A couple of questions for DIEPsters (or TRAMsters)
Question #1: How soon after surgery did you return to regular (cardio) exercise?
I am six and a half weeks out from a unilateral, delayed DIEP reconstruction. I'm back at work FT this week and my energy level is finally getting back to normal -- yay! I'm still wearing the abdominal binder about 50% of the time. I've been walking every day but after I've been active, I still get sore and achy and a bit swollen around the middle. I really want to get back to my step aerobics classes but I'm thinking maybe I should wait a couple more weeks? Could I set myself back or hurt myself if I am too active at this point?
Question #2: Belly hair on the new breast. Does anyone else have this? Do you just ignore it or have you tried to get rid of it? (shaving, Nair, what?)
Question #3: Scar tissue -- I've been massaging the side of the new breast (per ps' suggestion) and it seems to be softening up. But underneath it feels really hard, almost like cartilage or bone or something. I know it's probably just more scar tissue, but I'm wondering if it will ever soften. Or is this something that my ps will deal with in stage 2 (scheduled for August)?
Thanks!
Lauren
Comments
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No answer Lauren, just wanted to say those are good questions. I'm interested in hearing any answers.
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I think that you are right on track with the binder - I wore it part time through 8 weeks but less and less each week.
Belly hair? Yeah, that's pretty common but it does go away. Mine disappeared by at least 6 months out.
Scars - massage will help to break up scar tissue. What you are feeling on the underside of your breast may well be necrosis that your PS may or may not remove during stage 2. We didn't want to lose any volume so let mine go.
Hang in there. Your doctor will probably let you start back with more strenuous excersise after 8 weeks. That's when I truly felt back to my old self - or at least as much as is possible after all this.
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Lauren, ask your ps (you can just call the office and ask the girl to relay your question and get back to you) about the exercise. I am a maniac so was trotting around within a couple of weeks of the free TRAM but I don't advise pushing yourself.
Re: the belly hair. I still have mine over a year later. The good thing is that there is not too much but it does contrast with the extremely smooth post-rads skin next to it. Sigh. Well, you probably don't have much feeling there, if any, so you can pluck at will if it's just a few stray longish hairs or you can wax as soon as your ps says you are not going to do any damage.
The hard areas that feel like cartilege are likely just still-congested tissue and will soften with time. I had those areas and none turned out to be tissue/fat necrosis and they DID go away. You need to wait and be patient. It will take many months.
For the scarring, read my post elsewhere about the Oleeva scar shapes. My ps recommended them. They are used a lot for burn patients and they do work for post-surgical scarring. I started using them a month or so ago on my abd. scar and you would not BELIEVE the diminishment of the raised areas, the smoothing, and the fading so far. They're expensive but well worth it. Some ladies on this board have used drugstore scar strips and they say that they work, too, and are possibly less expensive but I have no experience with those. I can only tell you about what I have used. Fantastic!
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OMG! I'm so glad to hear others have had hairs grow on their new breast! I can't believe this much hair ever existed on my stomach! It's a lot in my opinion but not yet enough to do a comb-over. :-) I was planning on asking my PS whether he took part of my hay-nanny-nanny along with my tummy. Haha. I've been plucking away and hoping they go away. Thanks for the post!
Birki
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Birki, that is hysterical: not enough for a comb-over! I'm having a double DIEP in September now, and I guess that belly hair (do you mean um, pubic hair???) will just be a little somethin' extra to look forward to! Yay us!
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Mine is definitely not pubic hair -- the skin they take for the DIEP isn't that low down (at least, mine is not). It's just regular body hair that happened to be on my belly -- in my case it's fine and light in color, so it's not horrible, it's just strange to have fuzz on my boob!
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A light line of hair from the belly button to the pubis is quite common in women. Some societies and individuals consider it to be extremely erotic. As with all types of hair, the amount and color varies with the individual. Also, some individuals' bodies are covered with a light fuzz of fine hair which is not noticeable under ordinary circumstances.
So, no, the foob hair is not from the pubis!!! LOL If they stretched the pubic skin up that far for the surgery your hay-nanny-nanny and points south would be right "out there." Cause for alarm. ROFL
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abadoodles,
How expensive are the Oleeva scar shapes. I'm thinking of getting them, but no price on their website.
Thanks,
Denise
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I don't have the price list in front of me but the huge abdominoplasty shape cost $93.00. I was able to cut 1/3 of it off to use elsewhere, like my belly button scar and breast scar.
The brachioplasty shapes are about $32 each and I just ordered two of them to cover my abd scar, so it's only $64 instead of $93.
I've been using my original one since about the 4th or 5th of April and it is still good, so they do last a long time. The deciding factor, though, is that it is working BIGTIME on the scar.
