After FLAP Thoughts-DIEP, TRAM SEIA

Dejaboo, be sure to get some other opinions if you really want the perforator flap surgery.  I had an SIEA in 2006 so when DCIS return in left breast this year, I had no stomach fat to work with.  I thought I would have to have a GAP (butt tissue) but I don't have enough back there, plus w/sciatic nerve problems, PS didn't want to take a chance.  I'm having a TUG using the tissue (fat) from the upper inner thigh.  PS (who trained w/Dr. Allen) said the TUG is much easier than the GAP and recovery easier.  We'll see after Aug. 4.  Check out www.diepflap.com for some really good info.

Best wishes and good luck.

1.  What kind did you have?   Unilateral SIEA  Immediate w/skin sparing mast

2.  How long for initial healing?  I was walking upright the second day and went to Alaska to work at a bible camp @ 7 weeks after.  How long has it been total?  I had the SIEA done 4/06

3.  Was pain more or less than expected?   About what I expected although there was less after out of hospital than I thought there would be. 

4.  Any complications?  None

5.  Did your surgeon estimate your size?  Are you that size now?  I asked the surgeon to make me the same size as I was, since the other side was staying.  The two are exactly alike.

6.  Before surgery size and after surgery size?  Medium B - 34B

7.  Did you have your nipples done?  What kind?  I had the nipples done 9/06 and they used the skin from my stomach that they had taken in April during the SIEA.

8.  How did you like your stomach before surgery?  How did you like it 6 months after?  I hated my stomach before.  I had gained alot of weight w/my pregnancy 17 yrs ago and had quite a pooch.  It's now nice and flat but not hard.  Scar has faded to almost invisible.

9.  Did you sleep in a bed, hospital bed or recliner?  I slept in a bed from the day I left the hospital to go back to the hotel.  I don't remember having any problems other than I HATE to sleep on my back.  I was told I could not sleep in my side for 30 days to prevent blood pooling into the recon breast.  If the PS would have know I wake up every 2 hours and move, maybe it would have made a difference.  It felt so good the first night I was on my side.

10.  How long was your hospital stay?  Surgery was on Thursday, released on Monday.

11.  Did you have any complications?  What?  I did not have any, thank God.  Only problem I had was that the pain pump wasn't working correctly, so that every time I hit the boost button, nothing happened.  I was pretty uncomfortable for about 8 hours until they figured it out.  All they had to do was check the amount of meds going out and the amount remaining.  Should have been lots more gone.  I told them!

12.  Any suggestions for husband or significant other?  The hospital I was at was WIFI equiped in the waiting area, so DH had his laptop.  Surgery was supposed to be 5 hours, turned out to be 3 1/2 hours.

Anything else you would like to add?  Get as healthy as you can before hand.  Also, if you are a person of faith, get prayer coverage.  I was covered by persons praying from Alaska to Florida, from Maine to Washington, and Ukraine.  My PS said he had not had a patient that had recovered as quickly, easily and well as I had.  I told him it was because of the prayers. 

I was out sightseeing in Charleston the day after I got out of the hospital.  I also started walking as soon as possible in the hospital and kept moving once out.  I tried to get back to a regular routine ASAP, leaving out vacumning and lifting.  I came home and finished piecing and quilting a quilt.  It kept me moving my arms w/o thinking too much if it was uncomfortable or not.  I went to Alaska to work at a bible camp for 5 weeks 7 week after surgery and had no problems.  I really felt I was blessed. 

However, I must say that the mast & recon were the 18th & 19th surgeries I had since I was 18 yrs. old, so I was no stranger to surgery; my worst was total knee replacement.  Thanks for this thread, it has been interesting reading about everyones experience.  Best of luck as they continue the healing process.  God bless.

Wendy 

1. What kind did you have?   

Free flap TRAM

Unilateral Or Bilateral?   

Unilateral.   I had a double mastectomy 3 years ago, both sides implanted with silicone.  The left side failed repeatedly.  I have a 600 cc silicone implant on the right and a TRAM on the left.  

Delayed Or Immediate?

delayed

How long of a Delay if delayed?

See above, three years

2.  How long for Initial healing?  I had the drains taken out at one week. A small area of the breast incision opened up and drained lymph fluid for 2 weeks.  It resolved by itself.  How long has it Been total?  I went back to work at 4 weeks.   It has now been 6 weeks since the surgery and besides a lot of tightness I feel fine and have resumed regular activities. 

3. Was the Pain More Or Less then Expected? About as expected.

4. Any Complications? What? Excessive bleeding at the flap site after the surgery. 12 hours after the original surgery they wheeled me back in to take a look at what was causing the bleeding.  I don't know how long I was out the second time, but they said everything was OK. 

About three weeks later a small area of the flap site opened up and ozzed lymph fluid for about two weeks.  It healed up by itself.     

5. Did your Surgeon Estimate your finished Size before surgery?  And are you about that size now?    He tried to match my implant on the other side. I am a C on the flap side, C+ on the implant side. 

6.  Before surgery Size & After surgery size (cup) Before surgery I had a colapsed muffin on the left side from having the implant removed.  I wrote on forms that asked, -A, C+. 

7.  Did you have Nipples done?  What kind?  Not yet.  Skate flap and tats in December.

8.  How did you like your Stomach Before Surgery?  Fine, just some fat around the belly button area.

 How did you like it about 6 months after...  Not there yet.  I am hoping that I will get some lipo at the second stage surgery.  I do like that my belly is tighter and flatter than it used to be.

