DIEP 2011

treesprite

It was very reassuring to see my PS today. They pulled my doppler wire today and cleaned off most of the tape goo. My belly button is still kind of yucky but they said that is because they use super glue and it is best to leave it alone for awhile yet. 

I am very happy to have my breast back again and feeling like me; even with a scooped neck, I look pretty darn good and I actually have a waist! I can't wait to get back to the gym.

I am feeling pretty worn out; it has been a tough couple of weeks but I know it is extremely early in the process. I have a lot of trouble with side effects; if it weren't for those, I think the past two weeks would have been much easier. I think I'm through the worst of it and it will keep getting better and better.

I really admire those of you with the BiMX/DIEP procedure and what great attitudes you have!

NotAfraid: So glad that they were able to save your left side and it sounds like you are doing amazingly well for such a short time home from the hospital.

Yes - keep asking questions, interview docs, and do your homework. See if there is a reconstruction support group in your area so you can meet women who have experienced the various choices. 

XRAYestInMA

@LuvRVing Hi Michelle. Best of luck to you as well. I'm sorry that you do not qualify for a standard DIEP, but have you looking into a stacked DIEP or perhaps a SGAP - I think the latter uses some of the gluteus maximus tissue. Just a thought...Also, about the link on the DIEP info on your blog = The DIEP Breast Reconstruction Forum, I tried to register so I may read the posts and could not. Something about my email address cannot be used in the registration process. I have no idea why.  I only have one email address and it seems to work just fine for everything else. Any insight on that?  TY

SAMayoFL

Mspradley, honestly, if it wasn't for the reassurance you have all given me I probably would have already canceled my appointment.  Then when I hear about all the flat tummies and the new better than ever breasts it renews my hope and determination that I too can do this.  My PET scan is on Friday.  I just have to get beyond that so my onc. will release me to move to the next step.  Please continue to let us know how you are doing.   I am curious about two things.  In the center of my chest, where my cleavage used to be, I have a place that is maybe an inch long.  It is concave and kind of looks like a hole.  My skin folds over there.  Did you have that before your surgery?  If you did do you still have it?  Also, why were your breasts such different sizes after surgery? It sounds like they have settled some and are closer to being the same size now?

Susan

SAMayoFL

treesprite, were your side effects from medication?  I remember you posted shortly after your surgery.  I am worried about things like they just pulled your doppler wire today.  If I am from out of town, who in the world is going to pull my wire?  There are so many loose ends when you have to travel for surgery.  UGH!!!!

Susan

mspradley

SAMayoFL - I did indeed have the concave area, which I called my divot. It is completely gone and while I don't have the cleavage that comes at 45 only when your breasts are smushed together, I have a natural looking space between my breasts.



My ps explained that the difference in the sizes are due to the difference in trauma each side experienced. The left side was simply reopened and a flap was added. The right side had a mastectomy and the addition of the flap. Each day they are looking closer in size. I think they will be fraternal twins until stage 2, but only evident when I am naked. You really can't tell with clothes on.

treesprite

SAMayoFL:  Travel for procedures is common but the women who traveled can fill you in. My doc said they have local docs handle the minor follow up issues for patients who travel. Pulling the drains and doppler wire were non-events, tickly odd, but no pain.

I have trouble with the antibiotics and pain meds but nothing serious, just unpleasant. I'm sure there are alternative meds my doc can use for stage 2.

I thought about how I would feel a year from now if I did or did not have the DIEP and DIEP just keep coming up the right answer for me; I still believe that will be the case.

LuvRVing

XRAYestInMA - I didn't try to register on that site, I was just using it for my family and friends who don't have a clue.  I'll check it out and see if I can figure it out.  And thanks for the suggestions on alternative DIEPs.  My gluteus is quite minimus...lol...family trait.  So there would be less to take there.    I think the stacked DIEP takes all the tissue for one breast...I need two.  At this point, I'm OK with the tram.  Not exactly what I wanted but better than not having recon at all.

