - as a matter of fact it's been so long that at this point I honestly forget most of the time that the "girls" are not the originals. Yep, it's a big surgery so you will have to plan for that, and I had a few minor revisions in the year after the surgery, but even with that for me it was well worth it. I'd choose DIEP again in a heartbeat.

I had a delayed DIEP, so I had several weeks after my chemo before my surgery was scheduled. During that time, my PS sent me to the hospital's PT unit to get some core and leg strengthening exercises. I did those religiously in the weeks leading up to surgery, and I think they really helped me recover more quickly.

Mary Dx 12/31/2007, IDC, 2cm, Stage IIB, Grade 3, 1/15 nodes, ER+/PR+, HER2-
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Dec 8, 2016 09:59PM JWoo wrote:


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Dec 8, 2016 10:09PM Meow13 wrote:

I have no physical restrictions I do yoga, swimming and the treadmill. I was concerned about strenghtening my core but I was ok doing weighs. The biggest issue is the tight feeling and under my arm where lymph nodes were removed. I can do everything without fear of hurting myself.

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Aug 4, 2017 08:51PM - edited Aug 4, 2017 08:57PM by Bern1020

hi, i am only 7 weeks post Surgery. I had a double mastectomy with die p flap reconstruction. I'm54 and in pretty good physical shape. I was doing piyo 5 days a week and the p90x ab DVD every other day for good measure. I've been told i can resume my regular activities but I'm finding my core to be quite weak. I can't even do one sit up right now. My abdomen is still pretty numb, especially in the center. Can you do sit ups since your surgery? I'm really concerned my abs will be forever soft and I'll never get them back!

Any advice on core strengthening would be so helpful.


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