DIEP 2014

Teacher64

Kat - prayers for you to heal and gain strength and well-being.

julieho

hi everyone,

I had BMX in July 2012 with immediate reconstruction with TE's.  Had post op infection in left expander, had it removed before chemo, after chemo had it placed again, another smaller infection after third fill, once they cultured the fluid we did the swap from TE's to silicone implants and I was six weeks inIV antibiotics.

After all is said and done I have two very lopsided, hard, very uncomfortable implants.  My PS said it was because of the scar tissue on the left the came out so uneven and she has offered to do new implants using gummy near and far grafting.  

I have now begun thinking I wish I had just done a DIEP.  I was reluctant to do it because I was concerned about the abdominal surgery and having two large surgical sites to recover from especially with a BMX.

I am now thinking I want breast that are soft and feel like my own body.  The implants feel horrible.

I am two years out from diagnosis.  Have not done nipples, which I really want because my foobs are so lopsided and hard.

I am thinking of doing a DIEP this late fall figuring the winter is a good time to recover.  Is it really hard to gain back the abdominal muscles?  I have been working with a physical therapist and trainer and am just getting my abdomen in shape. Also I am 55 and maybe 10 lbs overweight but very active, love hiking, walking, biking, xcountry skiing etc so wonder how long I will have to recoup.

Thanks, would love some input. I wish I had just done the DIEP from the get go.

Take care,

Julieho 

brendarj

Good Morning Ladies   Well it's two weeks since surgery and still have abdominal drains in. Fingers crossed for today. Nurse visits at 1. Did anyone else have a lot of sloughing, bloody discharge under and between breasts. Nurse phoned my GP yesterday for a script for fucidin ( an antibiotic cream). Trying not to be worried about this and hoping someone can offer advice or has had similar experience

Kat - healing prayers rest well and gain strength

Zenful

Julieho, they don't use your muscles for DIEP surgery, just fat. I had BMX with immediate DIEP/GAP, and for me there wasn't much pain. Everyone is different, but I would describe it as uncomfortable rather than painful. The 10 lbs will serve you well to have enough fat to harvest.  They will tell you 4-6 week recovery.  I needed every bit of the 4 weeks, and didn't return to work for 6 weeks. You will be mostly tired at that point. There are other women on this board who have switched from implants to DIEP. I am sure they will weigh in. BTW, I LOVE my soft boobs. The abdominal scar is worth every inch. 

jbdayton

kat ski my prayers are definitely with you.  I am so sorry for the clotting issue.  Take care and rest.  

aff

Julieho - I am just 12 days out from my DIEP surgery. I know that everyone is different but the only true painful days were the first couple days in the hospital. I have been uncomfortable in that I can't do what I used to do, but I haven't really been in pain since I've been home. I stopped taking pain medication 2 days ago and have been fine. You will not lose any use of your abdominal muscle as DIEP does not take any muscle. 

Kat - sending lots of healing prayers your way

marvelher2

Hi ladies, I need your advice.  I am three weeks post-op bilateral mastectomy with immediate direct to implant reconstruction.  I thought I had done my homework, originally hoping for a DIEP reconstruction, but my BS talked me out of it citing higher morbidity, the need to do it all at once, risk for loss of the flap due to poor blood supply, etc.  so I decided to try it his way, then if I had complications such as the need for radiation, I could opt for DIEP down the road.  The plastic surgeon that he uses for his surgeries does direct implant reconstruction rather than expanders whenever possible if there is enough skin available in order to avoid a second surgery for the exchange.  I live in Sacramento and there are no surgeons in my area that actually perform the DIEP procedure so I visited a surgeon in San Francisco that I really liked prior to my current surgery so that I would have my options in place.

Well, I know it's still very early, but at the three week mark I am utterly miserable, and I am one that has gone through many surgeries in the past and usually bounced back quite quickly from surgeries.  I have constant severe muscle spasm from the pectoral muscle due to the implant being inserted beneath it, even though I have an aloderm sling.  Some of the skin beneath the incision is necrotic due to poor blood supply.  Initially it looked as though I might lose a large portion of the skin below the incision, but that is improved, and now it looks as though I'll only lose a half inch around the incision.  Even so I don't know how I will be able to manage to lose a half inch of skin in this area without removing the implants. I see my plastic surgeon today to evaluate where I am at this point.  The muscles spasms were so bad last night that I couldn't get any sleep at all even after taking Percocet and Soma at four hour intervals.  I am concerned that I'm having to take so many drugs to try to mitigate the pain and muscle spasms at this point.

