DIEP 2011

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  • SAMayoFL
    SAMayoFL Member Posts: 958
    edited March 2011

    Xray, my prosthesis won't fit in any bra I have found except my mastectomy bra.  That sucker is huge!!!  Not so much the breast but I lost a lot of tissue above  and beside the breast itself. 

    Bdavis, I am so happy and envious of you going to NOLA (as I said on the other thread too!).  I don't think I had a skin sparing mastectomy.  I really don't know.  On my right side, I have very little tissue underneath, I can literally feel ribs, spaces between ribs, etc.  I wonder where they will get the skin to wrap around the fat?  Suddenly, I am feeling very ill-prepared for this.  I think I will call tomorrow and see if I can talk to someone.

    Kelly, GOOD LUCK tomorrow!!  I will say a prayer for you.  I hope you do great.  Please check in as soon as you can and let us know how you are doing.

    Anyone else go through this with one breast with immediate reconstruction and one breast delayed reconstruction?  That is no reconstruction at all on the first side?

    Susan

  • bdavis
    bdavis Member Posts: 6,201
    edited March 2011

    Susan... When you find out the answer to the lack of skin question I am curious what it is... I asked what happens if one breast has nipple sparing and the other doesn't and if they add skin to the nipple-less boob... answer was no... So I asked if it would be tight?? Answer was a little... so how do they create symmetry??

  • Iamstronger
    Iamstronger Member Posts: 378
    edited March 2011

    Waking up with breasts......priceless

  • XRAYestInMA
    XRAYestInMA Member Posts: 132
    edited March 2011

    Welcome KELLY ! Sorry I missed your post yesterday..that's what I get for not checking in last evening. I wish you the best with today's surgery. I didn't have a Hyst. but I did have a BSO (just both ovaries and tubes) done laparoscopically in Dec. I was up and cleaning the house/doing laundry in 3 days and taking only Motrin. I'm sure that you will take a while longer to heal with all that you are having done...please check in when you are up to it.

    As far as my thoughts on the missing tissue on the MX side...I am thinking that in such a case some abdominal skin might be used to make up for the lack of skin? My MX side is super flat and the scar is gorgeous (as far as scars go, HA HA), but I did not have a tissue-sparing MX or even TE placed. If fat is just added under the skin of my super flat side, the results would probably look like a puffy pancake. That's not quite the look that I am going for.  

     I have my 1st consult next Thursday and will ask this (as well as many other) questions. If anyone has any questions that you would like me to throw out there, let me know. My understanding is that the PS has an hour set aside for initial consults...and I have quite a few ?'s.

    Lori

  • XRAYestInMA
    XRAYestInMA Member Posts: 132
    edited March 2011

    To all....not for those with weak stomachs (or those who scare easily), but there is a very informative video on the Beth Israel New York website (OR Live) that shows a skin/nipple sparing bilateral mx. followed by iate DIEP. It was about 40 mins long but the results were wild. (as in great/wild).

    Here's the link:

     http://www.orlive.com/chp/videos/breast-reconstruction-deep-inferior-epigastric-perforator-full-surgical-version-

    There is also a less graphic version:

    http://www.orlive.com/chp/videos/breast-reconstruction-condensed

  • Anonymous
    Anonymous Member Posts: 1,376
    edited March 2011

    Kellybel1:  I used the pain pump in the hospital a few times, but not as much as some do.  Because I felt so sleepy yet from the anesthesia, I don't do well with that combined with narcotics for pain.  So do whatever you need to eliminate pain-- you may not have too much at all.  Be careful not to sneeze too hard or cough or else you'll feel LOTS of pain in the tummy.  I was sent home with a prescrip for Keflex (antibiotic) for as long as the drains are there, and also oxycodone, if I needed it.  I only needed one of those at night so I could sleep well.  Let us know how its going-- take care! 

  • bdavis
    bdavis Member Posts: 6,201
    edited March 2011

    I think the procedure for DIEP is staright forward with nipple sparing, but on the MX side I wouldn't keep the nipple so how do they make up for the loss (flatness) if they skin the fat and just use the fat? I would think they use some skin, but the doctor's office said no... i am CONFUSED.

