implant after diep flap reconstrcution

Options
rdumap
rdumap Member Posts: 10
edited February 2015 in Breast Reconstruction

Would love to hear from anyone in the "older women" who have opted for implant after diep flap recon as recon results were really insufficient...has anyone had silicone implants to enhance the recon?  how long after recon?? how are results?? complications?? how often have implants needed PS intervention due to implant related issues ??

Struggling with this decision and would love to hear from others...posted with love and gratitude 

«1

Comments

  • chinablue
    chinablue Member Posts: 545
    edited February 2010

    My diep breast is a size b cup and my natural breast is a size d cup.  My ps said that he could put an implant under my diep to help with protrusion at stage II.  Has anyone out there experienced a diep and an implant? 

  • chinablue
    chinablue Member Posts: 545
    edited February 2010
  • alexanjb
    alexanjb Member Posts: 304
    edited August 2011

    bump,  I'd like to revive this thread.

    I had DIEP with some necrosis and my PS mentioned a small implant.  I want to know what is involved with this.  Expanders?  Or not needed for the flap?

  • SandyinSoCal
    SandyinSoCal Member Posts: 2,034
    edited August 2011

    I know that the NOLA docs (DellaCroce and Sullivan) can sometimes add an additional tissue flap, so that you wouldn't need to resort to an implant.  This might be worth investigating.

  • lisa645
    lisa645 Member Posts: 61
    edited August 2011

    hmmm, I dont know!!! but I am interested too.  I might like a small implant when I get to that stage.  I would love to get it right when i go in for stage 2...i dont wanna wait...and then go back for another! surgery. 

    Since I have to get rid of these old saggy d-cups...I want perky d-cup foobs...like I had when I was 20!!!  

     I want a lot of  'jiggle' but also a bit of 'juggle' to them.... LOL, if that makes sense.

  • sunflowerE152
    sunflowerE152 Member Posts: 83
    edited August 2011

    I had UMX with delayed DIEP.  My noob is about a B cup and my natural breast is a C cup.  I tell people I have one 13 yr old breast and one 55 year old breast. 

    My PS said he could do implant and a lift or just a lift.  Does anyone know if a lift shrinks the breast?  Would I need an implant on both sides to stay a C?

    I did talk to a friend who is very happy with her bilateral DIEP and she had to have an implant on one side to make them even.

    I too would love to hear from anyone with experience.

    Thanks

  • alexanjb
    alexanjb Member Posts: 304
    edited August 2011

    Lots of questions and not too many answers.  Somebody? 

  • Soccermom4force
    Soccermom4force Member Posts: 631
    edited August 2011

    I added small implants to fix some asymmetry that fat injections would not fix. I had delayed (3 years) bilateral stacked DIEP in 07-08. Am very happy with results of adding 150cc to the mix and I have had no problems. Dr Sullivan at the Center for Restorative Breast Surgery in NOLA was my primary surgeon.

    Marcia

  • AnneW
    AnneW Member Posts: 4,050
    edited August 2011

    Shouldn't need expanders, as an implant post-flap should go under the fat tissue, and not the muscle. At least, that's my take.

  • alexanjb
    alexanjb Member Posts: 304
    edited August 2011

    AnneW, that's how it seems to me too, but I wish we could hear from someone who has had it done.

  • Marcidouglas
    Marcidouglas Member Posts: 44
    edited September 2011

    Ok Ladies, I just came from my PS pre op appointment for implants after DIEP that we had talked about earlier.  No TE's, he will make an incision under breast, regular implant on the non-DIEP side which goes under the muscle on the DIEP side it will go under the flap.  He will insert a temporary implant and inflate to determine size and then replace with the implants.  That's it, no fills, outpatient surgery approx 1 & 1/2 hours.  I will have it on Thursday October 6 and can go back to work on Monday.  It was either this or go smaller and I did not want to go smaller.  I have always wanted to be one size larger and now I have the opportunity to do it and I feel I deserve it.  November or December we will do nips and lipo to perfect.  Now if I could just get these 30 pounds off I gained during chemo and I will be a new person. 

