Cartilage removed from the rib during DIEP Flap operation

Delo3865

I am planning on having a DIEP Flap Reconstruction this month.  As part of the procedure my doctor will have to remove 2 centimeters of cartilage from one of my ribs in order a access the blood vessel which will be connected to the flap.  Since cartilage will be removed, I am concerned about how my shoulder, chest, and back may feel after my body is healed.  Can someone tell me how your chest, back and shoulder feel now that you are healed from the surgery after your cartilage was removed?  Do you notice the cartilage is missing?  Do you have shoulder pains?  Back pains?

lahela

Everyone's experience will vary, but for me it just meant a painful spot on my inner chest for a month or so. It has had no other effects at all.

LilacBlue

My experience was same as lahela regarding the change to  rib cage .  Shoulder well, I developed a left frozen shoulder after surgery.  My PS refered me to a orthopedic specialist and quite a bit physical therapy afterwards, brought me back to normal rage of movement, including being painfree.  My back has never been stronger as I now take a number of pilates and yoga classes at the gym.  Delo3865, I wish you smooth, forward moving recovery for this upcoming summer and autumn.

LAstar

This was done during my flap procedure also.   It hurt initially but then subsided.  It's at the sternum where the rib connects. I've noticed no other issues from it.  

Delo3865

As part of the surgery, my surgeon says he has to cut a chunk of muscle from my abdomen in order to get the artery that will be moved to my chest.  Was a chunk of muscle removed from your abdomen?  If so, do you have any problems with your ab?

Delo3865

As part of the surgery, my surgeon says he has to cut a chunk of muscle from my abdomen in order to get the artery that will be moved to my chest. Was a chunk of muscle removed from your abdomen? If so, do you have any problems with your ab?

Delo3865

As part of the surgery, my surgeon says he has to cut a chunk of muscle from my abdomen in order to get the artery that will be moved to my chest. Was a chunk of muscle removed from your abdomen? If so, do you have any problems with your ab?

NatsFan

A DIEP doesn't remove any muscle - instead the surgeon teases the blood supply out of the abdominal muscle without cutting it.  If your surgeon says he is removing a piece of muscle, then it doesn't sound like a DIEP, but more of a TRAM or free TRAM.  You may want to clarify with your surgeon about exactly which surgery you're having.  Here's a link to BCO's discussion of the various flap recons - if you read about DIEP and TRAM, you'll see that removal of a piece of muscle is only done in a TRAM, not a DIEP.  

http://www.breastcancer.org/treatment/surgery/reco...

  

jacee

Nats fan is correct. Once muscle is removed, it is no longer a DIEP, even a small amount.  To your question about rib cartilage, just slight soreness in the area for a few weeks.

goodrhue

In my consult with Dr. Holleman at Duke 2 weeks ago, he explained to me that when they are "teasing" the blood vessels out of the abdominal muscle during a DIEP, sometimes if the vessels are many and tiny, instead of a few nice big ones, the "teasing" can damage the abdominal muscle, with the potential for impacts similar to removing the muscle.  This apparently happens less and less often as the surgeons gain more experience, but it is a risk.   This is my big concern with doing the flap surgery - I don't want sacrifice any function in some other part of my body just to get rid of the prosthesis.   I also didn't know about the cartilage removal until he explained it to me, but he told me he had never had any complications from that part of it.

I've had 5 BRAVA+ fat grafting procedures with Dr. Khouri in Miami, and my radiated skin failed after the 5th one (had a 6th repair procedure), so I'm reconsidering what my best option is, IF I want ton continue.  I'm cruising these discussion boards and so thankful for all you ladies who share your stories!

lahela

goodrhue, my PS cut through the ab muscles in a couple of vertical incisions to access the vessels and I am recovering well with PT. Because the muscle is still all there, it just means extra work to get back in shape.

sonslovehockey

after a year and 4 months i still get pain in the chest area where cartridge was removed i had a lot of complications so that may be why i still have pain it is not constant though. i also get nerve type pain in the reconstructed breast- they said this is all normal