Michelle

SAMayoFL

Dang Michelle, I am really envious.  I wish I could donate to your cause!!  LOL. 

Susan

XRAYestInMA

@LuvRVing I'm with Susan, and wish I could also donate to your cause, HA HA. When the PS strolled into the exam room and got a look at me, I felt like a peach jus' ripe for the picken' so to speak. Sure, he touched on the 2 other types of breast recon that he specializes in (implants and Lat.flaps), but I could see in his eyes that I was DIEP material. I sure hope my extra belly fat post 2 pregnancies can be put to good use. I think I have enough gluteus for 2 foobs also, but am kind of glad that I do not have to go that route. It's going to seem weird enough to have my abdomen relocated to my chest wall...yet would probably seem even weirder to have my rear-end transplanted there. Oh man...such insanity. 

So by your post, you are going with a bilat TRAM? I thought a TRAM still uses abdominal adipose tissue to shape a breast, as well as abdominal muscle. So are you saying that you will have a bilat TRAM and since you don't have enough abd. fat, your PS will use implants also? Have you looked into a Lassimus Flap? I believe a PS can add implants under that type of flap as well, and the rectus abdominus muscles do not come into play at all. I work with a gal who had that done on one side (left the non-BC side alone), and had super results. She is slender also. Her reconstructed foob looks to be about a small B to my eye...and it matches the other very well - even without clothes on (yes, she showed me, and no, I didn't ask to see it, but I didn't wish to insult her when she was putting herself "out there" for me). I've also seen two diff. gals who had implants and their racks look great also. I guess when one works in the medical field, some inhibitions are set aside when it comes to showing other women their reconstructed breasts.  Once again...I would never sway your decision to go with a bilat TRAM if that's what you feel would be best. Just saying that there may be other options out there to achieve great results. 

Re: the DIEP website...it does seem like it could provide a wealth of info for gals considering that type of recon, as well as their families, however it simply would not allow me to register using my active email address. There was no link to "contact the moderator" or site owner or whatever. Strange...

LuvRVing

XRAYestInMA:  I went to the site, registered, and received the email overnight to confirm.  It is a British site, I think, and apparently not very active.  You might try again, but from a discussion board perspective, it seems to be very dead.  I couldn't find a new topic or post from 2011. When I found the website, I thought it did a good job of explaining the procedure. 

 It's funny, I've never thought of myself as slender because I had 4 children and I've got a pretty thick waist.  I did lose 15 pounds last year after my first diagnosis, and I am wearing size 6 jeans so I guess it's time to rethink my body image!  I'm 5'2" and 130...not exactly skinny.  I guess I'll weigh a little less after surgery takes my "C" boobs.  And the PS was really concerned about stressing out my body with the DIEP surgery.  I am diabetic, but in excellent health with no side effects or complications from it.  Nonetheless, he expressed some serious concerns.  I thought about getting a second opinion, but I would need a plastic surgeon that works with my breast surgeon.  They are all wanting me to either start chemo or have surgery ASAP.  So TRAM it is, maybe next Wednesday. 

 Maybe after going through chemo, I'll gain some weight and they can use that fat for enhancement....dream on, right?  Actually, I'm more worried about losing weight from nausea and lack of appetite.  My first onco said that people who are used to hangovers do really well on chemo.  If that is true, I am in BIG trouble.  Motion sickness, seasickness, morning sickness, and every hangover was accompanied by nausea.  I learned very quickly not to drink too much!!!

 Damn, I really wanted that tummy tuck.

