DIEP Stage 2

beaglesmom

Hi all, I haven't been back on in a few weeks and things are going really well.  The incision on my "good" side is still bleeding a little at the "intersection" as my husband calls it.  I go back tomorrow to the PS and will hopefully get those reinforcement stitches out.  All of the dermabond skin glue is gone now.  I have one question that I hope you guys can help me with.  How long did it take before you saw the final size?  It's been about 3 1/2 weeks and I still feel "swollen" and "full".  I started off a C cup and I asked to be a little smaller.  I believe I am a little smaller but not what I really expected.  I can't blame my wonderful PS because he is amazing but I can still "feel" them; just wondering since they won't do the nipple for 8-12 weeks if it really takes that long for them to settle down.  Do I need to settle down and just be patient? 

kcshreve

I'm behind you in stage 2 with a lift and reduction 2 weeks ago.  Mine are swollen still.  I requested a full B, but I'm more of a C at the moment. I do think the breasts are noticeably smaller in general, though, so when the swelling goes down, it will be interesting.  After Stage 2, it took me till about 4 weeks to see my breasts truly unswelling.  Maybe it's around the corner for you.

olivia218

After the second procedure do you have drains again? I am scheduled for May 21st.

Olivia 

beaglesmom

Saw my PS yesterday and he confirmed that it could take up to 6 months before the final results are there.  I still have the swollen "full" feeling but he said that will settle down. I am overall really  happy with the results so far and got the stitches out yesterday which makes everything feel so much better too!

Olivia218 - I did not have any drains (YAY) because they didn't need to remove any tissue.  Originally he thought he may need to and I was prepared for those yucky drains again but woke up in recovery and was so happy to hear I didn't have any.  If you do end up with some, I was told it would only be for a few days, not at all like the 1st time.  Good luck!!

kcshreve

I had a Stage 2 two weeks ago.  Lift/reduction, lipo, dogears.  No drains.  I had an ab problem which needed repair, and it did require a drain, but it was teeny and only stayed in a week.

olivia218

Thanks for all the information, it is helpful! I am scheduled for stage 2 in two weeks. I did not think to talk to the PS about the full feeling but I do have it. My stomach is numb and so is my breast - it has been 90 days since I had the DIEP.

I am nervous about the next phase, not sure why but I guess it is normal.

Olivia 

kcshreve

The only additional  numbness that I have from STage 2 is at my dogear repair area.  The doc did lipo there, as well as repairing, and there is reduced sensation.  All the other areas remain the same or slightly better.  While some docs will tell you the numbness will go away, I'm not so sure of that.  I had knee surgery as a teen, and while much of the knee was numb for many years, and some of it did get better, there are still some spots which are numb 35 years later. My PS said that he prefers women to get their nipple tatoos in their first year, if possible, since often there is increased sensation around that time, making it uncomfortable as time goes by.  So, you never do know how things will progress over time.

beaglesmom

Olivia - don't worry about this phase, it's much easier!  I was actually excited about it because I was so ready to continue the process and have 2 breasts equal in size and shape. 

kcshreve - I agree, I don't think all the numbness will ever go away.  My bs is honest and says one of two things will happen, either it will go away or you get so used to it, you don't notice it anymore.  It's been only less than 6 months for me, so I don't really believe I'll ever get used to it, but one can hope.  The tingling in my arm and arm pit is actually more annoying that anything else. The fact that I am cancer free and have 2 perky breasts with a flat stomach is what is more important to me at this point.  I'll be having my nipple done in the next 6 weeks or so and then they tattoo about another couple of months after that.  He does the nipple in the office under just a local.  Kind of strange that I'll be awake watching him manipulate creating a nipple but he's cute and nice on the eyes, so I guess I'll suffer through it :-)

kcshreve

bump

olivia218

Thanks for the information, I have wondered if it is too soon. I had my MX in Feb this year.

I love my PS he is also easy on the eyes, great bedside manner, smart and compassionate.  My husband even thinks he is special.

