DIEP 2011

BreakingBad

What looked odd about your appearance? I think the abdominal area/belly button looks odd. I assume there is a lot of swelling that adds to the strange appearance.

XmasDx

Treesprite, I know what you mean about the appearance, all that bruising, drains, tape, scars... quite the battle wounds!  I'm confident it will improve over time.  I have some hard spots too, sounds like it can be swelling or fat necrosis, personally I think mine is swelling since it has been like that since the surgery, immediately following surgery.  Supposedly it goes away in the 3-4 month timeframe I think?

The strange thing is the tummy is so flat standing, but of course sitting it still bunches up but nothing like before the surgery.  I am still wearing my compression garment, going on post-surgical week 6.  PS wants me to wear it until I see her in a month, and I feel "funny" (vulnerable?) without it on.  

Radninrah - dog ears are flaps of skin from doing the tummy that need to be revised by the ps later after things have healed.  I didn't really get "dog ears" but there is some strange muffin top on top of the scar, bigger on one side than the other, that isn't going away (thought it could be swelling, but it's fat) so I'm hoping my ps does some revised lipo down the line.  

BreakingBad

Tomorrow I am allowed to take a shower, which will be 48 hours since drain removal. Any tips? How did you cover the drain incisions during the shower?

XmasDx

I didn't have to cover the drain incisions during my showers, when drying off, pat pat pat, no rubbing on the incisions or around the drainholes.  After my shower, I did use a hairdryer set on cool to dry the drainholes good and then used neosporin and gauze or a bandaid for a week or two until things looked healed up.  My breast drain hole has taken over 3 weeks to "fill in" but is finally looking closed.  

treesprite

XmasDx: Thank you - I feel better after reading your post. I think my post surgery euphoria (making it through relatively smoothly) is fading and the reality is setting in. Also, from reading your post, I need to be just a teeny tiny bit more patient with myself and this process . . . . .Okay, well maybe I need to be a hell of a lot more patient!



It was odd to see my body full scale - I look normal from the hips on down and from the neck on up. My abdomen just looks odd to me . . . I was used to seeing my usual poochy belly and belly button and now it is totally flat and pulled tight with the scar running hip to hip. I was slightly heavier than I like just prior to surgery but not too bad.. And even though my result is better than I anticipated, it will take some getting used to. I had a similar experience just after my SMX,; I started out slowly getting used to the new me and eased myself into taking it all in.



So for now, I'm in bed and resting and talking to my friends and fiddling around with my laptop. I will probably get up later to take a walk, but resting right now feels like exactly the right thing. I'm going to hold off on thinking too hard about any of this until I see my doc on Monday.

XmasDx

Treesprite, I guess it all just takes time... I was so looking forward to trying on old jeans in the hopes that they would be looser... but you know what?  Any inches (if any?) lost by the DIEP were more than made up for by the tenderness of my skin and not being able to wear a waistband comfortably.  I was bummed.  That was about 4 weeks out (my uni mx DIEP was 2/28/11)...

BUT yesterday I had no choice but to go shopping for some work pants, and I tried on dresses.  YEAH!  A waist!  No belly!  I'm overweight anyway, but have not been able to wear a dress with a plain front in 16 years since baby #1!  I was very happy.  

For work pants I ended up going up a size and found tons that fit... I probably needed to go up a size before surgery, truth be told.   

XmasDx

I just removed my last piece of surgical tape!!!!  5 weeks later!!!  I'm so excited to be free of tape!  The tape on the breast didn't budge for the longest time, and the abdominal tape had some stubborn pieces...

Just had to share. 

SAMayoFL

Treesprite, Marci and Mspradley, thank you all for your responses.  I think I would have already canceled my appointment if it weren't for the information and positive reassurance ya'll have given.  Please continue to post as often as possible how you are doing.  I am absorbing every single entry like a sponge.

