Diep 2012

Robyn_S

Hello everyone, it will be two weeks post bil DIEP on Monday and doing better. Everything is healing and bruising and swelling resolving. I have basically a big flap (cancer side) and small flap where I had the TE. My axilla on the cancer side is still quite swollen and annoys me and worried that it is symptomatic of LE. I hope not as I refused in part an axillary clearance even with cancer positive sentinel node because of likely LE. My boobs are still huge- dd cup. Not happy as I really did not want big boobs, shape is what I wanted. Sounds ungrateful after having a successful surgery but feel like I have millstones around my neck again- numb ones at that!

Has anyone else felt like unhappy with the size of their new boobs? I have seen posts where women vent about being too small (usually implants)but what about the opposite? I see the surgeons next week for a post op check.

Chris13

Hi,

 Checking in after my May 1 UMX with immediate DIEP and a lift on the other side. Everyone says things look great, and aside from bruising and MX scaring (putting a burn cream on it), I agree. No dog ears, and I'm kind of matched--given the swelling.

 Worst was the nausea from the antibiotics taken when home; finally got a prescription for a nausea med and have just finished the antibiotics. Off my strong pain med...just taking the adult aspiriin PS requires to thin blood. Two drains out the first Monday home (day 7); other drain out day 10. 

Lower back pain id still, well, painful. No abdominal pain even when coughing. Intermittant shooting pains in DIEP side and around nodes. Will take some tylenol as soon as I figure out if it can be combined with the aspirin. Pain meds made my head too groggy.

Slept in an electric recliner (DH on sofa bed) downstairs until day 9. Bed okay sometimes; last night my back hurt in a kind of pressure sore way and it was hard to adjust my body given I can only roll a bit onto the "lift" side.

Overall, the experience has worked well. Dr. Serletti at UPHS did the outstanding DIEP, and my BS was Dr. Barrio at Bryn Mawr Hospital/Breast Center. She said my prospects were outstanding.....but. Nodes were thought to be clear but path found a 3mm tumor in 1 of 4. So I still have to visit a medical oncologist. And of course ILC can appear in the opposite breast. What a bizarre cancer--they actually found another spot in the breast----making three tumors, all separate!

Thanks to everyone who posts here. I learned so much beforehand. I'm definitely glad I woke up with a breast, and hope everyone in the DIEP pipeline will do well and recover quickly.

CookieMonster

Robyn - I was a G cup going in and said I wanted to be a C/D coming out. My DIEP breast was definitely smaller than my other one, but not small enough, I thought. When I had stage II to remove dog ears, I asked him to reduce the breast too, and he did. I'm not sure what cup size it is now, not bra shopping yet. The non DIEP side is being lifted and reduced this summer to match, so after that we'll see what size I am. I've not heard of many women wanting to go smaller and I've questioned the decision from an "is it necessary?" standpoint but I figured that if I have to go through all this other stuff, I might as well get something out of it. I also think that in the long run, my back will be healthier. I think my PS had a little bit of a difficult time wrapping his head around the fact that I wanted to be considerably smaller, but he did what I asked for. I hope to be happy with how I look in the end, but it's LONG process.

julianna51

Dressager - fingers crossed for you too.   I was thinking your DIEP wasn't until June sometime.  Did you get moved up or I am I thinking of someone else in June.   What did they do at your pre-op visit?  I'm one month out today, yay!  I am so excited to on the other side of this surgery.

stacyk

My BMX and Reconstruction is coming up on May 22. I have asked my PS for a smaller cup too (from a C to a . She questioned me when I told her, so I hope she follows through with it. I have always hated my C's...I might as well get something good out of this

I was not nervous about this surgery until the past few days. I think because it is getting closer....? I can't wait until it is all over.

Thanks for listening.    

goldlining

Robyn_S, I know what you mean. I was DD pre-reduction to B 35 years ago, but back to DD during pregnancy 15 years pre-DIEP. I so much wanted to be B again as the offsetting benefit of this ordeal. I had one mx already and had the other at the same time as a bilateral DIEP. One side (the immediate DIEP) is B but the other (the delayed) is C and if a touch up was out of the question, I would be disappointed. I do think I need a couple of divots filled on the smaller side, but to get to symmetry, I would prefer the larger side nipped and tucked to match rather than pump the small one up. Not only is it more comfortable on the shoulders, but I think the smaller bustline is leaner looking and fits my clothes better. The bra fitter after the original mx was all "oh you should be C or even D to balance your whole body out". (Trying to tell me something about my butt?) I guess the bustier the better for some people but I totally get the disappointment of too much of a good thing. The positive side is that the surgeon in trying to provide generous bosomage had to take quite a lot of ab flab and tucked it very taut. Now just trim the excess off upstairs and we'll be ducky!

