DIEP Reconstruction
Any of us 'older' ladies having or had DIEP reconstruction? I'm scheduled March 30 for bilat mx and DIEP and am extremely scared!
Comments
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Had my DIEP in ' 06 at 56. All went well and I was thrilled to finally get the prosthesis out of my life ! I was not scared ,but was apprehensive re: the time allotted( aprox. 10 hrs.) for surgery. I was given major tests and evaluations prior and nothing was found to be a concern .The actual surg. was more like 8 hrs . Recovery was uneventful . Perhaps I am atypical,but I was quite pleased with the process and even more pleased with my results....I wish you the same !
Letha
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I had mine at 54 and would do it again. I couldn't imagine having those horrible implants replaced in my 60s.
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Hi Mikita - you already heard from me - just wanted to say I'll be praying for you to have a completely successful and uneventful surgery and recovery! Check out this link to learn how to protect yourself as much as possible from MRSA and other hospital infections, taken from the RID web site (committee to Reduce Infection Deaths):
15 Steps You Can Take to Reduce
Your Risk of a Hospital Infection (click below): -
I had bilateral mx and immediate DIEP reconstruction at age 50 (does that count?) and would do it again in an instant. One side ended up being an SIEA which made the surgery simpler and faster as the muscle and fascia are not even touched. IIRC, you are having yours done at Johns Hopkins, right? Although there's always the anxiety that accompanies any surgery, you are in good hands. Most important - experienced hands Lots of experience is key to a good outcome.
You'll do fine!

Lisa
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Hey Texgirl,
If you had your surgery in Texas, can you recommend a plastic and breast surgeon/center there?
Thanks!
Ina
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mikita ~ I also had a mast + Diep (7.5 hrs. surgery) and sailed through it. As long as you have a very experienced team (did I see JH mentioned above?), you'll be absolutely fine. No institution or surgeon of that standing is going to expose you to a risk beyond what they feel is safe -- especially when the Diep part isn't mandatory. I had mine in May @ UCLA, but happy to share any details if you ever want to PM me. Deanna
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Ina..had my breast surgery (mast) done by Treneth Baker..just a baby from my perspective...but a fab. breast surgeon. My breast reconstruction surgery was performed by Dr. Aldona Spiegel....both from Houston and done at The Methodist Hospital.....Dr. Spiegel ( www.breastrestoration.org) Has more talent that I can even express..My DIEP results were incredible..I cannot say enough...PM me if I may give you more info !
Letha
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Hi Deanna: Thanks for your reply. I'm so scared of this surgery. I was at J. Hopkins yesterday getting my pre-op and CT scan. You said your surgery was 7.5 hrs. You only had one side done? I'm having both and they say it will be a 12-14 hr surgery. I'm now fearing MRSA, lymphodema, the stomach stitches... I guess everything.
When did they get you up to walk? I'm told I'll be walking bent over for about a week.
How far from home did you have yours done? J. Hopkins is 6-1/2 hrs away and I"m wondering if I'm going to survive the trip home. Surgery is on March 30, I'll be there 4,5, 6 days, then have to go back for follow up on the 8th. That is sooo much riding. When I had my appendectomy and gall bladder (separate surgeries), I live only 6 minutes from the hospital and had a terrible time riding.
We're going to borrow my daughters van and put a twin mattress in it, hoping that helps some.
Thanks for replying. Please, when you have time, tell me about your experience. I'll be anxiously waiting. : )
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Hi, Mikita ~ I was also very scared about my surgery. I think it's only natural to let your mind go to the "what if's." One of the things I found so helpful in overcoming my fear was a guided imagery CD for surgery. It's something one of my SIL's gave me, and it made a tremendous difference in my outlook. (I'll PM you the details.)
Yes, I had one side, and I was told it was an hour for the mast + 6.5 hrs. for the Diep recon. Since they have to do each breast separately, 12-14 hrs. sounds right for bi-lat.