Michelle

Michelle

Snobird

You should get a tummy tuck with a TRAM. It is virtually the same surgery except that it uses your ab muscle for the blood source and the surgeon takes your ab fat attached to the muscle and tunnels it up under your skin from your lower abs to your chest area. DIEP takes the same ab fat and detaches from the blood source (ab muscle) and adds it to the chest area and reattached it a new blood source without tunneling under the skin or damaging the 6 pack muscles of your abdomen. I'm not a PS but I met a women undergoing BMX/DIEP the day after me who didn't look like she had any fat on her at all. I met her again at the DOCS office and she said she was pretty impressed the Doc was able to get her C cup back with how little she thought she had. I don't think you are getting the right info from your PS. I'd get another opinion if you really want a DIEP. My original BS referred me to a PS who did TRAM and she was honest with me about not being capable about doing DIEP and sent me to another PS who did. So I traveled 6 hrs to NYC and had new surgeons(3 of them). My BS at home is doing the follow up care.

XRAYestInMA

@LuvRVing Oh yes, def rethink your body image I'm a size 6 in my fantasies only and afraid I'll never see that size again. I have that hourglass kind of figure that feels right at a size 10, and sadly am about 25lbs away from that right now. I'm working on that and will continue to do so for the next 9 weeks until my surgery. I REALLY want that tummy tuck also. There HAS TO be some good that comes out of having BC....there just has to be!

I went thru chemo 6 years ago (at age 37) and honestly, it wasn't too bad. I had no nausea at all...ever - took the meds I was supposed to after each infusion (I was prescribed Kytril). I'm not much of a drinker, social or otherwise, and have not had a hangover since my very early 20's. When I did have one, it wasn't pleasant so I don't think I did well with it, HA HA. I unfortunately did gain some weight during the chemo (figures, I was hoping to at least be thinner and bald, but NO, I got chubby and bald). To this day even the sight of a Lemonhead (lemon drop kind of hard candy) makes me sick as that was what I sucked on during the infusions of the chemo that caused a metal taste in my mouth. They worked great at the time, but I'm all set with them for the rest of my life.

I like your quote about BC being a wrinkle in your sheets ... get out your HOTTEST iron and some starch, and iron this wrinkle right the heck OUT!  as in gone for good  

XmasDx

Michelle,

I hope you consider Snobird's advice about seeking a second opinion.  I'm sticking my nose where it may not belong out of concern for you, I'm feeling like you are being rushed into a pedicled TRAM if I understand you correctly?  

I didn't think many docs even did pedicled TRAMs anymore due to the complications of hernia, etc.  

Does your PS do a lot of DIEPs and muscle-sparing free TRAMs?  

You sound like you are okay with the decision, and I'm not trying to make you nervous about it, but once it's done it's done so I just want to be sure you are comfortable with the direction your ps is taking.

XmasDx

@Xray - peaches just ripe for the pickin - you crack me up.  I got that same response from my PS, and also wish I could have donated to Michelle's cause!  After uni-mx DIEP I think they threw a lot away! 

charlottesmama

Hi all. I'm new here. I'm sceduled for a uniMx and DIEP all at once. I'm scared because the only surgery I've had since my tonsils 45 years ago was the inpatient SNB. This is BIG! Other than breast cancer, I'm extremely healthy. Lost about 32 pounds over the past 2 years, but gained back half during chemo. I'm looking forward to being done with all this.

Here's my question for you ladies: What will PS do about upper beely fat? Nice to have a flat lower tummy post-op, but I have plenty of fat above my belly button! Will it migrate down? WIll PS lipo it out? What have others experienced?

Thanks! 

XmasDx

Charlottesmama - I'm not sure about that question since my belly fat was VERY concentrated below my belly button.  I would ask your PS how it will be done and how it will look.  I would think once they "pull it tight" and make you a new belly button it would sort of even out, but I'm not sure!

I think you will love the procedure's results though, I am 5 weeks out from uni-MX & DIEP and very happy with the results so far.  

Snobird

I am 4 months out of BMX/DIEP. I have not had stage 2 yet but I got to tell you I look pretty good. Talk to your PS about what to expect. They may take it out right then or lipo it latter. Make sure you know what to expect when you are done. My surgery took 7.5 hours and I handled to anesthesia just fine. Recovery was tough the 1st day after but pain meds were very helpful. I stopped narcotics on the 3rd day post op and went to motrin/tylenol combo for the rest of the next 2 weeks and tapered off the following week. I was skiing in Vail on my 5th week post-op.