  • x-raygirl
    x-raygirl Member Posts: 373
    edited September 2011

    Marciroberts ~ thanks for posting.  I think I might be right behind you.  Soccermom's post was encouraging!  I called my PS to make a "reservation" for the 11/17 so that I could recover during Thanksgiving.  I can't wait for my appt with my surgeon in 2 wks.  My only hesitation is that I'm not crazy about another sx, but having lost a few more pounds, my boobs are shrinking!  Please keep us posted and best of luck to you!  Daiva

  • alexanjb
    alexanjb Member Posts: 304
    edited September 2011

    Thanks for the info.  My DIEP is less than satisfactory after over 3 months.  I don't want any more sx but the noob is still hard and not shaped like a breast.

  • alexanjb
    alexanjb Member Posts: 304
    edited September 2011

    Bumping this again.  I still need to make a decision and its hard.

  • Sherryc
    Sherryc Member Posts: 5,938
    edited September 2011

    This is very intersting as I will be having a BMX with diep and am very thin and having to gain weight.  Even with the weight gain I worry if I will be big enough and especailly after surgery I intend to loose the added weight.  I would love to hear more from you all.

  • Marcidouglas
    Marcidouglas Member Posts: 44
    edited October 2011

    I got my implants done on Wednesday.  It is Friday and I get to take a shower today and unveal the results.  They put a binder on and have not be able to take it off till today to take a shower and I have to wear it until I go for post op next Wednesday.

  • alexanjb
    alexanjb Member Posts: 304
    edited October 2011

    Oh wow!  And so....???  Please tell me everything.  I am pretty sure that this the way I am going to go.  My uni DIEP noob is so hard it is like body armour or something.

  • Marcidouglas
    Marcidouglas Member Posts: 44
    edited October 2011

    It was a very short procedure, arrived at 7 and left at 10.  He placed an implant under the muscle on the non-diep side and an implant under the diep implant.  I have a small incision under each breast, just like an augmentation.  The non-diep side is sore the most because of messing with the muscle.  the incision on the diep is taking longer to heal, I think its because of the radiation.  I am very please with the outcome so far, there are still cleanup to do when I get nipple done.  I have always wanted to be a size larger so this is my treat for everything I have been through.  I go for my followup on Wednesday I will let you know more then.

  • alexanjb
    alexanjb Member Posts: 304
    edited October 2011

    Thanks Marci.  How long will you stay out of work?  Are you happy with the results so far?  Or too soon to tell?  I wouldn't mind being a size larger but going under the muscle scares me.  Mainly I just want to be even.  I am worried that so much of the DIEP flap will have to be removed that I will mostly have implant, then if I lose weight I will be larger on the implant side then the other side....

  • Marcidouglas
    Marcidouglas Member Posts: 44
    edited October 2011

    I go back tomorrow, Monday.  Very happy with results so far, I still have some cleanup to do.  I wanted to be a size larger but more than anything like you more even.  So far it appears we have accomplished that.  None of my DIEP flap was removed, the implant was just placed under it.  I am glad I had it done.  I will let you know more after my followup on Wednesday.

  • ellena
    ellena Member Posts: 13
    edited October 2011

    Thank you for posting your experiences. I am scheduled for a stacked diep in early january. I had a mastectomy with tissue expander placement in early July. I also am on the thin side and my PS has gone from saying Im a good candidate for a DIEP to saying maybe I should try an implant first. I am having a terirble time with my TE and pain so I know an implant alone is not the right choice for me. Did your PS tell you to gain weight? My PS also said she would do fat grafting to increase the size. A free tram is also an option but really dont want to lose any muscle. Also my docs say I shouldnt have any pain but I do. Thanks for sharing!

  • tamlyn110
    tamlyn110 Member Posts: 195
    edited February 2012

    Anyone else with any more information?