I don't think I would worry about either lymphedema or MRSA. You will have a very experienced BS, and I'm sure JH has the same exceedingly stringent safety precautions that UCLA has.
I was in the hospital 4 nights; up and walking (with the help of 2 PT's) the 2nd morning. And yes, you are slightly bent over for a week or so due to the tummy incision. My biggest problem the first 3 days turned out to be that the morphine (which I'd never had before) did not agree with me, although it certainly keeps the pain totally manageable.
We live 3 hrs. from UCLA, and sitting in an SUV with a pillow between me and the seatbelt for that drive was fine. I'm not sure lying down would have been comfortable because you will not be able to use your arms to push or pull or move yourself around at all. Maybe some of the other gals here have some practical suggestions to make your long drive easier.
I'm going to PM you, too ~ Deanna
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Mikita - I had a uni mx + DIEP at Hopkins last month. Great teams, wonderful hospital. Feel free to PM me. But I'm wondering -- why don't you stay at the Hope Lodge instead of traveling between your release and first post-op? It's free... http://www.cancer.org/docroot/subsite/hopelodge/locations.asp
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Hi, Mikita,
I had BL DIEP in November 2005 in NOLA, three months after Katrina, at the age of 58. My first mast. was in 2003, so mine was delayed two years. At the time of recon., I had the "good" side done, too, just for my peace of mind because I had ILC, which is more likely to come back in the other side.
I have been thrilled with the surgery...would do it again in a second. As well as two perky breasts, I have a flat tummy because of the tummy tuck that results from the DIEP. I had no problems with the surgery or the recovery. I had extensive liposuction when I had stage 2, which resulted in a lot of bruising, but that only lasted a few days. I love not having to deal with the prosthesis; plus, I can wear any neckline without worrying about it. I actually have clevage, a first for me!
I wish you the best with your surgery. I think I was more excited than scared since I had waited so long for my recon. I know it is normal to be nervous, expecially if you haven't had your mast. yet. That's a lot to deal with at one time. I know you'll do great!
Hugs,
Trish
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Hi Trish:
I'm so glad you're happy with your reconstructions. I have DCIS, one breast, but I'm going the bilateral route for peace of mind also. I know it can still come back in the incision or chest wall, but I'm avoiding radiation this time around, so I feel I'm blessed. My mother died of ovarian cancer at 52 many yrs ago. I just had my ovaries removed in Dec '08. Path. report on ovaries came back ok but 2 wks later, I was diagnosed with bc. That was the pits! It's been a rough decision and every few days, I question my decision, but I know I must do it for sanity's sake.
I believe I'll be in good hands at JH. The length of the surgery has me scared, but I have to depend on God to bring me through it. I AM excited about the tummy tuck! I guess that'll be only good thing to come out of this. I am a D cup and will have to go down to a B or C. I've only had my D size for about 6 or 7 yrs. I was always soooooo small, then all of a sudden my hormones went whacky, I guess. So, I've not enjoyed them very long, now they're gonna take 'em off... But the trade off is the nice flat stomach. I can handle that!!!!
Hugs and continued health!
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Mikita
All the best for your surgery. Looking forward to hear how it goes.
I'm 54 and waiting to see PS on 3 May about my reconstruction.
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Mikita ~ Don't know if you check back to this thread, but just wanted to tell you that I will be praying for you tomorrow. I'm so glad you don't have to wait any longer. Please let us know how it goes. Thinking of you, and praying for a textbook perfect surgery and very speedy recovery ~ Deanna
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Made it thru surgery with no complications (thanks to God) except my heart ran away with me. Bad experience with morphine. (Why does anyone WANT to feel like that?) My clock in the room was either 10:00 or 10:30. It never changed. A spider crawled down the wall but never got anywhere. My husband paced constantly from the chair to his luggage. A monster's face stayed on the tv screen. Thought I was dying and no one just wanted to tell me. Finally when some of the drug wore off, I told them I didn't want anymore pain meds, I'd rather have pain. They then gave me something not as strong and I tolerated it well. Hate that morphine!