Snobird

I too preferred to downsize from a generous D to a small C. I'm tall (5'8) and weighed 176 lbs going into surgery. Wore a size 14. After about 6 weeks post surgery I had lost 15 lbs. five of which I gained back. After stage 2 I lost that 5 again. Now I've been on the 17 Day Diet for a little over 3 weeks and I have lost a total of 10 lbs. and almost into size 10 jeans. Having the smaller chest is easier to exercise and my tops fit much better. I had always had issues getting jackets to fit well and now I don't. Of course this all means I need to buy new clothes :-).

julianna51

I'm probably  going to go from a C to B also.   First, because the PS didn't think she could get enough fat for a C but then the more I though about it the more I liked it.   I'm pretty small...5'2" but not thin at the moment...definitely have a few pounds to lose most of which reside in my hips/butt and thighs.   I worry a little tiny bit about looking out of balance but not so much that I'm changing my mind!  My only question is this...if/when I lose some of this poundage will I lose it all from my new breasts?  Before, when I would lose weight tht would be the first place I lost weight and then stomach....  Guess I'm not going to worry about it too much, haha.

Happy Mother's Day to all.  It is a beautiful day and life is good!

weety

Julianna, I am also 5'2" and pretty thin, but I do have some extra flab in tummy, butt and thighs.  I am just curious about the comment you said about not having enough fat for your C cup.  How much fat do they need?  Do you have to be considered "overweight" to have enough, or is just some flabbiness the kind of fat they need?  I don't want anything large--I was not even quite an A cup originally, I'd probably be happy with a small B.  I haven't started to even look into a prodedure yet.  I'm still trying to wrap my head around all the different types etc. before I start searching around.  Thanks for any info and help! 

LuvRVing

I'm going smaller, too. I was a generous C for many years and would like some nice little B's.  I'm also 5'2" and weigh 128, so I'm hoping there's enough to get my B's.  My butt is pretty flat - family trait.  I am scheduled for 7/23.  I did have one PS who told me he I didn't have enough fat and he could barely give me A's and so DIEP wasn't worth it.  But my Boston PS said no problem. 

julianna51

weety - I dont believe you have to be overweight for this procedure and there are many women on here that can tell you more about the wonderful things some of the very best surgeons can do.   Mine just said she didnt think I have enough for a full C but probably a full B.   I am happy with that and honestly I am not too much overweight, probably only about 10 or so pounds.  If I wanted to take from my thighs or butt I would have enough to make DDs lol but personally I like my booty so don't want to change anything there.   LuvRVing, 128 is pretty much my ideal weight which is what I was going into my BMX last May....I've gotten a little out of hand this year and hope that once I am recovered from my DIEP that I can get back there again.

LuvRVing

I got down to 122 after chemo and radiation, and have actually "indulged" myself to get  back to 128.  The party's over now, though.  I also have type 2 diabetes and extra weight is not good for glucose control.  It's been a bit of a balancing act. 

Does everyone lose a bit of weight as a result of DIEP surgery?  I keep reading about the 10 pounds or so that people lose, probably from not eating much during those first couple of weeks post-surgery.  What's the general experience?

bdavis

I met a woman who had hip flaps in NOLA and she got C cups from her tiny tiny body. I swear she was 110 pounds, 5'6" so you'd be amazed at what some doctors can get...

And Michelle... I lost 10 pounds, after stage II probably from the lipo.

weety

Okay, here's an odd question, but I've been very curious abou it--if you have lipo to remove the fat (and I'm assuming the fat cells go with them?) then if you gain weight, does it go somewhere else on your body since the old fat cells aren't there anymore?  Does that make sense?  I guess what I'm asking, is if I have lipo on the tummy since that's the most common place for the diep, then if I gain weight, will it go to my flabby thighs and butt since my stomach had many of the fat cells removed????

bdavis

I asked this question to my PS and he said when lipo is properly done, they don't strip the fat clean... they leave a little, thus leaving the area open for fat to come back... If it were stripped clean, then it basically seals itslef off from fat. I wanted to make sure that if I gained weight I wouldn't have a skinny part and a fat part, that I would be balanced.

wrsmith2x

Am 12 1/2 weeks out from BMX with DIEP and in another 2 months will meet with the doctor to discuss Stage II.  I have a couple of areas that I need to have lipo done but others where I WANT it done.  Once there are in there it should be easy to do extra stuff.  BUT, will my insurance pay for the extra stuff I want done?  Also if I have a lipo done is it day surgery meaning I can go home that day?  Any info on this would be greatly appreciated.

So far so good.  Have pretty much decided against doing nipples at all.  Either I have them and they are always taut or they are just tattoos.  Either way I will have no feeling in them.  Just don't see the point, for me anyway.