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Thank Heaven, finally somebody mentioned the belly hair on the newbie! When I first saw it, I was WTF, now what? And also thanks ladies, for mentioning the scar tissue...ive got to make my follow up appt with PS, mines kinda up high, and aches sometimes...
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Belly hair on the new breast is not an issue if you have immediate DIEP in with Drs. DellaCroce and Sullivan in New Orleans, because they have not used skin paddles for immediate reconstruction for years. I have a friend who asked her very well-known NY DIEP surgeon not to use the circular patches on her DIEP breasts and he did anyways. She is very unhappy with his work. The circular patches are so huge that she will be having the first of a series of revision surgeries with Dr. DellaCroce In New Orleans next month to eliminate them. Yes, they do have dark hairs on them now. She won't have that problem when Dr. DellaCroce is done working his magic on her, but she will end up having had more surgeries than if she'd just started with him in the first place, and she knew better, but was afraid to travel. Now she'll be doing the travel several times to fix things up, but at least she knows where to go now to get everything fixed.
For delayed reconstruction for those who were not able to have skin-sparing mastectomy ,(or if your surgeon is still using the "circles" with skin-sparing despite the latest techniques being used in New Orleans), the relocated hairs can be treated with electrolysis.
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Hi, MomsDaughter. You sound like a walking/talking advertisement for the New Orleans doctors and DIEP. You have posted many positive messages on other recon threads about DIEP and these men and many negative comments about other methods of recon and other practitioners.
I have to say that I am very happy that you have enjoyed such good results with your DIEP reconstruction. However, there are many factors why some women do not select the surgery/team of your preference. I understand that you are very grateful and loyal to Dr. DellaCroce and his team.
If every woman who required a reconstruction insisted on going to NoLA, there would probably be a waiting line around the world. LOL Actually, that won't ever happen since some of us either cannot go to NoLA for financial reasons or timing reasons. Sometimes it is imperative to remove the cancer asap and not wait for insurance approvals, etc. to go out of network. Hence, many do not have the option of having immediate DIEP at NoLA.
As far as belly hair is concerned, some of us, even those who had skin-sparing mx, still do not have the required skin to make a whole, healthy breast. In my case, due to previous radiation, my skin was too thin and fragile so my surgeon, who did a free TRAM, inserted a paddle of skin. This was not because he lacked the necessary expertise. Stretching the skin that existed would have put the overlying skin in serious jeopardy. I had already had a small, about 1" stretch, of incision from the mx that had suffered what was luckily a small bit of necrosis and finally healed by itself. I had expanders inserted at the time of mx and did go through full expansion, then implant exchange, but the implant was not softening due to the condition of the overlying skin and muscle. Everything looked fine on the surface but the behavior of the tissues told the story. Frankly, I would have been perfectly happy to have an implant permanently if it had worked out that way.
There are many of us who require a second surgery at a later date and, as you know, once tissue is harvested from the belly, that donor site is no longer an option. Hence, the need to go to other sites such as the buttocks or the back or the thigh. And, everyone is shaped differently making the potential disfugurement of those donor sites different in different women. Actually, many women have much more donor tissue in the butt than in the belly and some of them have much more in the bottom of the butt rather than mid-hip, making the choices rather varied when all is considered.
Our situations are complex and one solution does not fit all. We just need to do the best we can with what we have. For some of us, that means dealing with foob hair! It's such a minor issue for me, I cannot begin to tell you. However, if it truly bothered me, rather than somewhat amused me, I know I could also choose laser hair removal. I had forgotten to mention that in my previous comments.
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LOL, Tina! That I am. My result is most definitely a walking advertisement and testimonial to the amazing skill and artistry of Dr. DellaCroce, and yes, there is a line to get in, but only for those who have already had surgery to remove their cancer or want prophylactic surgery. For those with cancer, mastectomy with immediate reconstruction can be arranged within 2-3 weeks tops. If a woman doesn't contact the Center, she'll never know whether or not her insurance would cover it, so let's encourage all women to seek state of the art reconstruction with the most experienced, artistic surgeons available to them.
Here's an example of donor site disfigurement after GAP by Drs. DellaCroce and Sullivan:
http://www.youngsurvival.org/blocks/_Forum/index.php?showtopic=16784&hl=rear+view
It's hard not to make negative comments about what other surgeons are doing or not doing, when you see the difference in outcomes. How could I honestly encourage someone to go to a surgeon who provides results inferior to what I and thousands of other women have received in NOLA? You will notice, however, that most of my negative comments are limited to the FACT that it is no longer necessary to sacrifice core abdominal or back muscles to enjoy fantastic breast reconstruction results. I'm not here to surgeon-bash. I'm here to point out that there are newer, better methods of reconstruction than what some surgeons are stuck in a rut doing as they have for the past 40 years because they don't know how to do the newer, superior procedures. I am here to point out that there are mediocre surgeons and then there are fabulous surgeons. I am here to help women know the difference, as I wish I'd known before I had my awful stage I done.