Before leaving for home, they gave me a pain pill. My dh and sister in law gave me 3 more during the trip home. I did well.
EXCEPT, when I got home, I found they'd given me 3 antibiotics instead of the pain pills! So, the 7 hr ride home wasn't bad at all and I had NO pain meds. Maybe antibiotics help pain? lol
So glad surgery is over and I'm home. I can see it'll be a long recovery, so ask me in a couple months if it was worth it!!
Thanks to everyone for their thoughts and prayers. I know God was with me and he's what got me thru it all. For those who haven't had surgery yet, may God be with you too.
Must go back to my lazy boy now. It's not bad to sleep in!
HUGS to all!
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Mikita I'm so relieved you got through it and reported in! I'm sorry about the weird effects you experienced with Morphine - I never got morphine because I have a history of violent nausea, so they gave me something else (Dilaudid?) I know I had percocepts to take at home - but no antibiotics. The percocepts gave me constipation - prune juice and a laxative took care of that problem. The lazy-boy is great - mine was too narrow though. I'm in the process of shopping for a new one now - I want a "chair-and-a-half" rocker/recliner to get me through my next abdominal surgery in July. Stay in touch Mikita - and go slowly - don't lift anything heavy and watch out for stairs!
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swimangel: I had a major problem w/constipation too. They gave stool softeners but didn't help. Had to wait for someone to ok a little old suppository. That took about 3 hrs to work. I was in major pain at that time. But we should've told the doc upfront that I have problems in that area anyhow (since gallbladder removed) and she would've put it on the chart and allowed the suppository when I needed it. Live and learn.
My recliner is comfortable but after I put the drains all in the pockets. it's not wide enough either, but I'm just happy I had it. I had given away a rocker and ottoman earlier and was going to give this recliner away...So glad I didn't!
I am taking it easy but I know I have to move around quite a bit also. I've gone up and down our stairs since I came home. Physical therapy taught me how when they found out I had 14 steps going to upstairs.
What is you surgery for in July?
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I'm glad the suppository worked Mikita. On July 1st I'm having opened abdominal surgery to repair the large hernia I'm stuck with since the MRSA infection destroyed what was left of my abdominal muscle after the muscle-sparing free tram last year. At the same time, the surgeon will be removing my gall bladder since it has a large stone. I am NOT looking forward to this surgery - it means a week in the hospital, more pain and drains, but the surgeon is excellent and my new plastic surgeon will be working alongside him to fix my awful-looking abdominal scar. So when it's over hopefully I'll be complaining less about my appearance. The same PS will be repairing my "foob" on May 6th - which is outpatient surgery - so little-by-little I'm being put back together - and hopefully the pain under my right ribcage will finally go away. They tell me it's from the gallstone - it's not debilitating pain - but it's annoying especially if I sit for too long. How long ago did you have your gall bladder removed Mikita?
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Hi everybody, I may be jumping the gun a little...but I am having a mastectomy on 4/21. I have talked to my surgeon about reconstruction and he says we will see about this later. I was thinking of an implant. What is the reason for having a DIEP? I doubt if they do that here in my town, don't know for sure. I've never had an implant, either, but was wondering what the difference is or why one is recommended over the other. I am sure somebody can tell me! Thanks.
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Hi, Cheyanne ~ I've had Diep flap reconstruction, so can answer your question from my own perspective. With Diep, they make a long incision across your tummy and remove tissue to replace the breast tissue they remove. It takes an experienced vascular PS to do this surgery, which takes approx. 6 to 8 hrs. I live in an area with abundant, upscale medical facilities, but I still had to travel into LA to get this surgery. You can find photos of Diep results on the web. The outcome is a very natural looking breast. Of course, you have to have enough tummy tissue to do this (I had barely enough), and you have to be willing to live with the tummy scar. Since I've never had an implant, I'll let those who have tell you about that surgery, which is more common.