I pray for all of us that one day the beast will leave us all alone!  Namaste'.

bdavis

wrsmith... The extra lipo for me was not covered by insurance. Then its between you and the doctor and any agreement you come up with... And I stayed at the hospital for 2 nights.. no way i would have left... but I had a lot done.

jenlee

Apologize in advance for this loooong post!  MY BS is trying very hard to convince me that I shouldn't have a flap procedure.

I was convinced that I was going to NOLA, had sent all my info & photos, talked to their insurance person and was waiting to hear back from them.  I've been told by 2 surgeons there that despite my current plumpness, I don't have enough fat for two DIEP breasts, but it seems that the center in NOLA can work all kinds of miracles, GAP flaps. hip flaps, etc.

I finally told my original BS (with whom I was scheduled for BMX & TE's) that I was probably going to do this and she had an absolute fit.  Once of those really know-it-all surgeons -- which was great when I wanted to do what she recommended,  She refused to accept the fact that I had talked to women here who had great results and that she knows better.  She says that there are many studies about flap failure.  She went on and on about how I don't want to do that, that they will mutilate my body, that if they use hip or buttocks, that it will take away my ability to run, do pilates, or any other athletic pursuits, etc.  (It's not that she needs the business, she is one of the top surgeons in the area.  We call her "the knife" because she does a LOT of mastectomies, and since I knew I wanted BMX since I was first diagnosed, I figured why not go to the person in the area who does the most.)

She has me so confused that I think I'm having a lumpectomy next week to buy myself a few weeks to get this figured out.  It would also give me some time to get a little more energy back from chemo since I just finished three weeks ago.  Then I can fly down to NOLA for an in person consultation, have my sister who is a nurse meet me there, and get some level of comfort.  I told my husband that my BS is almost wearing me down to go her way, but I'm afraid I'll regret it. 

Would LOVE feedback on how or if your DIEP and hip/Gap flaps may have limited your athletic capabilities, especially those who are fully healed.  Being active and working out are really important to me.   But I'm not sure I'd be happy doing that with TE's or implants either!  Also, does anyone regret the abdominal or Gap flaps on your body?  Did those who mention flat butts find they improved after stage II?

TIA, Jenifer 

Snobird

I did not go to NOLA but I have no limitations whatsoever after my BMX/DIEP. No muscle was used and I was downhill skiing at Vail 5 weeks post surgery. I would run from that surgeon. You will be in good hands in NOLA. Any surgeon that tells you that you will be mutilated by another surgeon(especially ones as well know and regarded as the ones in NOLA) is untrustworthy and is not thinking about you at all. Just her bottom line and the fact that when you are done you may rave about NOLA as most do and she will lose business. When a Doc gets indignent and angry that you maybe considering another option they are being extremely unprofessional. Just my 2 cents.

Adey

snobird's 2 cents make sense to me.  (c:  Your BS is very unprofessional.  When I told my PS that I was cancelling my exchange surgery for silicone implants to investigate flaps he said that I needed to do what is best for me and to let him know my decision.  I know I felt immediate relief when my pec muscle was back where it belonged and not stretched out over TEs.  I decided on Dr Massey and NOLA and am very happy I did.  The best of luck to you.

rtnyc

Happy Monday to all. I haven't posted in a while but will give an up and would love to hear from others with same symptons. BMX 4/23 and second surgery 5/3 to stitch up the flaps, fix some skin issues etc. Today is exactly 3 weeks from initial bmx w/diep. off all med's (kind of ) have extreme nerve pain under arms and going down the back of my arms but only to the elbow;; no swelling or pain, numbness in forearm or fingers. But the uncomfortable feeling of pins and needles is constant doesn't go away. Hard to move becuase of it, hard to sleep etc. Other than that, I have small shootting pains witin my fat filled breast but manageable. My under arms/arms is 100 times worse. If I didn't have that pain/uncomfortableness I'd be doing great. Anyone else have this, any suggestions. forcing myself to move, started walking this past weekend, moving shoulders, range of motion in arms is actually ok, starting walking my fingers up the wall today (someone told me about that).

rtnyc

Happy Monday to all. I haven't posted in a while but will give an up and would love to hear from others with same symptons. BMX 4/23 and second surgery 5/3 to stitch up the flaps, fix some skin issues etc. Today is exactly 3 weeks from initial bmx w/diep. off all med's (kind of ) have extreme nerve pain under arms and going down the back of my arms but only to the elbow;; no swelling or pain, numbness in forearm or fingers. But the uncomfortable feeling of pins and needles is constant doesn't go away. Hard to move becuase of it, hard to sleep etc. Other than that, I have small shootting pains witin my fat filled breast but manageable. My under arms/arms is 100 times worse. If I didn't have that pain/uncomfortableness I'd be doing great. Anyone else have this, any suggestions. forcing myself to move, started walking this past weekend, moving shoulders, range of motion in arms is actually ok, starting walking my fingers up the wall today (someone told me about that).

bdavis

Jenifer... I know it must be frustrating to have your BS bascially bully you... As you know I had the hip flaps and DIEP flap and I am at the gym 3-4 times a week, in spin class, zumba, Bowka, step, strength training... and I went downhill skiing this winter... no limitations at all... and just a mere 7 weeks post surgery, I was walking in the NYC Avon Walk for BC. It is seemingly common for surgeons who don't do a procedure to poo poo those who do.