Susan

mspradley

Treesprite - my ps told me that the hard spots were completely normal and may have to be removed in stage 2. He mentioned that a few patients believed that the hard spots had softened when light massage was reared several times a day, and I was welcome to try that. I do believe that a couple of the spots that are located under my original breast tissue (I don't seem to have any under my flaps) are less "lumpy", but not fully dissolved.

mspradley

I also was brave enough (or curious enough) to spend time in front of the mirror this morning. I am 12 days post-op with a double DIEP. I had an initial mastectomy on the left side in 2009 before chemo + radiation, so had the right side removed with port removal during the DIEP surgery. My new left breast settled in as far as swelling and appearance by day 7, but my rIght side is taking a little longer.



My ps was clear that his highest priority in stage 1 was to get the tissue moved and blood supply established and that stage 2 would focus on aesthetic appearance and shaping. While I can't imagine skipping stage 2 when the time comes, I am not disappointed with what I currently have.



Yes the flaps are a different color, but my shape in clothes is better than when I was in college (with some extra weight). I am not wearing any support or compression garments, and with the exception of one upper and one lower drain remaining, I have a better shape in a t-shirt than I would have dreamed! After a full year with one sagging (45 yes old with 2 kids) breast and one concave area, or heavy prosthesis, I am tickled pink!



I have been able to shower daily since discharged, just no baths. My flaps only have the glue stitches on them, but my abdomen has most of the paper tape remaining. About an inch of that tape came loose at the center of the incision, so I clipped that piece off. My incision looked surprisingly "raw", but wasn't open or oozing.



I am not in need of the assistance that was so wonderful for about 3 days after discharge, but I do not have much stamina. I am hoping to get the last two drains pulled on day 15, and plan to resume a light routine to decrease boredom and increase stamina. I have not needed any pain medicine, even OTC Motrin since day 8, but have taken Valium to settle my back spasms.



I look forward to stage 2 to give me cantaloupes rather than footballs, and am leaning away from 3D nipples in favor of the tattooed ones. My abdomen is flat with some numbness, as it used to be a michilen tire. Funny, I have sensation in my belly button, but not at the stitches! My ps is promising lipo during stage 2 to give me the shape I want. I never had a waist, but I am going for cantaloupes and an hourglass!



Good luck to those who have surgery ahead, and I look forward to seeing the progress of those who are post-op!

Anonymous

What is this video of the diep and how can I get see it?  Anyone?

Jerusha

http://www.orlive.com/chp/videos/breast-reconstruction-deep-inferior-epigastric-perforator-full-surgical-version-

Shelley56. This is the link (I hope) to the "full surgical version". There is a modified one floating around if you are squeamish ! You can probably find it from this.

oops. Doesn't seem to have come out as an actual link. Sorry. That's the address, anyway. 

XRAYestInMA

@mspradley When you had your bilat DIEP, I assume another surgeon removed your good breast (not the PS). That's what is going to happen in my case anyhow. The BS that I consulted with said she and "her team" will perform a skin sparing MX on my left side and leave the nodes intact. With that in mind, I'm wondering if when all is said-and-done, if my new frankinboobs will not have the same scars on them ? I figure it would look better if the scars on the boobs would be symmetrical and not so totally different. Is that what you see when you look into the full length mirror? And why 'footballs"? Are you new boobs foot-ball shaped?

After 2 children and months of breastfeeding them, I,too have a Michelin tire...and my one remaining breast is a full C but no where near the perky shape of how it looked in my 20's. Frankly, I'll be glad to be rid of the tire and the timebomb. I have that hourglass figure going on as far as a waist is concerned, and hope to not lose that, but I sure hope I end up with a set of cantaloupes on my chest as well! As long as they look more perky than saggy, I hope to love them. I guess the tire is a good thing right now = plenty of tissue for the PS to move up, HA.

@XmasDx YEAH on the tape! Free at last...for some reason that surgical butterfly tabe likes to "stick around". Now about the jeans...where you able to get into yours yet?Thankfully I'll be having my DIEP when the weather will be getting warmer but I still love wearing my jeans even in the summer. I have a few pair of Yoga pants that might be good in the weeks after the surgery, and also a few pair of shorts that have elastic waists from LLBean. Hopefully those will be okay as far as comfort goes.