The fact that your surgeon is advocating for "seeing about reconstruction later" without giving you options is a bit of a red flag to me, probably because I'd initially gotten the same answer from a BS who wasn't set up or aligned with a PS to do immediate reconstruction. When I went to an NCI-designated breast center (UCLA) for a second opinion, I was very relieved to find that immediate reconstruction was not only available, but strongly encouraged by that BS, whom I ended up using. I think you will find that the larger hospitals, especially teaching hospitals like UCLA, Johns Hopkins, MSK, etc., have PSs on staff who offer many types of reconstruction in tandem with your mast, and can explain which one(s) would be best for you.
So sorry you're going through this, but I hope this helps ~ Deanna
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Cheyenne - I had a DIEP also. Implants are not permanent and normally need to be replaced every 10 years or so. Reconstruction using your own flesh is permanent and your body doesn't reject it. I had mine at Johns Hopkins in Baltimore, Md. If you choose this route, make sure your surgeon is very experienced. I love my results! You wake up reconstructed -- implants need many follow ups to get filled to stretch the skin. (If you have invasive cancer you will postpone reconstruction anyway, as you will need further treatment which can affect the reconstruction. If you have DCIS you can normally plan immediate reconstruction -- having the mastectomy and reconstruction in the same surgery is long but then you are only "under" once.) If you have some extra tummy fat you also have the happy result of losing that like a tummy tuck with a DIEP. Good luck!
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Hi jillisucat, Thanks for the information. I doubt if I could have a DIEP done even if I wanted to, I am sure it is not available here in my town. Johns Hopkins is a bit too far away, as I live in central Texas! It is probably available in Houston, but that's even too far for me, we are a couple of hundred miles away from there. As far as implants needing to be replaced - I am already 68 years old. I won't be having a reconstruction at the time of my mastectomy. My surgeon says we can think about it later, that I may get along well with a prosthesis. Like I said, I am 68 years old and unlikely to go out to Vegas to become a topless dancer. Or, for that matter, have anybody except doctors see me topless, anyway.
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Cheyanne be sure you visit the Breast Reconstruction forums and read what the women have said about implant surgery - click this link: http://community.breastcancer.org/forum/44
Also for more information go to http://www.breastreconstruction.org/
Also check out the forum where women have chosen to do NO reconstruction at Breast Prostheses and Reconstruction Alternatives at this link: http://community.breastcancer.org/forum/82
Many women have travelled to find the best plastic surgeons to help them, even women older than you. You could also research the surgeons in New Orleans "NOLA" - here's a link to their web site: www.breastcenter.com
It is very important to do your own research and advocate for yourself. Good luck with your difficult decisions!
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Cheyanne, where do you live in TX? I lived in Kerrville at one point in my life. The hill country is beautiful. Definitely big spaces to travel out there -- but as swimangel said, people travel for this surgery all the time. 68 isn't all that old these days! My mom is 77 and plays tennis most days of the week and certainly doesn't feel or act old. But reconstruction (or not) is a very personal decision and it is all in what you are comfortable with. I like having the shape, don't care about the nipple and am not sure if I'll bother with that part of the reconstruction down the road.
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I actually had invasive cancer and was able to have immediate DIEP reconstruction. I did not have chemo or rads, although those would not necessarily rule out immediate reconstruction either. Drs. DellaCroce and Sullivan in NOLA can do stage I DIEP before rads, and then do stage II after. One benefit of immediate reconstruction is that there is less scarring.
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Cheyanne, there is a fabulous group in San Antonio called PRMA. I met w/Dr. Pisano there and spoke with a patient of Dr. Ledoux's. I still may go there, but I don't have enough belly fat for DIEP, so may go somewhere that does bilateral GAP flaps. Oh and PRMA is "in-network" for most insurances. You can see them at PRMA-enhance dot com. Good luck on your quest.
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MomsDaughter, thanks for your information about NOLA. There is also a great surgeon in your area named James Black. Does NOLA accept BlueCross PPO? I also live in So. Cal.
Thanks again for sharing!
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