TRAM Flap or DIEP Flap Reconstruction question

GreenGirl1

Steph, thanks for filling me in. I appreciate it. Luckily, I do not have pressure to go back to work so fast. I work in a small law office and my boss I think is glad she won't have to pay me for a few weeks! That sounds horrible, I know, but at least it gives me a little bit of flexibility. I will miss the paycheck for the few weeks I will be out, but I figure I won't be spending much either! Luckily, my husband works for a large corporation and can arrange to work from home for the first week or so, which will help a lot. Are you being pressured to go back? I'm glad your doc gave you a bit more time to ease back in to full time work. Sounds like that will really help you a lot. I hope you have help at home too.



I am not overweight but I do have a sort of ridge on my belly since I had 2 c-sections. I suppose a perk in all of this is that I will probably finally get rid of that! There is an up-side to everything, right?



No surgery date yet. I am putting it off for a family vacation we have been planning for months. The docs said there is no immediate rush since this time since it is DCIS. So, it will be in August. I will be happy when it is over. You guys are so supportive and wonderful. Have you found the DIEP thread? Wonderful ladies over there too!

Del11

Lisa- usually "postage stamp-sized piece of muscle" is how "free TRAM" is described. Are you sure you had pedicled TRAM?  Are you confusing free TRAM with DIEP and pedicled TRAM with free TRAM?

In pedicled TRAM the muscle is tunneled up to the breast area, so it's definitely more than a small piece of muscle getting moved. It's the whole muscle getting moved.

Anonymous

Green, no one is pressuring me to go back to work, except me. I work for a city, and the city clerk quit. As the deputy clerk, I have to assume the responsibilities of that position until we hire someone. Basically, my office is down two people, myself and the clerk, until I get back to work. Of the three girls left in the office, one is on vacation, and another one has a wedding this weekend for her son. I guess I just feel guilty about not being there, even though I know if I go back to soon everyone will pay for it.

GreenGirl1

Ah guilt! I know it well. But you are right, if you push too hard you may set yourself back. Be well!

lstevieb

Hello, Sisters! I am 3 weeks out from my tram flap reconstruction. Any feedback on pulling sensations under the skin near the reconstructed breast and the abs. Also, any comments on how long the tightness goes on for? I am a teacher, so I have the "luxury" of the summer to recoop. Thanks!

cgabbyj

Hi All

I am new here.  I am 4 weeks out from a pediculed TRAM.  I am starting to feel better although my abs and chest still feel real tight.  I just want to tell all of those who are in a rush to get to work to think twice about that.  Pediculed tram flaps are more fragile than DIEP flaps and you want to avoid flap failure at all costs, right?  I am in pretty good shape and I am finding this recovery pretty daunting.  I know it will be worth it in the end but still...

I am having lots of pulling sensations, lstevieb!  When things get too taut, I take a little 15 min break on the sofa to take the pressure off.  

1 more drain to go...

cgabbyj

Hi Lisa,

It is so good to know that your ab strength is ok even though you've had a pediculed TRAM.  I had the same recontruction surgery and I have been so worried about ab strength.  I was slated to have a DIEP/free TRAM but the surgeon had to go to the pediculed TRAM option because I had small veins in my left breast.  So it was either a pediculed TRAM or nothing.

Anyway, thanks for the positivity...it helped me  a lot!

Anonymous

I had the Free Tram during the Mastectomy.  I chose the flap surgery over implants because I felt the flap taken from my belly area would still feel like me and not foreign like an implant.  I woke up from surgery with a warm round perky breast mound which helped to keep me from feeling the shock of a lost breast.  The micro surgery done during the flap to connect blood vessels and get circualtion going to the new "breast" mound was reassuring when I awoke to the warmth and round naturalness of the mound.

 

Barb

TiffanyLeigh

Thank you all for your responses, they are much appreciated!  I met with my PS a few weeks ago and we decided to do the Dorsi Latt with tissue expanders.  I was so happy to hear that I will be able to get implants; something that I have always wanted.  After the past year and a half I figure I deserve something BIG, lol.  I hope all of you are feeling well, God bless!

carla53

hello.  I'm scheduled for a pediculed tram in the beginning of March.   Those of you that did trams, could you please give me an update on how you are doing, if you are satisfied,  or not and any other piece of information re tram that you could share.