If it makes you feel better to have the lumpectomy and then go to NOLA, then that's what you should do, but if I had known all that I know now, I would have forgone the lumpectomy and gone straight to NOLA... no regrets here really, but who wants extra surgery if you can avoid it.

RetiredLibby

Jenifer, RUN RUN RUN away FAST from a surgeon who tries to bully and frighten you into doing what she wants you to do rather than what you want to do. I agree with the other opinions that the surgeon is HIGHLY unprofessional! DIEP flap surgery doesn't take muscle. Apart from the longish (6 weeks give or take a few) recovery time, most women seem to have no impairment at all. I am 9 months out from a 20-hour BMX and immediate DIEP and 3 months out from Stage II, and I have zero impairment. I am not the most athletic girl on the block, but there is nothing I cannot do. In fact, the PS was seriously impressed with my arm range of motion a six weeks after surgery. At 10 weeks, I had complete range of motion and no restrictions on movement. I also agree with bdavis about just having the one surgery. The fewer times they make holes in you, the fewer chances of infection. Just my two cents ....



L

rtnyc

jennifer: you should not be in confilict with your doctors, you have enough stress. After going through MX w/diep, just 3 weeks out the BS has nothing to do with the DIEP. the BS only job is the MX. The PS is responsible for the reconstruction. Everyone has an opinion but honestly yours is the only which matters and it is a very personal decision. I would go with your gut and do what you are comfortable with. Go for a second opinion. I actually did that and 2 months after dx, I switched doctors both BS and PS and so so happy I did. I went from being unsure to 1000% happy with my doctors and trusted their every word. Good Luck.

rtnyc

happylibby: did you have numbness in armpits and pins and needles in back of arms? If so what did you do and what was the timing? I'm only 3 weeks out but it's putting a damper on recovery; would love to hear from you. thanks.

gale1525

Jenifer, can you get you BMX with immediate Diep from Nola so you don't have to go through 2 surgeries, I have heard you get the best results from having immediate reconstruction. If you have a lumpectomy and have clean margins will your insurance pay for you to then have the BMX?

Chris13

Jennifer, you don't need the stress from this dr. She only does the mastectomies. That's where the "multilation" is.....when I look at my flap there is a maybe 3/4 inch by 3 inch wound. It's normal.....they open a largish incision to do the work. Yes, it's freaky looking, but is healing and not that noticable as it is right right under the breast. In clothes, I have a nicer cleavage than before (being overweight.)

 I am two weeks out with UMX and immediate DIEP. I have a flattish belly (swelling of course in everything) AND a breast, plus had the healthy side lifted. A couple days ago I could lift myself from a lying postion in bed with little discomfort. I'm off all pain killers, even OTC Tylenol because I was spacy and constipated. The pain is not great, yes, occasional stabs in the flap side that last about 30 seconds. I'm doing my morning walk, was out and about with friends and family..... Everyone is diferent and I handle pain well, but still--2 weeks! Dr. did say no jogging for a while, but swimming ok when the incisions heal. I can't imagine not being active...it's so important for our emotional as well as physical health.

Take comfort from the others who have had the flap, along with myself. Don't be railroaded...it's your body!

RetiredLibby

rtnyc, I had an occasional stab down the back of my right arm, but not a lot of them. I had a stab or two in my noobs, too, but not often. Both my armpits are numb, but don't hurt or have pins and needles. When I had the stabs down the back of my right arm, I just put my hand over it and pressed, and it went away. Nine months out, I don't have any more stabs. Sorry I can't be of more help.



L

goldlining

jenlee I agree with the other posts. I had a PS tell me snidely that some DIEP surgeons take more muscle when they have to change the plan during the procedure than she does intentionally for a TRAM. To give her credit, she referred me to the DIEP surgeon whose flap skills are so good he does them on *faces* too (obviously not for BC!) and he did NOT touch my muscle. Like several of the others above, I was active quite soon. The stooping over lasts a while, but I walked the hospital floor and did 5km in laps, 1km at a time, 4 days post-op. I walked 4mph on the treadmill for an hour or more once a week, and ran a 5K and ran/walked a half marathon at 6 weeks, mostly upright. The experience is important and there is always a failure rate no matter how small, but I don't think "the knife" knows enough (or has enough respect) about things that aren't done in her practice to be giving you this scaremongering.