 How much do you like it now?   It's great.

9.  Did you sleep in your bed, Hospital bed Or Recliner?  Recliner two days, couch three days.  Regular bed after that.   

Added Questions: 

10.  How Long Was Your Hospital Stay?  Five days

11. Did you have any Complications?  What?See above.  No other complications.

Anything Else you would like to Add?  I am blown away at how nice the created breast mound looks and feels.  It's a big surgery, but worth it. 

One more bonus: I feel entitiled to call myself the "Queen of Green"  for having recycled ugly belly fat into a beautiful breast rather than throwing it away duing lipo or putting in an implant.    

bumping to the top...

bumping for anyone considering DIEP, TRAM or other flaps

bump for any newbies

1. What kind did you have?   

Unilateral Or Bilateral? Bilateral  

Delayed Or Immediate? Immediate skin sparing, nipple sparing with hip flap reconstruction.

How long of a Delay if delayed?

2.  How long for Initial healing? I felt pretty much back to normal at 8 weeks. I returned to work after 5 weeks.  

 How long has it Been total? 4 1/2 months.

3. Was the Pain More Or Less then Expected? Initially more. I refused to use the pain pump in the hospital and let the pain get out of control. However, once I left the hospital I never needed anything for the pain. 

4. Any Complications?  Yes.    What? I developed an infection in my right hip donor site after the drain was removed. I had to have another drain inserted and took a course of antibiotics. I also became dehydrated and had to visit the emergency room for IV fluids. 

5. Did your Surgeon Estimate your finished Size before surgery? He asked what size I wanted to be. I said the same size.  And are you about that size now?  I am a little larger, but I think I will be the same as before after Stage II. 

6.  Before surgery Size & After surgery size (cup). Full C & Small D

7.  Did you have Nipples done? I had nipple sparring surgery. My nipples are the same size, color and projection as before.  

  What kind?  

8.  How did you like your Stomach Before Surgery?   How did you like it about 6 months after... I had hip flaps, but I am having a tummy tuck at Stage II.

 How much do you like it now?

9.  Did you sleep in your bed, Hospital bed Or Recliner? I slept on a sofa for about 1 month. 

Added Questions: 

10.  How Long Was Your Hospital Stay? 5 days.

11. Did you have any Complications? See # 4 above.  What? 

Anything Else you would like to Add? I could not be more thrilled with my Stage I results. I am looking forward to Stage II. Dr. Sullivan and staff are wonderful. I received excellent care at St. Charles Hospital..

May not be the appropriate forum, but I'm scheduled for DIEP- unilateral in August.  Implant has recurring capsular  contracture issues.  this info is sooo helpful, however, why aren't you able to sleep in your bed when you come home?  Seems like a sofa would be just as hard to get in and out of?

I just wanted to say a HUGE THANK YOU to Dejaboo that started this and everyone that answered. I have a consult soon for DIEP and was really wondering about what people really thought and how they found the best way to sleep and everything else. This is awesome!

Thank-you for posting these questions and to the individuals who responded. I am scheduled for  a Tram-flap surgery and had similar questions. Belle

bumping it up!

1. What kind did you have? DIEP

Unilateral Or Bilateral? Bilateral

Delayed Or Immediate? Delayed

How long of a Delay if delayed? 3 years

2. How long for Initial healing? How long has it Been total? phase 1 was done Aug 3rd 2016, at 12 weeks- i was still healing, but it was time for phase 2 On Nov 4th. I am now 5 weeks out, and still feel like a wreck. I'll update in a few months on how I am feeling.

3. Was the Pain More Or Less then Expected? So much more.

4. Any Complications? What? not really.

5. Did your Surgeon Estimate your finished Size before surgery? And are you about that size now? Full C or D. Now, they are about that round, but they are flat like hamburger buns. soooo, no.

6. Before surgery Size & After surgery size (cup) When i had my DMX i was a 38 E

7. Did you have Nipples done? What kind? no

8. How did you like your Stomach Before Surgery? How did you like it about 6 months after...How much do you like it now?

It as big, but i just needed to work out and eat better. Still swollen, so, will update later

9. Did you sleep in your bed, Hospital bed Or Recliner? Recliner. I've been in it since we got home after phase 1, and will likely be in it at least another few weeks. It helps keep the cats off me. Mostly.

Added Questions:

10. How Long Was Your Hospital Stay?ph1- 6 full days. ph2- 2 days

11. Did you have any Complications? What? while at the hospital for ph1- I had to have a transfusion due to excessive blood loss. I recommend banking your blood if you are close to your facility. Ph2, I had massive blistering..wait for it..... on the back of my knee from them failing to put knee-high compression socks on under the leg pumps. Omg it was so painful once I felt it (was on the good meds, so didn't feel it right away) Make sure they put those on you. Or bring your own knee-highs. Took weeks to heal as my body was working so hard on my surgical sites.

Anything Else you would like to Add? Traveling far or out of state isn't always worth it.

If you have skilled people in your area that really communicate with you about expectations, and more importantly - LISTEN to you and what you want out of it, and have a good reputation, stay closer to home. I traveled 9 hours one way... really should have just found someone where I am.

Bumping this post. I need to make my surgery decision in about 4 weeks. I'm torn between a single mastectomy w/o reconstruction or single mastectomy with DIEP reconstruction.

Would anyone like to share more recent experiences with DIEP?