DIEP 2011

I agree that it's important to hear from your surgeon how many DIEP surgeries he actually performs.  I had my bilateral DIEP at John Hopkins in September and just had my Stage 2.  The option of a "free tram" doesn't exist at Hopkins.  Sorry, but a free tram sounds like an easy out.  If at all possible, get a second opinion from somebody who really does a lot of DIEP flaps.  IMHO, it makes a huge difference.

Are you going to have a CT angiogram prior to surgery? That procedure maps the blood vessels giving the surgeon vital information about the blood vessels. The decision is ultimately yours but most true DIEP surgeons won't switch to Free Tram in the middle of surgery. It's any easy out of a complicated surgery. It's a ling surgery and there should be at least 2 microsurgeons working on you.

Hi everyone. I was wondering if any of the diep gals 5-6 weeks post op notice any funny "bumps" in their incision line? If I run my finger along my abdominal incision, i feel smooth,bump,smooth,bump etc. I guess what has me worried is one of the bumps feels larger than the rest. It is painless. I am hoping and praying it is not a hernia. It is about the size of a m&m. Thanks!

Susan - I'm so happy to hear that your hubby is on board! It makes a huge difference when my DH hears the info directly from the source. Now that I'm 6 weeks out from surgery, we both love that my breast is all me! I'm looking forward to stage 2 and the tat's when it will be even better. 

Now you can really start looking forward to it and planning!

The motorcycle rally sounds like so much fun - my DH and I went for a motorcycle ride today, such a perfect day for it.

BreakingBad: Could the bumps be scar tissue? 

@XRAYestMA My BS was Dr. Hasselgren who performed a double MX, left breast cancer, right profilactic and my PS was Dr. Adam Tobias.  I am 66 years old and had quite a bit of stomach fat.  The quality of the skin on my stomach was not the best.  First baby stretched it out and looked like a deflated balloon ever since.  My surgery was longer than expected but the transfer of tissue was 100% viable.  I had a small complication in that I developed some bubbling of the skin that created a large scab under my left breast.  The only care was a salve to put on it until it heals and it is healing nicely. 

He transferred a lot of tissue and my two footballs are hugh but I have been assured that Stage 2 will address that and I will end up with a more attractive product.  Remember that the number one concern is to make sure the transfer is viable and they worry about the rest later.  My stomach looks great and the belly button is my own and looks great also.  I had very little pain and after the first day took only Extra Strength Tylenol. 

It was a wonderful gift to awaken from surgery and find two breasts and not a flat chest.  I think it gives me more confidence that I will beat this thing and that it won't define my life.

My operation was on Monday and I came home on Friday.  By Friday I was very ready to come home.  I had 4 drains - one in each armpit and one on either side of the abdominal incision.  First two went withing 10 days, 3rd within 2 weeks and the last one I pulled just a few days ago so I had that one for about 5 weeks. 

I don't know if you have been to this blog but it helped me a lot.

http://breastcancermom.blogspot.com/p/my-team.html

Feel free to PM me if you have any other questions.  Good luck.

alexanjb  My PS al so explained the tram just in case (I think they have to give you all scenarios) and her said the muscle part they use is so sm like 1/4 in square that it is no big deal. I think as trained as your PS is he will do is best for you and be as least invasive as possible I cant imagine getting all ready for this and being closed up without anything done for you to go home and rethink your options.  I f your surgeon has done that many he will make good choices for your health.  I think you will be very happy with the results and very susrprised at how well you recover, I am 52 and had ants in my pants to get up and go.

I feel much better after my PS emailed me his information.  If he were saying that it could turn into an attached tram flap, I would be much more concerned, but that is NOT what he is saying. It doesn't appear that the Free Tram surgery is any shorter than the DIEP, so I can't believe he would change to it as a shortcut or something.   I am not looking at this any differently than when my OBGYN said I might end up needing a C section (I didn't).  I appreciate being told the possibilities however remote.  I am still very nervous of course......My PS said he would call today, so I will see what else he has to say.  It is not like there a lot of surgeons in Syracuse that do this type of surgery and I am thankful there are 2, I would not be comfortable travelling for this.  It would add too much anxiety for me.