Also...here's a question for anyone who has had the DIEP and is not post-op = How soon after the surgery did you feel well enough to venture out of the house, and I mean to go to a function, not take a stroll down the street or a trip to the market? I am having my Bilat DIEP on June 6th, and was told to plan on being in the hospital for 5 days. If I am discharged on the Friday (day 5) assuming all goes well, do you think attending my friend's baby shower on the Saturday is a possibility, or a no way? I'm thinking "no way" since I'll most likely have several drains hanging out of me and I will not be able to lift my arms to do my hair. DH and the kids are invited as it is a family affair type baby shower - held outside in a tent, games for the kids, etc, so I would not have to drive but I fear I'll feel like a train wreck and not want to leave the house so soon after such a major surgery. Any thoughts ?

Snobird

I am 4 months post op but I don't think I could have handled that type of social function that soon. I think you will be exhausted in short order if you went. Tell your family to go and have a good time and take a nap. Have them take some photos to show you later and bring you some cake.

XRAYestInMA

@Snobird - Sounds good Snobird...I'm all about the cake. I'm the eternal optimist but also a realist. I'll probably feel awful so soon after the surgery. I'd rather not go if I'm going to feel terrible and probably not look so great either. I have a trip planned for mid-August to visit my sister and mom/step-dad in Florida so I don't want to try going out and about too soon and not feel good for the trip. The vacation will mainly be chillaxin on the beach and by the pool, so I'm hoping 10 1/2 weeks will be plenty of healing time before I can travel. 

~Lori

dannade

Snobird - I am just about 4 months post op.  I still have tummy bloat and numbness, have not lost an inch.  Ps says to walk and I am.  I probably should lose 10 lbs. that I gained going on Arimidex. Going for phase II April 27, fat necrosis being removed from top of reconstructed breast, some revision to try to match the implant side, fixing the hip dog ears and a little lipo on my fleshy handlebars.  PS said about 3-1/2 hours.  I forgot to ask him what kind of recovery I will have.  Anyone know?  Won't be ready for nipples for awhile yet.  Taking lots longer than I expected.

XmasDx

@XRAY - I'm 5 weeks out, I tried on my old (tight) jeans and the waistband is too uncomfortable; ended up buying 7 pair of pants/jeans one size up and they fit fine and I think will be okay to be in for 8 hrs at work.  Also dresses!! After my Michelin tire has been removed, dresses look SO much nicer - that was exciting!

Also, as far as the baby shower on day 6... I got released from the hospital on Thurs after a Monday surgery, that Saturday/Sunday some friends came over, brought me meals, I stayed in my bed.  I could get up & down, but WOULD NOT have wanted to be driving with the family anywhere, certainly no desire to attend a social function.  I wore only nightgowns until my drains were removed, and put on a robe when people came over.  Yoga pants for weeks after drains were removed.  Just now at 5 weeks considering real clothes, and that will be OVER my compression garment which protects my tummy a bit from the waistbands. 

On day 6, I was on valium every 6 hours, Tramadol every 6 hours alternating, and there is no way I would have gone to a baby shower on day 6.  I have a baby shower next Saturday (6 weeks out) and I WILL be attending in my new dress, but before now I would NOT have felt like it.  Maybe that's just me though.  

I think you will love having a chillin vacation planned at 10 1/2 weeks though!

treesprite

My DIEP breast is definitely a football at this point (day 12 per my DH).  I have what feels like significant fat necrosis but it does seem like there will still be plenty to work with after that is removed. It helps a lot to hear that this is normal for stage one. I wish I had talked to my PS about the fat necrosis part ahead of time. 

I feel like my yoga pants will be my best friend for awhile.  Size XL shelf type camisoles give me just the right feeling and are easy to get on and off. I'm going to try to get my DH to go out and get me a looser pair of the compression panties to alternate with the stronger ones. 

I would have probably felt like I could go to a baby shower right after discharge but I doubt that it would have been a good idea. As it was we took a long time getting home because I felt so good and then I ended up being exhausted and dehydrated; I just really needed to be home resting, getting liquids down, and recovering no matter how super human I felt! I can get kind of 'show-offy' about how quickly I bounce back - not good. My worst days came a few days after getting home as I developed thrush and nausea as side affects from the nasty antibiotics. I think the valium sounds like a fabulous idea for those first few days after discharge - that would have made that first weekend so much better; I was so stressed out when I got home and I worry that may have affected my blood supply. At this point, there is no 'do over', so I just have to let it go.