My question for those of you that of been through this is whether or not muscle spasm of the pectoralis muscle was a problem for you at all with your DIEP procedure.  While I know that three weeks is not enough time to really evaluate something like this, I am very concerned that I have not had more of an improvement in my pain level since the surgery.  If any of you had gone through implant surgery and then had a revision for the DIEP procedure please let me know why you made that decision, how you came to it and how long you took to make that decision.  Any insight any of you can give me would be greatly appreciated at this point.

goldie4040

Aff, sounds like you are doing great!!!!  Congrats. 

Julieho, welcome.  I had implants and switched out to diep.  If I were you I would continue to exercise until your surgery (being strong makes recovery so much easier), but I wouldn't lose that last 10 pounds until you see a surgeon.  A little extra is a good thing when you have diep, not a lot extra, but a little extra.  I was a little too close to not having enough and my tummy had to be pulled very tight.  There are woman who stand up straight on day one, and other's that take weeks.  As far as the tummy muscle, I probably could do a sit up if I wanted to right now, but I am still afraid to injure my incisions.  My tummy muscles were not cut at all.  Zenful is right.  Most of us need the whole 6 weeks to recover.  4 weeks seems to be the magic number as far as feeling better after anesthesia, pain, moving around.  But, full energy doesn't seem to be back till about 6 weeks. 

sibrhusky127

Just curious -- I am now 7 weeks post bilateral DIEP flap.  It seems that the numbness in my abdomen is now being replaced by pain.    I actually think that the swelling is (finally) going down and the nerves are now letting me know that they are there.

Has anyone else experienced this?

Wishing you all much love, strength, and healing!

brendarj

Drain Free..Yeah!!!

trish01254

good for you Brendarj.  I can't wait for that day myself.  

goldie4040

Yeah Brenda.  I know you feel so much better!!!

sibrihusky, I too have been noticing pain again in my lower abdomen.  No bad, but it's there.  I had a lot right after surgery, which turned to numbness.  It seems like it's mostly my incision that feels sore.  How about you?

pollyanna5

Last drain removed by homecare today!

A question, when I cough, sneeze or sometimes just move, I have tugging pain/twinge in the centre of the chest under the skin, about a few cm's down from my collarbone.  Would this be internal stitches of the flap?  Is so, any concern I only feel this above the left breast?

THanks!

thinkpink4ever

brendarj and pollyanna, congrats on being drain free!  It's a good feeling...

I just sneezed for the second time in my 2 weeks post-op, and ouch, that's painful.  The pain was in my cleavage area.  Hopefully, there's no danger of popping a blood vessel, because it surely felt like I could have!

One love,

tp4ever

aff

brendarj and pollyanna - Yay! Having the drains removed was pure heaven for me.

The pain in your chest is most likely where the rib was shaved. It's the area that is giving me some discomfort. 

Zenful

marvel, the DIEP flaps do not disrupt the pecs because the fat is placed on top of the muscle and under the skin. I chose DIEP surgery as soon as I found out about it. I will never have to worry about implants or the problems they can cause, and I did not have to give up any of my muscles. Win, win. 

thinkpink4ever

Zenful, those are the exact reasons I chose DIEP.  I have no regrets, and am only 2 weeks post-op.  A local PS told me he could only get one breast from my ab tissue - a stacked flap from both sides for my previously radiated breast, and then he would have to put an implant in the other breast.  That just wasn't good enough for me.  Once I went to NOLA, I spoke to two specialists that said I had sufficient ab tissue.  

I just hate to read about those women who are given such limited options or only one option based on the limited abilities of the surgeon, and then down the line, they have to have additional surgeries to fix that initial reconstruction or attempt at reconstruction.  If you don't do your own research, you really don't know the full range of options.

One love,

tp4ever

Dyvgrl

I agree completely. I live in AK and there are only 3 decent PS's here, none of which can do DIEP. I had to travel to Seattle but it was so worth it. After having a TE, there's no way in hell I'd ever get implants. I had to do my own research to find a good surgeon. Glad I did!!

optimi

I finally got home today after a successful surgery and a week stay at the hospital. They unfortunately had to make my left cancer affected breast smaller than anticipated as BS had to remove more of the original tissue and abdominal tissue wasn't enough. But that can probably addressed during stage 2. Other than that I am happy with the results and incredibly grateful to the excellent microsurgery team I had. (I am still waiting for my final pathological report).

