Implant reconstruction failed now Trans Flap

Ibethewife

I was curious if any one had skin saving mastectomy and have it fail? My PS has had to swap out implants, tighten things up, and use different types of dermal matrices to try to keep everything from dropping.( two inches this time) so our last option before going flat is the Diep or Trans flap which is scheduled for the end of November. I have some concerns and fe course questions about it. Any info or advice would be appreciated

Lula73

Make sure your PS does DIEP. Be adamant that you do not want a TRAM flap - it uses your abdominal muscles where DIEP just uses the skin and fat on top of the muscle. A regular PS can do TRAM, but they cannot do DIEP. They have to be a microsurgeon to do DIEP. Insist on seeing his before and after photos for DIEP and if you wouldn't be happy having those results for yourself (not just happy considering everything you've gone through with bc), you need to cancel that surgery and consult with other microsurgeons that do DIEP. You'll also want to ask what his conversion rate to TRAM is (it needs to be 0), What his personal DIEP flap failure rate is (needs to be well below national average of 10%), how many DIEP flaps does he do every month (needs to be a minimum of 4 - more is better), ask how he addresses the changes to your bottom 1/2 during stage 2 and does he get it covered by insurance (if he says you won't need anything or insurance doesn't cover cross him off your list and move on to the next microsurgeon. Here's a link to the site for the group referred to as NOLA. This is what good looks like in their before and after DIEP photos. We always need a point of reference otherwise we have no clue what good looks like. www.breastcenter.com

Ibethewife

thanks Lola, he does have a micro surgeon who works with him. It may be the Diep as he is not moving muscle. I saw him in January and will again 2 weeks before surgery. I live out of the country the majority of the year and it is the reason we are waiting till we get back in the country in November

Runrcrb

what Lula said. No tram flap