Hurray for the last piece of tape! Each milestone feels so good!  My breast surgeon had the 'leave it alone until it falls off' approach, while my PS wants all the tape removed between days 8-12 post op, so most of mine was pulled on day 8 when I went in for drain removal. I had my MX drain in for 6 weeks! Yikes -- looking back it seems like I had that darn drain forever.

I am looking forward to the day when I can put jeans on again but it won't be anytime soon.

I don't think I would want to see the full surgical version DIEP video . . . as it is, I feel like I know more than I wish I did. Understanding how it all proceeds is good but having too vivid of a picture in my brain is kind of creepy - but that's just me. 

My most recent milestone was sleeping on my side last night. Food is finally starting to taste normal to me as my thrush is almost resolved; thank goodness I'm done with the antibiotics -- they are super hard on my system. I am going to give myself another day of rest today; I'll see my PS tomorrow morning and will go forward from there.

XmasDx

@treesprite -

HOORAY for side sleeping!!!!!! 

dee7493

I was more upset with frankinstein scars from  bi lat mastecomy   and the area where lymph nodes were taken looked like someone took an ice cream scoop under my arm creating a disformed area that when I came out of shower and saw myself I cried every time.

Now the elipital delayed DIEP scars on breastes and even a thin (but hip-to-hip) ab scar are both more minimal than expected and as time goes on should even be faded.

What is everyone using for scar cream?   

new realizations...went down a full size in pants and feel trim, enjoying side sleeping ,taking daily walks helps posture , light massages soothes soreness, working on being patient to heal completely and wait for stage 2.

NotAfraid

I've been posting over in the DIEP 2010 thread since January.  I had quite a few trials and tribulations just GETTING to the point of having DIEP.  It was quite insane.

I had my BiMX and DIEP on Tuesday, March 29th at UCLA with Dr. F.  I had complications with the vein in the left side and was rushed back into surgery on Tuesday at 7:30 to get another vein transplanted into the left tissue.  I come home on Saturday and have been doing pretty well puttering about the house on vicodine.  I still have 4 drains - one of which is leaking at the skin site.  But, they are still producing, so in they stay.

I know having had 2 back to back surgeries probably took more out of me than if I just had one, but I'm still doing quite ok.  I'm pretty sure I would be up for going out if a) I didn't have drains and b)I could take a shower.   Those two things are what is keeping me house bound and a bit bored.

I'm not even close to wanting to evaluate how they look.  I know it's just stage 1 and there's a lot more work to do.  I'm lucky I've got 2 flaps at this point.  I'm greatful for an amazing team that caught my flap issues early on and were able to fix it.

blondie45

I am 5 weeks out today. There was never a day or time that I said to myself that I made a mistake in doing this. I am totally happy with the outcome so far. I have not had stage 2 yet and my surgeon did a fantastic job at making mine almost the same size. I cannot say enough about how good my surgeon is and would recommend him to anyone in my area.

I still have some stomach tightness, can pretty much stand up straight now. The physical therpy is still tough but I get very stiff if I don't do my exercises a couple times a day.

I am finally rid of all my drains, the last one finally fell out last Friday, and am in sports bras and the best of all is being able to sleep all the way on my side once again.

SAMayoFL

Mspradley, I had totally talked myself out of this surgery and then you post how remarkably well you are doing.  I am SO happy for you!  I am also 45, had the michelin tire that I can't get rid of for anything and more sagging than I would like to admit.  I am surprised that your side with radiated skin has healed faster than your "good" side.  Please continue to let us know how you are doing! 

All of you who have gone through this and are doing so well and are so strong amaze me!  Thank you all for continuing to post your journey.

Susan

marejo

Just wanted to chime in on what Blondie said.  Her surgeon (our surgeon) is top notch.  He is a Plastic Surgeon in Milwaukee, WI.  Froedtert And The Medical College of Wisconsin!  I had my bilateral DIEP in 2008 and his work is PHENOMINAL!  Honestly, it was like perfect to me.  I even contemplated having a stage 2 surgery because I was so happy with stage 1.  But, after waiting a year there were a few areas that needed some filling in but if I would have opted out of that they still would have looked great!  I did not choose to do nipple reconstruction but instead just had tattooing.  Even those look "real!"