Thank you - Carla

Jennt28

I had a free TRAM which is more like a DIEP so my experience is not likely representative for you I'm afraid...

1.5 yrs out and I have just had the nipple reconstruction. Abdominal scar is almost invisible, Breast scars are still pinkish. Stomach is still tight and I have to roll slightly to the side to sit up from lying.

Jenn

Rosebud14

Hi Carla53,

I was sched to have a TRAM Flap until I read the DIEP 2013 thread in this forum. My PS did not offer to do DIEP surgery so I switched to a PS that does. DIEP is a more refined flap surgery and I expect to have a better outcome, preserving abdominal muscle. I hope you look into DIEP... I am glad I did.  My surgery is Feb 24. Good luck to you.

Rose

carla53

Thank you Jenn and Rose.  Jenn even though it was a free tram, I am still interested in what you had to say about how it has gone for you.  How did the nipple reconstruction go?  Are you satisfied with it?  Rosebud DIEP does seem to be a better way to go.  My insurance doesn't go outside my county and no one does DIEP here.  Fortunately my PS is very good.  Good luck on your surgery.   It's coming up soon. 

Carla

Nissi

Hello Carla,

It has been 2.5 years now since my pedicled tram reconstruction.

I am very happy with the results of my breast reconstruction. In fact I wish my normal breast looked this perky

The only part that is still uncomfortable is my stomache area.  It might be worse because I have gained 10 pounds in the last 2.5 years and I was overweight to begin with. If you are not overweight, you may not have this problem.  My discomfort is the tightness  of my skin not expanding after full meals.I feel like there is not room for my stomache to expand after full meals.  It feels like I am 8 months pregnant sometimes with the bloated and tightness.  I am due to go back to my PS but I was hoping to have lost my 10 pounds   

I hope this helps, if you have any questions for me you can private message me and I can give you my phone number.  It really helped me to be able to call someone who had been through it before.

Blessings, stay strong!

Denise

DaleElena

Your story is exactly like mine, although yours was quite a few years ago. I am resistant to removal of my breast because of all the obstacles caused by previous radiation.

Have heard positive things about DIEP, but also negative (difficulty with blood flow). Was advised against expanders. Like you it is DCIS, again after initial lumpectomy and radiation.

I have read some things that say DCIS is not actually cancer. Stage 0. Cant help but wonder if I should just leave it alone.

Nissi

Hi DaleElena,

If I can help answer any questions with tram procedures and recovery let me know. send me a personal message through the message board.

I had DCIS in 2006, had lumpectomy and radiation and tamoxifen then it came back the second time 5 years later in 2011 so that is why I decided to go with breast removal. I would not have done it the first time, but since it came back in the same area I thought it was best to have it removed. it has been 6 years now and it is going very well.

I also have heard that DCIS is not cancer, so it is a little confusing. maybe they have more data on it now?

Praying for you to have clarity and peace in your decision

Lula73

hi DaleElena- one of the big factors in any of the natural tissue recon options (DIEP, SGAP, TDAP, etc) is the skill of the surgeon. You would want to find someone who preferably only does these types of surgery (no face lifts, no augmentation, etc). And they should be doing at the very least 1 per week if not more. Theiir before & after photos speak volumes. If you dont like what you see in the photos move on to the next doc. many have their photos accessible from their webpage which makes it easier to whittle the list of possibilities down. I had skin & nipple sparing BMX with immediate DIEP done at NOLA. No one does more of these surgeries than these guys. Women travel literally from all over the world for them to do their recon or to fix another PS’s botched job. And these guys are the ones pioneering the new flap surgeries too. I did a lot of in depth research before choosing to travel to them and I would do it again in a heartbeat. If NOLA is too far, they have another doc that’s affiliated with them with offices in Charleston, Chicago & Salt Lake. Here are links to their sites:

www.breastcenter.com

www.drmarga.com

Shanleym7

I was wondering what doctor you thought was the best at New Or,eans Breast Center. I will. Be scheduling surgery. I originally spoke with doctor Trehan but not sure about it. I have read that the other doctors there seem to have a little more experience. Do you know which doctor is the best. thank you so much.

Lula73

truly, they all do excellent work at NOLA. I’ve seen several photos of Trahan’s patients and I would trust him to do a stellar job. I had Dr Dellacroce.