PAP vs. TUG

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  • Sociologist
    Sociologist Member Posts: 237
    edited June 2012

    Hi Sweetbean,

    The breast drain came out 3 days post op and the donor site drain 1wk post op. The pain was managable and was off pain meds the day I came home. I just needed to remind myself to take things slow. The day of surgery, they will check the new boob every hour for first 24 so you will not sleep. After that it drops to every 4hrs. I was able to stand (against med advice) about 7 hrs post op. Was walking in room at 6am day after surgery. This was a much easier surgery than the mastectomy and even easier than what I thought it would be. I stayed in the hospital gown entire time (why mess up my own clothes!). I hope you get the ok from insurance. I haven't seen a bill yet but will keep you posted. You can pm me and I'll give you my number if you want to talk. Good. uck!

    Margaret

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  • sweetbean
    sweetbean Member Posts: 1,931
    edited June 2012

    So how's everybody doing? 

    Question - someone said it would be hard to ride a bike after this surgery.  Is this true?  I mean after the incisions heal.

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  • amac645
    amac645 Member Posts: 51
    edited June 2012

    Doing great here, thanks sweetbean.  It's pool season.  Aside from the fact that I still hide my legs under swim skirts and shorts so as not to scare anyone (the incisions are still very visible), I'm actually getting tons of compliments.  They are funny to get too.  Everyone knows the girls are fake, but they just can't believe it.  Me either!  They actually feel so real to me that I forget too.  It's AWESOME!

    Not too sure about a bike at this point (9 weeks out).  I actually have an opportunity to ride one this weekend and, honestly, that's the only part of me that is still sensitive.  I think a bike will still be uncomfortable, but I will let you know if I change my mind.

    Cool

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  • sweetbean
    sweetbean Member Posts: 1,931
    edited June 2012

    I'm so glad that you are doing well!  Where are the scars, exactly?  When the PS showed me pictures, it looked like it varied from person to person.  She said it had something to do with where the bloodvessels were?  Did I misunderstand?

    When you say "sensitive," do you mean your nerves or the muscle or the incision?

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  • Sociologist
    Sociologist Member Posts: 237
    edited June 2012

    Hi all, Doing okay...having second surgery next Friday to get nipple and do remaining noncancerous breast. The biggest issue I have had was with the thigh incision opening up in various spots. Got lots of scabbing but he is also going to revise that scar so more healinb. The boob looks great and I couldnt be happier. Margaret

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  • sweetbean
    sweetbean Member Posts: 1,931
    edited June 2012

    Wow, so happy for you!  Still waiting for my surgery date, but they are confident that they can get me in, so I am very hopeful!

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  • bientot
    bientot Member Posts: 21
    edited June 2012

    Hi Margaret,

    Sorry to hear the thigh incision continued to give you problems. Thank goodness only one more week before your PS repairs it !  Wow - am excited for you. You will soon have a perfect pair !  This next surgery will probably seem like a breeze after the last one. I wish you an easy and very quick recovery. Keep us up to date on your progress

    I won't be too far behind you on the OR table. My PAP surgery with Dr. Allen will take place 9 days after yours, on the  17th  in NYC -  both legs.  Am flying up on the 11th as my MRA is scheduled for he next day- the only date they had available at the imaging center - so will try to enjoy the City a bit before my big day.  Starting to get nervous now and can't wait to get this  whole thing over.   

    Everybody, THANK YOU all. Had it not been for all the wonderful information and input from you those of you who have gone through this surgery I never would never have been able to consider it or go into as prepared as I am.  I am very grateful to you all for your candor.  A very special thank you Margaret,  Stacy  and Andi for speaking with me at length on the phone. You have truly been a God send. 

    Good luck Friday.  Will check on you a few days after.

    Eileen

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  • amac645
    amac645 Member Posts: 51
    edited July 2012

    Good luck Eileen!  You are going to do great.  Keep us updated.  :)

     Sweetbean, the incisions themselves are still tender for me.  For example, when getting in and out of a car or sliding on or off a seat, if I put direct pressure on them I notice they are still sore--almost like pushing on a bruise.  They are also still "lumpy," which doesn't seem to help the sensitivity.  I also have some mild muscle discomfort on the TUG leg (when I stretch it further than my newly shortened muscle is prepared for), but nothing that really bothers me.  Then finally I still get "zingers"--that big shooting pain that comes out of nowhere and moves on.  My doc says those are from the nerves regenerating.  They are not a big deal, just always a surprise.  My scars run about a half inch down from the panty line and go from almost the center of the front of my legs to the center of the backs of my legs.  Hope this helps :)

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  • sweetbean
    sweetbean Member Posts: 1,931
    edited July 2012

    Thank you so much for the updates!  I have another question - has anyone gotten any sensation back?  My breasts are completely numb, but my PS said I might get sensation back.  Anyone experience this?

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  • Sociologist
    Sociologist Member Posts: 237
    edited July 2012

    Car rides are difficult fof me as well. Do not try to slide across seats! Had issues driving yesterday...felt EVERY bump and I am almost 2 months out. I am nervous about him doing the scar revision Friday. There are parts that have healed ok but the outer part from midthigh to the outer hip is still scabbing and oozing a bit. Not far along enough to answer questions about sensations. The new boob has very fine blond hair which is a tad disturbing! Guess I'll be adding that to the shaving list!



    Eileen, I was thinking about you the other day when I turned my calendar. I'll give you a call after my next surgery.