  • Snobird
    Snobird Member Posts: 593
    edited March 2011

    They used abdominal skin on my radiated breast side due to lack of enough good quality skin left. They used a small amount on my other side (prophylatic MX) to patch in the nipple area. So I have a much larger patch of skin on my left than my right but the shape of both new breasts are almost identical and they are both the same size. I could of had a nipple sparing MX on my right side but I wanted the nipples to be the same on both breasts.

  • XRAYestInMA
    XRAYestInMA Member Posts: 132
    edited March 2011

    @bdavis. I know what you mean about the confusion. Since my MX was 6 years ago, I have no nip, no extra chest wall skin, and the scar has faded to almost nothing. I am hoping that some skin can be used in my case since without it, I'll be lucky to have even an A cup with just fat placed under my flat right side. When I watched the video on the ORLive site, it showed the surgeons placing the abdominal tissue inside the hole left in the empty breast mound...with some skin on it. ??? That kind of didn't make sense to me since unbroken skin doesn't adhere to unbroken skin. Then the PS in the video goes on to explain how he trims off some of the skin over the fat so it will adhere inside the empty mound. Go figure .....

    I'm just really bummed that I didn't have the opportunity to have all of this done when I had the MX. My head was really spinning from the dx in the first place...and oddly enough, the General Surgeon who did my MX didn't even mention reconstruction at that time. Maybe that was because I practically fainted in the exam room when he broke the news to me and my DH. Surprised

  • XRAYestInMA
    XRAYestInMA Member Posts: 132
    edited March 2011

    @Snobird...That's what I'm thinking as far as what might be done in my case. I don't plan on keeping the nip on the "good" side either, so I suppose the PS can use some of my abdominal skin for that patch, I didn't have any Rads, just have a very flat chest. Do you have many scars on the side that the PS had to add skin to? I am happy to hear that the size and shape of your B's are the same. Also, pardon my asking, but how's the cup size? I am hoping for full C's when all is said and done...or at least plain C's. It's certainly better living with scars than BC, IMO.

  • Snobird
    Snobird Member Posts: 593
    edited March 2011

    The cup size is a full C. The scaring really isn't bad. It's just a larger circle around the breast. None of the scaring doesn't show above my bra or any bathing suit tops that I have. The abdominal skin is lighter than the original breast skin but it feels the same.

  • XRAYestInMA
    XRAYestInMA Member Posts: 132
    edited March 2011

    @Snobird...TY for your reply. Interesting about the difference in skin color. I'm not sure if mine will appear different since it looks pretty much the same in color right now. My breast area has never had a "tan" but my abdomen skin has (way back when in my bikini days - like when I was a kid I mean). Good to hear that you wear able to attain C cups also. I'm pretty sure I have enough fat for 2 C's, but I will know more next week. How about cleavage? I SO miss my cleavage. I love V-neck style T-shirts as they tend to elongate the neck and have to be very careful how low the "V" goes on my T's as my prosthesis has peeked out in past.

  • pupfoster1
    pupfoster1 Member Posts: 1,484
    edited March 2011

    Hi girls, hope this finds everyone doing well.

    @SAMayo---I did DIEP on my cancer side with my ab tissue to get to about a C/small D cup.  I was a DDD before mx.  The left side I got an implant!  So that might be a good option for you too if you wouldn't mind the implant.  I got the left side removed with the cancer side as they saw some suspicious spots on my MRI and couldn't determine what it was---my BS said to "wait and watch"---but to hell with that!  He wasn't the one having to live with that!  And gues what?  They found LCIS when they did the pathology.  So trust your gut on your decision and don't look back!

    @Marci and any others waiting for your surgery---I didn't bring a lot with me, just some good smelling lotion, toothbrush, etc.  But for the ride home, be sure to have the person picking you up bring a pillow to put under the seat belt.  As far as pain went, most of it was in the abdominal area, and I ended up having a bad reaction to the pain pump by day 3---severe nausea until they got me on oral pain meds.  OHHHHH, and if you get constipated by pain meds, MAKE SURE they give you extra stool softeners and eat lots of fruits and nuts (once you can)!!!  I had a HORRIBLE time w/it even once I got home.  NOT what you need w/ab surgery that's for sure!