Olivia 

dah0123

Hi all,

I had Stage 1 Delayed Bilateral DIEP on 3/8.  Stage 2 is scheduled for 6/10.  Anyway, here is my question . . . I have 2 areas at the top of each breast (toward the center) that are hard and sore.  I know it is fat necrosis.  I assume that they will take these areas out during Stage 2 and try to fill the areas with fat from lipo.  But I am concerned since these areas are rather large that they won't be able to fill in enough w/lipo to get a permanent and symmetrical result.  Has anyone else had fat necrosis and if yes, what did they do about it?  Thanks!!!

olivia218

I have necrosis as well, but no mention of removing it or replacing it with more fat during Stage 2.  I guess I did not know that was a possibility.  

kcshreve

Yes, there are option regarding fat necrosis during Stage 2.  Definitely bring this up with your PS now, and then again later.

olivia218

Stage 2 accomplished! I had the  stage 2 of my DIEP Friday, May 21st. I am very sore! The PS did not remove the necrosis. It is getting smaller and I am wondering if my body is absorbing it.  

The PS straightened my abdominal scar so it is straight and I think he lifted my non MX side. Then he did something with the MX side but not sure exactly what. I have follow up with the PS, on Wednesday the 26th. I do not have any drains!!  

 

Thanks to you all for the information, it is helpful

 

Olivia 

olivia218

How long did anyone wear the compression bra after stage 2? I did not have one for stage 1.  

Thanks

Olivia 

beaglesmom

Olivia,

I only wore the compression bra for a few days (it was so horrible) and then went to a normal one and wore it all day (sleeping too) for about 4-5 weeks.  It was actually more comfortable sleeping in one for a while as it provided more support.  My PS suggested I do that and he was right (funny how that is).  I've now gone to not needing one at night and am doing well.  I go back to the PS tomorrow and cannot wait to find out if he is ready to schedule the nipple yet. 

olivia218

Beaglesmom,

Thank you so much! The compression bra is not too bad.  I have not worn a normal bra since before my MX. My PS told me not to.  If I have to wear this for 4-5 weeks, UGH!  Thanks for the information, it is helpful!  Good luck to you and the nipple. 

Olivia 

beaglesmom

Olivia,

It was certainly strange when I started wearing a "real" bra again.  But, when you get ready to, try the Warners Elements of Bliss.  They are comfy and don't rub against any of the incisions/scars.  My PS told me the other day that I no longer need to wear a bra to bed anymore (YAY) but to be sure to wear one during the day.  Even though I can technically go without one now (of course, depending on what I am wearing ... HA) because the girls are perky, I will always continue to do the right thing.  Afterall, gravity will eventually take over again and I want to prevent that for as long as possible especially after induring what I've been through. 

olivia218

Beaglesmom,

I went to the PS and they removed the surgical tape, stitches next Tuesday. I am so swollen. I cannot imagine any of my clothes will fit.  He did tell me to wear the compression bra at least through next Tuesday and then maybe try a regular bra. I tried on an old bra today and it does not fit and hurts under the arm.   I will try the Warners Elements of Bliss, thanks!

What did you find out about the next phase, nipple tattoo? 

Olivia 

olivia218

I had my stitches removed today. I guess the next step is nipple reconstruction. Has anyone had that step completed?

Olivia 

beaglesmom

Olivia, I go back to the PS on 6/29 and I am hoping and praying that he'll be ready to schedule the nipple after he sees me.  His nurse told me they do that in the office!?!*  They just use a local numbing on the area (I don't really have feeling there anyway); I am a little baffled by this because I really don't think I want to be wide awake for it.  I'll need to ask a few more questions about this part. 

jseda

Hi girls!! Thanks for all your posting relating to Stage II. Yes I had Stage I last Sept but still haven't had Stage II. I had a lot of fat necrosis; known mainly as the hard spots post DIEP I. They do re-absorb overtime with massaging. My DIEP breast was 1 1/2 times larger than the other normal size post Stage I but is now 1/2 the size of the normal breast 9 months later. My blood pressure was quite low during the first 5 days after Stage I and I personally believe the low BP wasn't high enough for my blood to perfuse through all the fat and consequently lost some circulation leading to necrosis. I also had a lot of scar tissue that prevented me from being able to full extend the arm on the side of my DIEP and caused me to have a frozen shoulder. I did see an orthopedic Doc who explained this to me. I then chose to work it out myself (vs surgery to relieve the scar tissue causing the frozen shoulder) with weights/exercise. It wasn't pleasurable but doable. There are no guarantees with these surgeries and you just have to hope things go the way they are planned. I have my appt to recheck end of June and am hoping to get on with Stage II. I still, even with daily  massaging, have a lot of hard areas in the remaining DIEP breast. I assume he will take out some of the remaining necrotic tissue during Stage II as well as fill in as much as needed from lipo suction. I don't know how much I will actually end up with even after lipo as the body does reabsorb at least 40%. Shall see. I know that if I had had an implant, I would be done and have had nice results but I personally don't want any foreign materials in my body so will rely on Stage II to bring something back to the table, so to speak. Was surprised at how much reabsorbed but as they say, every body is different and every case unique.