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MomsDaughter
AMEN!
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MomsDaughter, I agree with your point that every woman deserves all the best options when it comes to breast reconstruction -- and all types of cancer treatment for that matter. I am fortunate to live close to a major city (Boston) where I was able to access a world-class cancer hospital, and learned that there are several local plastic surgeons who have expertise in microsurgical reconstruction. I did not need to travel to New Orleans to get excellent results from my DIEP surgery. As a single mom, travel to another city would have been hard for me (though not impossible) both in terms of cost and due to the fact that I don't have a significant other to accompany me. My personal opinion is that it makes sense to explore local options first, while at the same time researching all the possibilities -- and then if you can't find a doctor close to home with a track record in the surgery that you choose, by all means travel to NOLA or another top-notch hospital to have it done.
As the original poster of the belly hair question -- my recon was delayed because I needed to have radiation post-mastectomy, so of course they had to use abdominal skin. As abbadoodles said, it mostly amuses me, but if it doesn't go away by my stage 2 surgery in August, I'm going to ask my ps if it's ok to wax or use laser hair removal. Considering that I had major surgery with good results, a steady recovery and no complications whatsoever, I feel very fortunate and don't sweat the small stuff like a few little hairs!
Thanks everyone for your responses. I decided to wait a week before returning to my aerobics class. I still get sore and achy if I'm on my feet a lot -- in fact, it's worse if I just stand around for hours than if I take a walk. This healing process is making me realize how important those core muscles are -- I'm really glad I didn't have to lose any muscle in this surgery.
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Thanks, Lorena, for agreeing. I'm so glad that you are also happy with your reconstruction.
I do want to point out that the need for radiation does not automatically mean that skin paddles/patches and the accompanying amusing hairs are necessary. It's so important to interview multiple surgeons before proceding with reconstruction.
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No skin patches for me -- but I do have a little bump that used to be my belly button! I've been reassured that my ps will fix this in stage 2.
And I wanted to add, thanks to Abbadoodles for your comments -- you are so right that every situation is different and there is not one solution for everyone. It sounds like you had a long road to get to where you are now, and I'm glad for your that the free TRAM finally gave you results that you are happy with. It sounds like you have a good doctor who was able to work with your complications.
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Interesting evolution.
As technology improves and microsurgical breast reconstruction becomes more available, it is probable that more women will have it (microsurgical breast reconstruction.)
As more and more women have microsurgical breast reconstruction, it is probable that more and more women will be able to demonstrate superior results produced by a number of microsurgeons across the country.
Go team!
tl
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Also interesting that Momsdaughter had to post a link (to YSC) to view Rosebud's butt...no such photos are available here.
tl
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It is noteworthy that all women are not good candidates for immediate breast reconstruction.
If the cancer is regionally advanced, it is advisable that a nice, flat chest wall is preferred to optimize the delivery of radiation to the chest.
Skin sparing mastectomies generally produce the best cosmetic results regardless of surgeon.
There are surgeons all across the country who are not using "circles" / patches of skin to create nipples.
As with any major surgical procedure...it pays to shop around.
tl
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First and foremost, beyond who is the best surgeon, etc., may we all remain healthy and cancer free!!! That being said, Dr Christopher Crisera, UCLA Medical Center, is an amazing plastic surgeon and did a fabulous job on my DIEP!!
Although, I do have an appt tomorrow to see him and will absolutely ask him about where the heck the patches of hair on my new boob came from! OMG if this jungle was on my stomach all this time and I never saw it, WTH? LOL Before I had the surgery I remember laughing with my friends about potentially having the "happy trail" of light hair from under my bellybutton to my hay-nanny-nanny transferred to my boob, but who knew it would be more of an all over random patch situation! Again, I focus, fine, just keep me cancer free! Perhaps a Brazilian wax would work out better than the comb-over.
So, I've been having headaches every day off and on for the past 2-3 weeks. They started out feeling like sinus headaches (I do have seasonal allergies), but then it increased to feel also like tension headaches where it starts at your neck and feels like your neck muscles are in a vice. I'm terrified that it may be a sign that my "c" has spread to my brain so I'm having an MRI. Re-focus again, may we all remain cancer free!!! Time to get my tweezers and attack my boob......
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Birki~
I am laughing because I just had to tweezer my boobs last night.
((((hugs))) and well wishes for your MRI.
