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Topic: DIEP flap

Forum: Lymphedema — Risks, tips for prevention, and info about products that can address the symptoms of lymphedema.

Posted on: Sep 2, 2006 09:41AM

AliceJean wrote:

I am a 5-yr survivor, my surgery was a modified radical mastectomy w/axillary node dissection, 3 (sentinel) nodes were positive but no others were. No reconstruction at that time. I have 2 armpits (on that one side!) and a huge flap of tissue that prevents me from wearing tank tops, etc. I have very mild LE, ccntrolled w/massage and sleeve when necessary. I am now considering reconstruction of my "missing" breast along with reduction of the other, using the DIEP flap which was not available 5 yrs. ago. Any advice? Will another surgery make the LE worse? If I lose weight, will both breasts lose? Thanks in advance!

Don't sing of Yesterday, Yesterday is gone; Tomorrow isn't written, Make Today your song.
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Sep 2, 2006 10:20AM Binney4 wrote:

Hi, speederpuppy, and welcome to both bc.org and the LE board!

The Lymph Notes site has an article on "Lymphedema and breast reconstruction" that might be helpful:
http://www.lymphnotes.com/article.php/id/265/

And another good site for information is the National Lymphedema Network at:
www.lymphnet.org

LE massage leading up to and following surgery should certainly help, and of course prophylactic antibiotics starting a couple of days before can help ward off LE-type infections. Any trauma to the chest (including reduction or augmentation) has the potential for making LE worse (or developing it in the first place), but it's certainly not guaranteed to do so. You might want to talk with your therapist about your own individual risk, as none of us is the same.

Don't know anything about the weight loss issue, but from what the women say on other boards here, weight loss or gain can be a problem following reconstruction. The ladies on the "Breast Reconstruction" board might be able to answer that question -- it's two boards above this one on the Main Forum Index.

Congrats on being 5 years out! Wouldn't you think by that time you'd be past all the tough decisions?!?! Thinking of you as you weigh all the factors and come to a decision you can be at peace with,
Binney
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Sep 2, 2006 10:54AM AliceJean wrote:

Thanks so much Binney, for taking the time!I thought for a long time I would be satisfied with just wearing a prosthesis (I'm a simple kinda gal, 58 yrs old and very overweight) but a close friend just had a MRM with DIEP flap and got me wanting to have a whole chest again. I have been unsatisfied with the way I look but just not willing to do anything about it until now. I think having this done would be a real boost for me...I just retired in July and I am so excited to be starting a new part of my life! I bet it would get me to lose weight too.

Don't sing of Yesterday, Yesterday is gone; Tomorrow isn't written, Make Today your song.
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Sep 2, 2006 03:49PM mstanton-2005Dec15 wrote:

Speederpuppy,
I had stage 1 DIEP in May of this year as well as radical left masectomy and axillary node disection. I am now doing 4 fields of radiation since I had 12 p[ositive nodes. All of this puts me in the high range for lymphedema. I still need to go back and have stage 2 ( nipple construction and breast symetry ) as wll as stage 3 which is the nipple tatooing. Whew!! I am looking iinto the precautions and protocol since all of my nodes are destroyed on the left side. I am really worried about the whole thing. I did see a PT therapist before radiation and have no symptoms of Lymphedema at the present time. She told me to comme back after rads and then I will quiz her about fllying and surgery. I really want the reconsntruction and I am very happy with my breast so far. I think you will be too. Let me know if you find out any info and I will do the same. There has got to be more women who have had the DIEP procedure on the forum. I hope they chime in so we can benefit from their experiences.
Good luck and keep us posted.
MJC
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Sep 5, 2006 01:39PM AnnaM wrote:

Speederpuppy and MJC, I had a bilateral mastectomy with SNB and immediate DIEP reconstruction last September. I knew a wee bit about LE and I realized that I would be at risk. My breast surgeon does not belive in LE. My PS told me he doubted I would have a problem, but he did tell me what to be on the lookout for.

I had some "knocking on the door," namely, slight swelling after a bout of window washing in February. I did a good bit of reading and learned that any and all breast surgery puts us at risk for LE. It's not just the node removal that does it. I studied all the LE threads on these boards and learned a lot. I benefitted from the wisdom of many women, especially Binney and Pat, who answered my questions no matter how often I pestered them.

I asked my PS to refer me to a LE therapist. She taught me MLM and measured me for compression sleeves and gloves to wear when flying. I see her every two months or so just to make sure my arms and torso are the same measurement. I saw the therapist just prior to my stage II revisions in July, and we worked on a plan to ensure I wouldn't have to kick and scream to keep needles and cuffs off my arms in the OR. The plan worked beautifully. I prepared myself by doing extra MLM sessions prior to the surgery and I was allowed to wear my compression garments into the OR.

Thus far things have worked for me, and I am going in for my tatoos on the 20th of September. I am very happy with my reconstruction. I will never allow myself to become lax about the risk of LE. I am in the process of changing my primary care physician only because my former PCP acted like it was a huge inconvenience to take my BP on my leg, take blood from my foot, etc. I liked everything else about him, but that is now a deal-breaker for me. I realize that if my life is at stake, medical personnel can use my arms any way they please and put BP cuffs wherever they wish, but I will not allow routine tests to be done in a manner that puts me at greater risk for LE.

Good luck to you both, and don't hesitate to PM me if you wish.

Anna
Bilat. MX + DIEP 9/2005, 0/9 nodes and 2/2 nodes; IDC, <1cm, Stage IIa, Grade 3, ER-/PR-, HER2+; 4x A/C, 4x Taxol and 1 yr. weekly Herceptin
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Sep 18, 2006 07:45AM Anonymous wrote:

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Sep 18, 2006 07:55AM DoreenF wrote:

SPAM reported to Melissa
Doreen
"Cancer May Leave Your Body, but It Never Leaves Your Life" - Lance Armstrong Foundation Manifesto. Dx 4/18/2005, IDC, <1cm, Stage I, Grade 2, 0/2 nodes, ER+/PR+, HER2-

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