DIEP flap/implants years after mastectomy?

lightningblue

Has anyone gone flat after a mastectomy, and then reconstructed with DIEP flap after time has passed? Do you get tissue expanders placed for this, or just go straight to the flap?

Anyone gotten implants later on after mastectomy? Can you get pre-pectoral tissue expanders if reconstructing after going flat initally?

I'm having a BMX in a few days and elected to go flat (no tissue expanders) and regret the choice. It's too late to change my choice because coordinating the plastic surgeon and the oncology surgeon together would push surgery too far into the future to be safe. After I heal from BMX I have chemo and possibly radiation... so I would not reconstruct for at least a year or so.

I'm looking for info and others' experiences to try to calm down about it.

DesertPup

Hi! Had my BMX end of Jan and I went straight to implants and honesty? I wish I would have went flat and gotten through ALL my recoveries (radiation, healing) and THEN decided about my reconstruction, etc. The BMX is SO much, then healing from that, then doing radiation which kicks your ass energywise. It's a lot ya know? Having these implants and getting used the feel, the size, the weight, sleeping positions, etc. I would have been nice to not worry about any of that until I was more myself energy and mentally. So maybe you did make the right choice? Just speak with them saying you're going to want reconstruction so they know while they're in there? Either way, it wil be fine. Try not worry and just take THE BEST care of YOU. I'm no expert but I'm almost 100% positive you do whatever you want even after being flat for awhile.

lightningblue

Hi DesertPup, thank you so much for responding! Your post makes me feel less stressed about making the wrong decision. I'm sorry you went through all of that, I hope you are ok now.

beeline

lightningblue, I had umx with no recon and was told I can reconsider at any time. I ended up needing rads, so I’m glad I didn’t do immediate recon. They’ve suggested waiting a year post rads to let everything heal fully. In any case, you can change your mind later! Good luck with surgery. Wishing you a quick recovery!

Meow13

I had to wait 4 months after my umx due to scheduling, my surgeon was booked out that far. After I had the DIEP my friend who had a mastectomy almost 15 years earlier decided to go for it. Her surgery went very well too.

Wendysch

lighteningblue I just had a bilateral DIEP done at PRMA on February 6th. I had been flat for over a year and no expanders were used, they did what was called a skin sparing double mastectomy to help with reconstruction at a later date. Chemo and I did not get along and I ended up being neutropenic and septic, so they did not want to do anything for a long time to allow my body to heal. I absolutely love this procedure and what my results have been. They just took the excess fat including the skin and blood vessels from my lower abdomen and inserted that in my old mastectomy scar. I did not have pain, the most I took was Tylenol! I was up, walking and standing straight the very next day and out of the hospital in 3 days. And the bonus was a tummy tuck!

lightningblue

Thank you all so much for your responses! This is so helpful.

rmgrmg

Yeah, if you look at the Johns hopkins site here they explain and verify delayed reconstruction on a webcast--

https://www.youtube.com/watch?v=UOlwSsUXQTY

tjohnson1971

I just had my plastic surgeon consult today and she said she will not do diep flap or Latissimus Doris flap reconstruction until 3 months after mastectomy. She said it’s a terrible idea and does not recommend it. I was disappointed because I have heard of women having it done all in one.

rmgrmg

Did she say why she feel the DIEP is terrible. Her response is odd, especially without explaination. I would definitely get a second PS opinion or more. Are you going somewhere that has a great reputation and does high volume of breast reconstruction cases...that is very important. Don't despair and keep trying to advocate for what you desire with varous great PSs.

Flynn

I had tissue expanders in for almost a year and a half and I just had diep surgery last week. My chemo ended unexpectedly early so we placed the TE to leave my options open because we just didn’t have time to see multiple PS once chemo ended. I didn’t enjoy the TE but I was happy to have time to evaluate my options and heal from rads before making a final decision

rosesinwinter

I had my unilateral mastectomy in 2008 and just had DIEP flap done in 9/2018. I had inflammatory breast cancer which required extensive radiation. They told me I could not do reconstruction for a year afterwards while they continued to observe where the skin involvement had been. And then when I had a plastic surgery evaluation, I was told that implants were definitely not possible or DIEP flap either. So I wore a breast form/pocketed bra for 10 years. But then found an awesome surgeon at University of Pittsburgh Med Center who was certain that he could do a DIEP flap despite the scarring. I have great results - went from D cup on remaining side to B cup to match the reconstruction. A little delayed healing on the abdominal incision which just required dressings a little longer. Not that much pain. Whatever you do in the end will work out fine. It is just so hard to make any decisions right after diagnosis. Our current slogan at work for all of us perfectionists is GEIGER - Good Enough is Good Enough, Really. You are doing the best you can with your current scenario.

teaka123

I had thought I would have DIEP immediately following my upcoming mastectomy too. However, my plastic surgeon will not do the DIEP at the time of mastectomy. He says it is important to know that the skin and nipple are healthy at the time of the DIEP. There are cases where there are problems and skin and/or nipple(s) do not survive following a mastectomy. After hearing directly from him I understand. It would be awful to go through a mastectomy w/ immediate DIEP and not have the outcome you want. Since there is only one shot at the DIEP surgery and no nipples to spare do everything you can to have insure the procedure and results are just what you wish for.