Anyone in the mid-west area.........consult with Dr. John Hijjawil. 

Blondie....so happy to read that all went well with you.  I see you are having physical therapy.  I did not have that when I had mine.  It wasn't offered.  What do they have you do?

Mary Jo

marejo

Blondie, I did send you a private message after I got yours late.  I never knew you sent one to me.  I was notified via e-mail and don't always check in here at breastcancer.org

Mary Jo

mspradley

@XRAY – yes, my breast surgeon removed the “good breast”, but since I had both a 4.5 cm tumor and Paget’s disease of the nipple, I haven’t viewed it as “good” in a year!  I requested matching scars with little skin sparing on the second MX, but they will never be identical twins in terms of scars.  The original MX spared no skin and the recent one spared “some”.  However, I can see that the skin sparing side will be absolutely fine with future v-necked t-shirts but I’m not positive about the other side. 

I will tell you that having two different sized scars will distort your idea of how balanced your frankenboobies are, so the best measure of how even they are is to look at their size and shape with a t-shirt on. 

My new frankenboobies are somewhat “football shaped” in that at first they were wider across than from top to bottom.  As the swelling has subsided, I don’t feel like I have the sides of each breast in my armpit, but they still are not round like cantaloupes.  I promise they do not look weird and could even skip phase 2 (but I’m not!)

What I went into surgery with was a concave vacancy on the left side and a 45 year old sagging full C cup on the right.  One week out of surgery, I had a full C cup on the left and a DD on the right and 9 extra pounds on the scales (fluid – I truly didn’t eat much over the week).  Today is two weeks out of surgery, and I feel I have a full C cup on the left and a smallish D on the right and am about 3 pounds under my pre-surgical weight (even though I’m eating everything that doesn’t move).  Yesterday, I put on a pair of pants that were a little loose before surgery (size 14) and low and behold, they were a little loose then – they just fit differently due to my flat stomach.  I am certain that I still have a lot of swelling, so I anticipate that if I will start moving more and eating more sensibly, I will go back to work in a few weeks in a size 12 bottom and large top.  Then hopefully, I can get myself into even better shape to prepare for the stage 2 shaping.

I second what the others are saying about your not venturing out too soon.  You may likely slow down your recuperation by trying to do too much, too soon.   I had far too much back pain to do anything until at least day 10, and even then you will likely have those yucky drains.  Send the family on and take a well deserved nap!

rem9939

I am at week 5 of my recovery from double mastectomy with diep flap surgery. I was first diagnosed in december of 1995 with invasive ductal carcinoma with no node involvement. I did radiation and cmf with a lumpectomy.

16 years later I was diagnosed with bc again in the same breast, docs think it's a new cancer, but not positive.

The surgery for me was very painful for the first 3 weeks, the first week I barely remember anything. I stopped the meds. after the first week, they just made me feel weird.. I feel so much better now.

I have to say my breast really look exactly like they did before mastectomy, of course with the new flap.. my tummy is still swollen and numb, not sure if it should still look and feel this way, have an appointment with ps next week.

I have to say the worst time will be the first week, maybe the second as well, but I was up and around very quickly.. moving slowly, but that's to be expected...

Jane

redninrah

Im worried about how my PS wont be doing liposuction.......is it really important to do? Im having DIEP next yr.

mspradley

SAMayoFL - It sounds like there are a great number of wonderful surgeons in all areas that can take you through this metamorphosis.  Take your time in finding the team that makes you feel at peace with whatever decision you decide to make.  I will be honest with you in that I read the forum while I was still under chemo and about to face radiation and there were so many posts that scared me to death.  I deliberately only went to the sites that my surgeon suggested and felt totally prepared for my surgery. One thing my surgeons offered that helped was a monthly reconstruction forum where all types of options were discussed and real patients (post-op) were on hand to help answer questions, much like this forum.  Keep asking questions and good luck!

LuvRVing

Well, damn.  No DIEP for me.  I don't have enough fat to make two "B" foobs.  So I guess it will be tissue expanders.  Looks like surgery may be on 4/13. 

Good luck to all of you. 

Michelle