DIEP flap vs other reconstruction

Emarta

I am having a unilateral mastectomy on right breast this week with no reconstruction right away to make sure lymph nodes are negative & don't need radiation, I will have reconstruction, the DIEP flap is a option just worried about all the scaring, my issue with implants is they will need maintenance & I am keeping my left breast & want a more real natural feel without anything unnatural in me that could rupture or have complications down the line, I am in Charlotte so anyone with any advice or experience with this I would greatly appreciate any input. This is new & unexpected for me. Thank you anyone w/ help or knowledge & ex

Runrcrb

Emarta,

My advice to you is to explore all reconstruction options and then choose the one that makes the most sense for you and your needs. I spoke to my breast surgeon, two plastic surgeons, and the friend of a friend who had recently had a unilateral mastectomy with DIEP flap reconstruction. Ultimately, I chose unilateral mastectomy and DIEP flap reconstruction. If you haven't, ask your surgeon about skin sparing and nipple sparing mastectomy.

I had a tissue expander placed at the time of my mastectomy, knowing I had chemo and radiation in the future. For me, the expander under the pec muscle was never comfortable and I knew that flap reconstruction was the right answer. I am fairly active and now that I have had DIEP reconstruction am glad that using the pec muscles is feeling more normal.

There are several threads on the topic of DIEP - search and read up. Do note that, as in most things, those who have complications are more likely to post.

I have never regretted my decision to have a unilateral mastectomy and DIEP reconstruction.

Good luck

Emarta

thank you so much! I am leaning towards the DIEP I know they are taking my nipple is skin sparing possible with them taking nipple & does it matter in DIEP flap end results? I have heard nightmares about the wxpanders

Runrcrb

Any reconstruction can be done with or without nippled

Skin sparing can be done even if the nipple has to go. My hope was nipple sparing and due to tumors near the nipple my doctor wasn't sure he'd be able to leave it until he got in there and could get clear margins, But even if he'd taken the nipple, the skin over the rest of the breast would have been spared. My incision is under my breast.

NotVeryBrave

I would advise seeing any PS before your MX if at all possible. My PS is in favor of starting reconstruction at the time of MX, especially if rads will be involved. He feels that it's easier to work with the skin and tissue before radiation than after.

Meow13

I had left side diep done in 2012. There are scars, mine look pretty good. The tummy incision is low but still significant and feels tight lying down. The match is excellent so I am overall happy.

Lula73

I had BMX with immediate DIEP in NOLA (yes I traveled from NC). The pathologist did the SN testing during the surgery. Scars are fewer if you go with skin sparing. I’d ask if they are taking the nipple because it’s warranted in your individual case or if they always take the nipple. If it’s not an individualized decision I think I’d reschedule and seek a second opinion. Have you seen the PS who would do the DIEP procedure yet? If not I’d see about getting in with him prior to mx. He may have some recommendations on oncology breast surgeons too. It’s important for the PS and BS to be on the same page. I’m very happy with my results and would do DIEP again in a heartbeat. Good luck to you!

Meow13

I should add my tumors were close to the skin surface so I couldn't have skin sparing mastectomy. My plastic surgeon did a fabulous job but I have visible white scar line mostly near my underarm.