    Good luck to you all!

    Sharon

  • dannade
    dannade Member Posts: 61
    edited March 2011

    Kelly,  Just read this.  Hope everything went well - take as much pain meds as you need at least the first 2 weeks.  In the hospital I had Fentynol push button every 10 minutes and then increased to every 8 minutes. Then, they put me on hydrocodone (Norco) every 4 hours because it lasts longer than the push stuff.  There is no doubt you will be in pain, but I'm sure everyone has told you that.  You will survive.  I'm not a patient person, but your body will tell you to slow down.  I did walk the 3rd day around the hall way, but I was exhausted.  I did sit in a chair everyday for awhile and on the 3rd day, they took out the catheter so I then used the commode.  I can  home on the 5th day. Had my sister with me that night and the next but then I was on my own (I live alone).

  • XmasDx
    XmasDx Member Posts: 225
    edited March 2011

    Hi everyone, I made it home Thursday at noon, just posted all the details on the Feb 2011 Mastectomy thread....

    I hope everyone came out well with their surgeries this week!

  • dannade
    dannade Member Posts: 61
    edited March 2011

    Can someone explain what is "abdominal contouring"?  I've seen this on some before and after pictures in the explanation that in phase 2, they  had abdominal contouring.  ???

  • Iamstronger
    Iamstronger Member Posts: 378
    edited March 2011

    Hi all,

    Hope everyone who had surgery last week is recovering well!  I had my surgery on 3/2 and came home on 3/5.  The first day was pretty rough, even with the pain pump.  The nausea was pretty bad as well. So, on day 2, we switched to percoset .  Actually, I felt that I got more relief from the oral meds than I did from the pain pump. 

    The PS were very excited about the results of the surgery.  While they were in surgery, they came across some suspicious tissue and sent it to get biopsied right then and there.  Came back clean.  They said it was just scar tissue.  So, that was good news.  Also, they sent all tissue in for pathology, which i guess is their standard procedure, and that came out cancer free too!  We all like to hear those things.  So, I was very pleased to get more reassurance that I was cancer free!

    Now, I am just trying to not do anything, which for me is going to be extremely difficult.  I keep forgetting about not lifting more than 5 pounds.  But, I am really trying to rest and heal. 

    I have to say it is nice to have cleavage again!  :)

    V

  • XmasDx
    XmasDx Member Posts: 225
    edited March 2011

    VMaria - yeah!  Isn't it great to have it over with? 

    It sounds like you feeling good, and cancer free - double yeah!

    Dannade, my impression of abdominal contouring (although I may be wrong) is that after the  abdo tissue is removed, it can leave "dog ears" in the corners that need to be cleaned up, or other lumps and bumps that need to be evened out perhaps? 

  • blondie45
    blondie45 Member Posts: 580
    edited March 2011

    Hi guys doing pretty good from my recliner 6 days out!

  • XmasDx
    XmasDx Member Posts: 225
    edited March 2011

    Blondie!  Glad to hear it!  :)   Hopefully everything went better than you thought it could.

    Have you heard from Marxi yet?

  • scubacat
    scubacat Member Posts: 113
    edited March 2011

    Last week ladies now at home, dont do too much, relax a little, and heal well. Best wishes.

  • dannade
    dannade Member Posts: 61
    edited March 2011

    XmasDX - your are probably right.  PS did say we'd see how the scars heal, but that he thought we'd do some 'tweaking' on the dog ears and maybe some in the new breast area also.  Thanks.