I haven't had a chance to catch up on the threads here but to all the wonderful ladies waiting on surgery, I can only repeat what others have said before. This surgery is very doable. I was incredibly anxious and scared the week leading to surgery but everything went so well. EVen the week at the hospital flew by.

My prayers and thoughts to everybody on here.

marvelher2

Well, I kind of regret allowing my cancer surgeon to talk me out of DIEP.  He felt that I was opting for too much surgery.  I have a complicated problem in that I have polycystic liver disease which causes pain in my upper abdomen due to major pressure under my rib cage due to the cysts.  I was worried that adding an abdominal surgery would cause me too much postoperative complication. 

I saw my plastic surgeon today, and he says to expect the swelling under my arm to persist up to four months.  I am very concerned about the ongoing muscle spasm.  I am going to have to have some of the skin removed that did not survive, probably next week.  Seems to me that I am having more complications from this seemingly less complex surgery than I might have had I chosen the DIEP procedure, and I'm not entirely sure I won't still have to do it down the road.  I guess I should give this more time, but it is definitely frustrating me at this point.

aff

optimi - I'm so happy to hear that your surgery was successful and that you are back home. I have thought of you often since your surgery. 

Teacher64

I had to lose a 1-2 x 4" strip of muscle because veins ended up being too small. Three months out, I've just begun sit ups. So all is ok.

nihahi

julieho.....I had a muscle sparing Tram free in April of last year, and a few months later I turned 63. I'm 5'6", and was about 128 at the time of surgery. I had a long history of implant issues and a severe capsular contracture was the reason I decided "enough" with the implants. My choice of activities is very similar to yours, and I was doing low level hikes within 2 months. In August, I was hiking in Glacier Park with another Diep gal. This past winter, I was skiing and snowshoeing. You should be able to return to your "fun stuff" too. Everyone has a different experience, both pre and post surgery, but the common thread seems to be once the first few challenging weeks are over, most everyone feels they made the right choice. A flap breast feels and often looks, much more "real" than an implant, from my experience. I had nipple recon this past April....couldn't be happier. Hope I can be of help to you, so ask any questions you may think of.

The1toC

Hurrah for all those who have made it to the land of drain free! And next week will be even better!

Marvelher2 I cannot recall if it was implant or TE but I recall asking my PS if he could inject botox into that TIGHT painfl pec to let it loose. He would not - no evidence based medicine. I think implant was infected on that side and that is why poor healing wound and TIGHT with pain.

Marvel i know that it is becoming popular to do immediate DIEP recon even before rads but to me it doesn't make sense because of contracture possibility. That is why I chose delayed DIEP. BTW none of the PS here recommended that as an option. I figure it is because they wouldn't get any income from me by doing so. From their perspective I suppose that if the patient wants boobs it doesn't matter how they get to that end point and, sort of like commissioned salespeople but with sharp instruments, may as well make a buck off it. But we are PEOPLE and it DOES matter and we have a whole long life ahead of us after surgery. My concern for you with DIEP is the long time with anaesthesia given the liver cysts. Good question for anaesthesiologist (doctor, not CRNA) next week when you are there.

goldie4040

Hey guys,

This is totally off subject, but we need some heavy duty prayer's in my family tonight.  My beautiful 15 year old niece was in a terrible accident and was badly burned.  She is away from home in Germany doing a semester of school.  Her parents have flown to be by her side.  She is now in a medically induced coma, which I understand is common for burn victims.  My heart hurts so badly for her, and her parents.  I just can't imagine.  I have been making bargains with God for the last couple of hours since I got the call.  Anyway, I needed to unload.  Thanks for listening, and if you can find it in your hearts, some prayers for our beautiful Lily.

Cherrie

Oh my goodness Goldie! I am thinking of you and your family and would make bargains too. :-(

JerseyMomOf3

Oh goldie I am so, so sorry. My daughters are also 15 (and about to leave the country on an academic trip as well) and I can't imagine your family's fear and pain. My thoughts and prayers are with you all. God bless Lily and may she have a complete recovery.

JerseyMomOf3

Optimi, so nice to hear your great update- glad you are doing well!

sbelizabeth

Praying for Lily and her family, Goldie.  I'm so sorry.

Zenful

Goldie, I am so sorry. I am praying for Lily and your family