I did delayed uni-DIEP; I had a skin sparing MX with TE; no new boob scar after the DIEP except where they used belly skin to lay the ground for a new aerola/nipple and that has healed very quickly - faster than it did with my mx (I think due to more rest & vit C after DIEP). So a circle with a straight line from the cirlce and straight down under my boob from the center of the circle. Do a google search for DIEP images and you'll see the range, depending on what the PS is starting with. I found a photo that was closest to me in size/shape etc, to get an idea of where I would end up.

I saw my new breast in post op - just steri strips over incisions, so it was there it all its glory, plus they check it all the time, so I saw it every hour when the flipped open that shoulder of my gown to check. Yes, cleavage, right away! 

6 weeks out and my DH loves everything and thinks I'm hot, even with the belly scar. That is nice, especially after 34 years of marriage. I have a flat tummy, skinny waist (as long as you don't look around the corner to my hips/butt!) and nice cleavage. I'm super inspired to getting back to working out to take care of the hips/butt/thighs!

I have significant fat necrosis, but I'm still quite happy. My PS said my flap bled well on transfer, so no reason for it but I guess that was my body and I'm happy and looking forward to stage 2 where things will be even better. As everyone is saying, the goal is to get as much viable tissue as possible and to have a healthy blood supply. Fine tuning comes later, all though I could fine just as I am, but since I've come this far, I'm going for it. 

Thanks brigadoon: treesprite,I will be having delayed reconstruction. I finished radiation last year in April. I thought at first that I would have a prophylatic mastectomy on my left breast,but after talking to my oncologist,have decided to just have a uni DIEP.I went on the 13th and had my port removed since I have atleast a month before surgery. I am also trying to loose a little weight. I will still have plenty of stomach fat to use. Some days I am excited and some days I have to ask myself if this big surgery is neccessary? When I went in to see my PS for the first consult, he kept apologizing for having to pull my pants down to take pictures. I am probably old enough to be his older sister.

@NotAfraid That is what my PS said as well. I believe he has no intention of performing a TRAM on me, but if he has to take a piece of muscle, I trust him to do so with my best interest in mind. I guess I will not know until after the fact. TY for the post-op pill taking advice. I hope I will at least be able to suck on ice chips within a day or so after the procedure. 

@brigadoonbenson Dr.Tobias is my PS of choice also. I'll send you a PM a little later...kids are home from school today due to a professional day for the teachers.

@alexanjb The scar from my 6 y/o right MX is so faded that it is pretty much non-existant. The surgeon who did it was a general surgeon and it was not skin sparing. Even the PS's that I consulted said that it healed beautifully. It is horizontal - across my chest. The PS who will be doing my DIEP said he can make both scars symmetrical after all is said and done.Hey, if I have to have scars across my breasts, at least they'll match. He can also do a skin sparing DIEP on the side that is getting a PMX, but then the scars wouldn't match. I prefer the former option.

4 weeks, 6 days to go. I'm not nervous (yet), but pretty psyched. Working on my gardens and Spring cleaning indoors on my days off. 

Alexan and LadyM, Mspradley had a delayed DIEP as well.  If I am not mistaking, she is like the three of us - mx without any reconstruction at all.  I am totally flat on one side and I have a D cup breast on the other.  When I think about having TWO boobs plus cleavage again, I get so excited I feel like running up and down the street shouting.  It is funny how much I have suppressed my feelings about being so lopsided.  I really didn't even know how much I disliked having one breast until the opportunity to have two again was within my reach.  I have been on cloud 9 all weekend since talking to the DIEP surgeon.

Mine is scheduled for 3 months from tomorrow.  I hope all of you who go before me continue to post.  We all learn so much from each other.

Susan

Does anyone know if it's okay to wear an underwire bra three months after DIEP?  I had mine Jan 12th and all my old bras are underwire, so just wondering if there's any reason not to?

 Best wishes to those of you recovering or still waiting for surgery.