  • 2FriedEggs
    2FriedEggs Member Posts: 640
    edited January 2013

    llr10200  Did Marciroberts in this thread have done what you are talking about? http://community.breastcancer.org/forum/44/topic/747808 

  • seagan
    seagan Member Posts: 166
    edited March 2013

    Just wondering if anyone else had had this done since these original posts, or is considering. I am 3 weeks out from a bilateral DIEP/SIEA and although my new girls are quite cute, they're quite small too. I knew that was likely, and I wasn't big originally (a small B before and a small A now - even with likely swelling still there!).



    My PS says we could do small implants later, under the new flaps. I've also heard of using fat grafting to augment DIEPs, though it sounds like my PS limits that to contouring, etc vs augmentation.



    I'd love to hear more thoughts on this. It's tough to find much about it. Thanks!

  • littlesara11
    littlesara11 Member Posts: 20
    edited November 2013


    I had a DIEP (unilat.) in Oct. of 2012. Then had a complication 6 days after surgery. I did not lose flap although, it was touch and go for two days in ICU. I ended up with a good deal of fat necrosis which my ps was able to break up with reverse liposuction.


    I had a fat transfer in Sept. of 2013 with some improvement to the volume but, it is still not large enough. Although I am small breasted, I still want a matching pair so I don't have to wear a padded bra. My ps suggested we do another round of lipo. or put a small implant under the flap and also put a small implant under my native breast. At first, I was going to go for another round of lipo after thinking about it I decided I may want to try the implants. They will be small but give me more projection than I will get with fat transfer, as some fat is generally absorbed and very few people retain it all.


    I will have another consultation in Dec. with surgery currently scheduled for Jan. 21. He said he has had wonderful results with the implants under flaps. I will post after consultation.

  • mammalou
    mammalou Member Posts: 823
    edited November 2013


    I just had a 210 CC implant under my DEIP flap placed last week. No TE needed, but I am very tight right now. He wouldn't do a nipple yet because of tightness. I also had fat grafting to fill in some shallow spots. My other breast had a reduction/lift and I love that. I am hopeful that the implant will be softer with the flap above it. I had an implant before the DEIP that developed CC, but I was told that he had never had a case of CC with implant under DEIP, although he hasn't done a lot of them.

  • littlesara11
    littlesara11 Member Posts: 20
    edited November 2013


    hi mammalou,


    Still trying to decide about implant under DIEP . I am concerned it is going to feel very tight on that side. I realize yours was only done recently and you may still have some tightness. Can you update as you progress as it will help me make a decision about what I am going to do.


    Thanks,


    Janet

  • mammalou
    mammalou Member Posts: 823
    edited November 2013


    I will keep you updated. I asked my PS about tightness. She said it would loosen up but would probably always be a little tighter than natural breast. I will let you know how it goes.


    Either way, I really didn't have much choice on the implant if I wanted to be symmetrical. I didn't want to reduce my other breast again and I didn't want another flap procedure that cut up another part of my body.

  • littlesara11
    littlesara11 Member Posts: 20
    edited November 2013


    Thanks for your reply. You have been through a great deal. Hope you are doing better and getting stronger.


    Surgery take a great deal out of you, even when you feel strong and fit going into it. I've had five in the past year and I always considered myself in good shape but, it takes its toll. I think the anesthesia is rough on my whole body, even my hair became dry and frizzy.


    Keep me posted on your progress with the implant. I do have a choice between more fat graphs or the implant. I will see my PS on Dec. 12 but, can always change my mind before Jan.21.


    Wishing you a wonderful Thanksgiving and sending healing thoughts your way.


    Janet

  • bdavis
    bdavis Member Posts: 6,201
    edited December 2013


    I had necrosis in one breast so I had a tdap flap added to my one side. It is kind of like a lat flap, using the fat in the back of the armpit, but no muscle is taken. I then had the contralateral fat excised. Couldn't be happier. Its an easy flap procedure as it is not microsurgery, but rather a rotational flap... just sort of flipped from the back to the front.

Categories