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Thanks Trishia! I'm so happy to know that I'm not alone and appreciate your well wishes.
So I have fine thinning hair on my head and now nice fast hair growth on my boob! Life is great! LOL
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When I was initially reconstructed, I had noticeable fine hairs on my flaps.
They fell off, I guess. No longer noticeable.
tl
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Hi TammyLou!
I agree, it's unfortunate that there just aren't many photos of reconstruction here. You are one of very few who's posted photos of your fantastic outcome on this site. Rozebud has a gorgeous result too---GAP doesn't disfigure or deform the butt when done right.
I had hairs on my "circles" after stage I, and plucked them. My first surgeon told me I could have electrolysis later on, but that skin was removed when I went to NOLA.
Sandy
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Sandy I was disappointed that my new plastic surgeon wouldn't remove the skin on my circles during my Stage 2 revisions. He did everything else - moved the flap higher, lipo'd it - gave me a new inframmary fold, etc (had a drain for a week) - but he said he couldn't remove the skin. Possibly because he didn't want to spend as much time as your Dr. D - I know it took quite a few surgeries to get your beautiful results. My new PS is excellent though - he listened to me about how my circles were "flattening" the foob........so he reshaped everything and now it's much rounder and I can wear a regular bra! He did admit he wasn't able to do as much as he'd like - that I'm only 75% of the way done - because he was afraid to hurt the perforators under my arm. So I still have some fat under my arm - but it's much less than it used to be. Unfortunately, he had to create a new long incision from under my arm all the way across to the areola/circle - it was the only way he could access the flap and move it. It's healing well and my scars never look bad - they usually fade away to just silver/white...........and I'm happy he didn't make a scar in the inframmary fold so bras won't rub it all the time. Still - I no longer can claim to have a "skin-sparing mastectomy/recon" because of the addition of this long scar - just semantics, really - ultimately I'm much happier than with my Stage 1 results with the old PS.
Strange how some PS's connect the perforators under your breast/chest bone..........and others connect it under the arm. I read that if it's connected in the chest bone area, you get a much more natural "drape" - and when it's under the arm it never looks quite normal. Just my luck to get the latter..........do you know where your perforators were originally connected Sandy? And did Dr. D have to worry about the flap dying during his revisions?
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HI Swim! I've been thinking about you, because I met with hospital staff yesterday and my complaint has brought about policy change. I was wondering if you'd talked to your hospital about your difficulties after surgery.
When Dr. D had to move my flaps, he made a horizontal incision in the inframammary fold under each breast, so I have L-shaped scars now, with the leg of the L extending outward to about where the cup of a bra ends at my side. I have no idea at all about the difference in the "drape" of the breast due to location of the perforators! Mine were done with the vessels in my chest. Dr. D told me that he'd had to completely unsuture both flaps. He had to move them back up higher on my chest because they'd slipped down. He reshaped them to give them projection (they were flat like hamburger buns) and he also moved them toward the center, which created cleavage. My guess is that he left the blood vessel connections intact, but I really have not questioned him about it. He did such a major overhaul to the stage I my first surgeon did, and I didn't ask for many details. I woke up and everything was so much better than it was before that it was fairly overwhelming to me, and even after going home a few days later, I was still discovering things he'd fixed up. I think my biggest concern was what he found in my abdomen when he opened it up and removed what turned out to be a pseudobursa, since my original surgeon had been telling me that I was allergic to my sutures.
It took three surgeries to close up the circles and the nipples/areolae were done during the third one. I actually didn't mind the additional procedures because I was very goal-oriented and had committed to them the first time I met with Dr. D. Plus, he did lipo every time and that was a great consolation prize!
I'm so glad that you are happier with your result now. Are you having more revision when you have the abdominal surgery, or are you done with the breasts?
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Swimangel, where did you hear that about the difference in the drape depending on where it's connected? And do you know why that's supposed to be true? I have one connected under my arm and one connected in my chest (bilateral DIEP) and there is absolutely NO difference in the drape between the two sides. They both look totally "normal."
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My DIEP is now almost 8 wks post op. Had bilat mx w/immediate DIEP.
I've been doing wonderfully until yesterday and today, The boob that was cancerous has been hurting very badly. I'm wondering if it's because I've been massaging it since it has a few hard places under the skin? Anyone else have bad pain this far out from surgery?
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Something else, ladies.........
How does the ps 'round out' the flat circle flap on the foobs? Both my circles were caved in after surgery. One has come out nicely and is the same level as the rest of the boob but the other one is still sunk in, making both flat on the ends. With just a regular padded bra, the ends flaten out quite often, so I've found some with heavy padding that 'push up'. Could a push up bra be causing my pain?
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