SAMayoFL

Chalottesmama, I am so glad you asked that.  I had the same question!!  Actually, more of my weight is above my belly button than below it.  The problem with the spare tire around the belly is that no matter how much I diet or exercise that roll never goes away.  I am excited at the prospect of just chopping it right off.  Anyone else have any input about upper belly fat?

Susan

marxi

anyone have a wound vac?  please pm me and tell me about it.  i'm scared. 

dee7493

a wound vac heals extremely well.  The device is the size of a small purse and is a minor annoyance may be disconnected to shower.  I had one for almost two weeks.

marxi

dee, did it hurt when they took out the sponges?

NotAfraid

These drains are a pain in the BUTT!  I would be out and about, all over the place (and in the shower) if it wasn't for 4 cumbersome drains.  What's the average time for drains to remain in?

LuvRVing

Everyone - I may have misspoken - was definitely in information overload situation.  I am having skin sparing mx on the right, mx with alloderm on the left, and tissue expanders. And now surgery is scheduled for Monday, so I'm going to proceed.  There is time for adjustments later, I think. 

 Thank you all for your advice.  I'm disappointed it's not DIEP, but both the PS and his nurse  independently shook their heads when they looked at me.  This is one battle not worth fighting.  I'm sure the implants will be ok in the long run.

Michelle

Snobird

LuRVing- what's impt here is you. It is your choice. Sounds like you have a plan you are comfortable with and that is all that counts. Well be thinking about you as you go through this phase of treatment. All the best. Keep us posted.

XRAYestInMA

@ LuvRVing I second Snobird's sentiment. For me dealing with BC once sucked bad enough, so I can't imagine finding out that the beast was making a return engagement in my body. You have enough on your plate at present. While I can certainly understand your disappointment, having to go the TE and implant route is not unacceptable. I have seen some hot looking racks from gals who had implants placed after BC, and you can be one of those HOT chicks also! My best to you...and I will be thinking of you on Monday. Take care.

~Lori

LuvRVing

I do have a question and maybe someone can answer this:

I think I've read that this is possible, so please could someone confirm.  After I finish all other treatment (chemo and maybe rads) is it possible to have DIEP to supplement implants?  Or at the time of switching from saline to silicone, can the DIEP question be re-evaluated?  That would buy me time for a second opinion. 

Your advice/experience would be extremely helpful.

 Thanks,

Michelle

LuvRVing

XRAYestInMA  - just wanted to let you know that I was able to fully register on that DIEP reconstruction website, and received a confirmation email.  You might want to just try again - maybe the site was down.  In any case, it's not a very active discussion board.  I poked around and couldn't find anything current.

Michelle

dee7493

MARXI   when the sponges were removed i felt mildy unfortable but not all painful.  The wound vac device comes with a black canvas purse which I clipped to a nice wide fashion belt.  The most annoying aspect was sometimes its impossible to have adhered perfectly flat and air gets in making a noise,  like a motor.   It was sometimes embarrsing in public  I laughed about it .

treesprite

I found that my drain output increased with activity, so maybe slow things down a bit? I had a drain in 6 weeks post SMX, but less than two weeks post uniDIEP. I would also imagine it  depends on how much tissue was removed, swelling and other factors. I had trouble healing last time and this time healing seems much better; my doc recommended taking vitamin C and zinc in addition to a multivitamin to aid healing.

I got my jeans on today and I have a much slimmer silouette than pre-surgery. My sister got me a selection of cute, nearly new camisoles at the thrift store (she is a super bargain shopper); I'm starting to feel like myself again. 

Snobird

LuvRVing - DIEP can be done after TE and or implants but it is usually done 6 to 12 months after RADS. In fact if you have RADS you wouldn't really want to to DIEP until it's over.