Laura

samayofl  I cant imagine going so long with being  "unfinished".   When I talked with my PS before surgery he kept saying that he would make the new one just like the other in size, and I was saying "no way" cause I am also a full D.  I did not want to a have another D (tired of carrying these lunkers around!)  told him I wanted a C and so I wouldnt be lopsided wanted the other to be reduced to a C.  He originally said no and that he would do it later, but I argued that being lopsided would be awkward and didnt want any more surgeries, wanted it all done at once...so I got my way and he reduced the other side.  the diep side is a tad bit smaller but has not fallen into shape yet.  Its amazing though how my shirts fit with just a little difference, the neckline tends to fall to the smaller side, always off kilter.  I hope this will all fix itself when I get the go ahead to wear structured bras instead of the soft ones.  I love my new ta tas and hopefully no more back and shoulder strain.

alexanjb: My surgery was Tuesday 9and another on Wednesday) and I didn't want visitors, TV, a book, my iPhone or even my iPod.  I really just wanted to sleep and the machines to stop beeping (and the bear hugger blanket OFF of me).  

At home, I surrounded myself with pillows - one under my knees, one on either side of my arms, one over my middle body (pet protection) then whatever I needed for my head.   I did buy a used reclider before surgery, but I ended up on the couch more than on the recliner. I seriously slept most of the first week I was home (c/o drugs, I'm sure).

Having food made beforehand and frozen was a big saving grace.  

 

SAMayoFL, Alexan, Lady M - I am six week out of having my bilatDIEP.  I had my left mx in late 2009 and had the right mx during my DIEP surgery, so I was a full year with one flat side with a horizontal scar.  Like you guys, I was worried that my scars would not match because the initial mx was not skin sparing in the least.  Well, they don't match - but it isn't the shocker that I thought.  The scars are already very fine, but what never dawned on me is that I don't notice the scars, but I do notice the difference in color of the flaps against my native skin.  I am very fair and have had little to no direct sun on either area in decades, so I assumed the color of the skin would be the same.  The flaps are a little lighter and I am already used to the difference, but suppose it would be very noticeable to others (but I'm not going to go around flashing anyone).

One thing I love, love, love is that I mentioned to my PS that I dreaded seeing my pregnancy stretch marks moved up to my Frankenboobs.  During surgery, he turned the flaps to the perfect angle so that my native skin stretch marks lined up almost exactly with the stretch marks on the flaps.  Now, my stretch marks are silver and barely noticeable, but I thought that was pretty cool of my PS.  So instead of the original stretch marks on my boobs that radiated out from the nipple, my stretch marks now all seem to run north to south.  I never thought about this and it might be standard procedure, but I know I would have noticed if they were going diagonally.

My PS never mentioned the option of the TRAM.  I am a high risk vascular patient because I was so recently on Avastin for a full year.  In the best scenario, I would have waiting a year out to allow my body to heal.  However, a mammogram in November had my oncologist giving me only 3 months to heal from my last infusion (TCH was one 9 months ago, but stayed on Avastin + Herceptin until early January).  Avastin works to inhibit blood vessels from forming quickly (tumors need blood), so you can imagine that my PS was clear on my vascular risks.  My oncologist did explain that most PS would shy away from the DIEP in my case, but that Dr. Robinson would not.  Dr. Robinson did a CT scan and was confident that I was a good DIEP candidate.  He only said that my surgery may take longer (it didn't), but my healing would not be in the normal timeframe.  

My healing is not "in the normal timeframe".  I have been keeping up with treesprite, who is also 6 weeks out, and realize how much the Avastin and radiated skin have not been working in my favor.  My DH keeps reminding me that in a few months, I will be exactly where I want to be and I will have forgotten that I took the long route in healing.  I have an open wound the size and depth of a golf ball that I must wet pack twice daily under my armpit where the radiated skin refuses to heal (the flap is fine and dandy).  I have another area about the size of a nickle and probably an inch deep on my abdomen scar that also must be wet packed and is not healing.  Will these two areas ever heal - certainly!  The infection is gone, and the wet pack forces the healing to happen from the inside out (without the packing, it would scab over an abcess to restart the nightmare). Would I do all of it again - absolutely!  I have just had to come to an understanding that my healing issues have valid reasons, and in the meantime I have beautiful cleavage (no scars or flap color differences show in even my medium/low v-neck t-shirts) and haven't worn a bra or spanx in over 6 weeks!  Wooo Hoooo!!

I do go back to the PS tomorrow and am hoping he will allow me to return to work.  I'm going to ask him to write me a script to the wound clinic to allow more specialized people to pack my wounds/holes for at least a week - just to see if it will make any difference.