MsSherryInFL

Jseda with implants you may not have been done.  They were my first choice just cause I wanted it done and over with.  I had at least 4 surgeries regarding implants, too many infections to count that cause me to spend about 30 days total in the hospital and also sever CC that was to the point of destroying my movement/sensation to my right arm and it was starting on my left also.  Do you have a date for stage 2 yet?  

KCmama

MsSherry - it's remarkable how much we go through, and we have no clue at the beginning of the journey.  If it weren't for this site, I'd still be in the dark.  My BS suggested only implants, and was horrified when I told her I was going to have a diep.  Best decision I could have made.  But I'd not have known about it, or how to ask the right questions, etc, without the women here. I wish we were given the whole story up front in order to make a better and more balanced decision.

dah0123

Hello everyone,

Just wanted to post my DIEP Stage 2 experience.  I had it yesterday.  The PS revised the abdominal scar - removed dog ears and re-opened most of the scar because the stitches that were placed in Stage 1 did not reabsorb as they are supposed to and scar tissue had formed around them.  Thus, it felt like there were hard marbles along the scar line under the skin.  He said that they would likely eventually be reabsorbed but since I was already having surgery, he took them out. 

He also did lipo on my hips and placed the fat in to my right breast as that one was slightly smaller after my Stage 1 DIEP (I have pectus excavatum so that makes perfect symmetry challenging - but it is SO much better than it was when I had implants and will likely be close to perfect now with the new lipo fat added).  I also had fat necrosis, fairly large hard areas at the top of each breast.  He "broke them up with lipo" - actually I think he must have sucked it out and then put new fat in. 

He also did lipo at my request under each arm to give more definition to the breast area (and get frankly just get rid of the fat that I created on my own under there).  Then he created the nipples.  Last night and today I feel sore - sort of bruised an battered - but really not bad at all.  The good thing about bruises (I have significant bruising in all areas that I described above) is that they only hurt when you touch them or lean on them.  I have no "traditional pain", though I have taken dilaudid all day on a "just in case" basis.  I will stop these tomorrow.  The procedure took approx. 2 1/2 - 3 hours and I was in recovery for about 4 hours prior to being released. 

That's about it.  Just wanted to post my experience in case it helps someone else to understand what their experience may be like.  Really not a big deal - certainly nothing like Stage 1.

Thank you all for your insight.  It certainly helped me to understand what to expect prior to my surgery.

Debbie

jseda

Hi Ms Sherry: I have an appt with my PS end of June to determine again whether or not he feels I'm ready for Stage II. I believe he's hoping that with massage and time, more of my necrotic tissue will reabsorb. Shall see. If he tells me I can have surgery the next day, I'm ready. Like everyone that's gone through this, I'm past ready! I'm sorry you had such a tough path re: implants. My PS told me upfront that DIEP is the way to go and not implants because I would have a lifetime of surgeries. That was enough for me to make a decision. LIttle did I know that a lot of my DIEP breast would be necrotic. He did tell me I could choose as to where we took the fat from and I resoundingly said YES!! Ha.

olivia218

Has anyone had problems with their arms after stage 2? I am barely able to lift my left arm. I only had a single MX, left side.

Olivia 

chinablue

Are tests are done before stage 2 to determine there is no cancer before they begin?

beaglesmom

Prior to my stage 2 my oncologist surgeon wanted me to have another mammogram on my healthy breast to make sure everything looks good.  It did and I had the stage 2 on April 8.  I don't think this is typical procedure but yet determined individually by your doctor.  I was glad he wanted it done though.  It gave me comfort.  I would ask your doctor.

nmi

I had small pea bump on scar on mx I was concern about. BS ordered mammo on both breast to make sure everything was ok before surgery. radiologist did US too-all ok.  PS ordered blood work, urinalysis and chest x-ray, before stage 2. think it depends one cancer stage and surgeon.