  • dannade
    dannade Member Posts: 61
    edited March 2011

    SamayoFL:  I had bmx Oct. 2009 with immediate reconstruction - silicone implants.  2 weeks later, the left side blew up with fluid and I had 10:30pm surgery to remove the left side implant and was left with quite an ugly scar and pouch on the left side.  Following that surgery, I had lymph node dissection because the frozen dissection of the sentinel node in the original surgery showed clear, but pathology 2 days later found cancer in the sentinel node.  The lymph node dissection was a rough one, 23 nodes taken out and only the sentinel node had cancer, so that was good, but I am left with a big space of numbness under my arm and up the arm a little.  Scar tissue like crazy, physical therapy over a year now on that arm (no lymphadema, thank goodness).  Anyway, I had radiation ending in March of 2010 and had to wait till the skin was softened and healed before having the left breast re-reconstructed.  Dec. 7 was my DIEP surgery just on the left side.  Having problems with the tethering PS did on the top of the breast, my own skin.  Everyone is different, very different.  Please ask PS questions, alot of them even if you think they are stupid.  This is your one time operation and you deserve to know everything.  

  • dannade
    dannade Member Posts: 61
    edited March 2011

    Xrayestin mas - I watched this video last night.  It was super informative and the 3 doctors were great.  I saw some smaller versions before I had my DIEP or whatever it was (took a little muscle, so I hear it was a free flap TRAM).  I wanted them to video my surgery, but no one took me seriously.  I like to see what is being done to me and this video was probably similar.  The last picture before they sewed up everything from above was a bit much, can't believe we get put back together - no wonder it hurts afterwards!

  • kcshreve
    kcshreve Member Posts: 1,148
    edited March 2011

    Abdominal contouring is different per each PS.  Most do dogears, plus some lipo other spots.  I am very shortwaisted, which means I don't have much of a waist.  With a DIEP, I had less of a waist, but a flat tummy.  So, at Stage 2, my PS lipo'd with a focus on my sides so I had more of a natural waist shape.  Without that, my pants would still be falling down.  Now, I do have a better shape and my pants stay up.

  • dannade
    dannade Member Posts: 61
    edited March 2011

    Oh yes, I didn't mention.  I have a huge patch of tummy skin (I wish I could send a pic).  It starts on what is the top half of the top of the breast mound and goes all the way down to the crease underneath.  I have not been able to comfortably wear a bra yet because of the tenderness under the new breast where all the stitches are.  But, this was because of the radiated skin.   The other side which survived with an implant looks different and, of course, feels different.  Hopefully, when the new side settles down and tweaked, they will look similar.  I don't have nipples on either side, it might be six months before that happens.

  • dannade
    dannade Member Posts: 61
    edited March 2011

    Can anyone answer to the cleavage problem?  I saw Xray mentioned this.  My two breasts, one with tissue and one with implant now are quite far apart and I can't imagine cleavage ever happening.  I do miss it also.  I had size 42 D, very large droopy breasts and am enjoying the smaller uplifted ones which I asked for a C, however the new tissue one is very flat right now compared to the other.  I have a good mastectomy bra that hides the differences (it is a molded cup), but I'd rather wear something less rigid.  Does the cleavage come back eventually????

  • blondie45
    blondie45 Member Posts: 580
    edited March 2011

    Xmas dx. No I have not heard from Marxi.

  • dee7493
    dee7493 Member Posts: 155
    edited March 2011

    Just got home last night from Delayed DIEP. Surgery was 8 hrs, only needed pain meds for day after surgery. just extreme trunk tightness, 5 drains ,a little more mobile each day,.  This morning a shower and BM made a big difference  :)   Mending and healing wishes to VMarie and Blondie !

  • XRAYestInMA
    XRAYestInMA Member Posts: 132
    edited March 2011

    dannade I agree that the video was informative and also a bit much at times, but I really like to know what I'm getting myself into. A big difference between me and the video star is the fact that she had nip/skin sparing BMX's and I don't. I just hope I can achieve similair results with what I have to work with.

    vmarie WELCOME HOME ! I'm happy to read that you are doing good and are on the mend. Also great news on being oficially cancer free! You and I have similiar dx except my BC was 2.5 cm and Grade 3. 

    blondie45 Good to hear that you are broadcasting well from your recliner. 

    dee7493 WELCOME HOME to you also. About this delayed DIEP of yours - was it a bilat? 8 hours sounds great if it was....Isn't it amazing what a shower and a BM does for your well-being.Embarassed 

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