    Margaret

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  • sweetbean
    sweetbean Member Posts: 1,931
    edited July 2012

    I have a date - Sept 25th.  That is cutting it pretty close since I want to have the Stage 2 surgery done in 2012 as well.  But the surgeon's office seemed OK with coming in after Christmas, so we'll see.  They are going to see if anything opens up earlier, but if not - Sept 25th is the big day!

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  • bientot
    bientot Member Posts: 21
    edited July 2012

    Congrats Sweetbean!  So happy to hear the insurance came through and you are now scheduled for surgery. Perhaps a  little later than you would like, but on the plus side the weather will be cooler.  Frankly, am dreading wearing those compression garments in this heat .  So, be of good cheer. 

    By the time you go I will be two months out from my surgery, and will be more than happy to add my input, and answer any questions you may have.  The more people I talked to the more I learned. Each person's experience seemed so individual , so I feel free to tap into mine. 

    Will try to post a day-by-day chronicle the way Stacy did. Have printed that one  out, as well as the affter surgery feedback from some of the other gals, and I'll be taking those along with me to New York.  I can then refer to them and be assured I am on track, and that what I am experiencing is NORMAL.  Hopefully I will have good things to report.

    Eileen 

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  • sweetbean
    sweetbean Member Posts: 1,931
    edited July 2012

    Oh, the insurance isn't settled yet - they couldn't start on the in-network exception until they had a date.  So that is the next hurdle.  Keep your fingers crossed for me.

     Thank you in advance for your day to day journal - that will be very helpful!  How long do we have to wear the compression garments?

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  • bientot
    bientot Member Posts: 21
    edited July 2012

     Hi Swetbean.

    Sorry the insurance isn't a done deal yet.  Went through the same thing as am with an HMO and it was out of network.  To my surprise, once all was finally submitted the approval came quite rapidly.  Hope it works that way for you !

    RE: compression garments, from the instructions I received,  and from what I have heard from others, they have to be worn 24/7 for at least 3-4 weeks. After that  people switch to a lighter more comfortable compression garment,  such as Spannx or bicycle shorts, and tend to wear them for quite a while, particularly when doing their walks or exercizing.

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  • Sociologist
    Sociologist Member Posts: 237
    edited July 2012

    Hi All,

    I am day 3 out of stage 2 and boy am I sore! I think this is actually more painful than thr flap surgery. The compression garment is my friend that I have a love/hate relationship with. I am sore from my pubic area to right above my breasts. Of course, I have bruises as well.I feel okay just cant get very comfortable because its very uncomfortable to move alot. Ive been sitting in the den watching tv but getting up every half hour or so just to move.I have faith it will gwt better soon!Margaret

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  • sweetbean
    sweetbean Member Posts: 1,931
    edited July 2012

    Hang in there, Sociologist.  I've heard that  the Stage 2 is more painful than the actual flap surgery.  But I think it improves more rapidly.  Hope you are feeling better soon!

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  • amac645
    amac645 Member Posts: 51
    edited July 2012

    Oh Margaret sorry!  That sucks!!  I have stage 2 at the end of August and not looking forward to feeling like poo again.  I hope it goes fast.  Good luck Eileen!  I'm thinking about you and hoping for an amazing result!!!  Sweetbean, congrats on the date and praying for you with insurance.  Boy does this process suck.  On an up note,, it's hard to explain, but at 2.5 months out I have definitely picked up sensation.  The skin is still numb to the touch in about a 3 inch diameter around what would have been my nips, but I can feel them more from the inside??????  For example, when I get cold I get the CIW feeling even though nothing is there.  I don't know if that makes sense.  They just feel real--like a part of me :).  I'm hoping to get more and more although I know they will never be like the real thing.  I too have heard of women getting back sensation with the flaps.  I'll keep you updated.

    We just got back from vacation in Colorado.  Cross hiking off the list of things I can't do, and I even managed to sit on a horse for a bit.  Yea me!  Hope everyone else is doing well  :)

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  • sweetbean
    sweetbean Member Posts: 1,931
    edited July 2012

    So I had a confusing 2nd opinion yesterday with a doctor who does fat grafting, but not PAP.  Basically, she said that I didn't have enough fat on my body for more than a small A cup.  She hadn't heard of PAP and didn't examine the potential donor site.  The PAP surgeon said that she thought she could get at least a D cup, maybe a DD.  Yesterday's doctor recommended smaller implants with fat grafting.  She just felt the surgery would be super invasive with minimal benefit.  What do you think?  I feel like I need to see another doctor who does PAP - I don't want to be a A cup.

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  • GointoCarolina
    GointoCarolina Member Posts: 753
    edited July 2012

    sweetbean,have as many consults as you can.You will learn something different every time.Have you checked with Dr.Julie Vasile? She does both fat grafting and all kinds of flaps,I had long phone consults with her and she impressed me because she wanted to help me find the type of recon that would work best for me.She works out of NYC and CT.

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  • Sociologist
    Sociologist Member Posts: 237
    edited July 2012

    Hi All,

    One week out from stage 2 and its all good! Still a tad sore on my sides but other than that, all is well. Saw Sadeghi yesterday and I get my stitches out next Wednesday. All thats left is the tattooing!



    Sweetbean, get as many consults as you need. Dr Sadeghi in New Orleans is awesome! I dont know how far youd be traveling but it would be worth it to check him out. I couldnt be happier with my results thus far.



    Eileen, if I dont talk to you beforehand, good luck next week!



    Margaret

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  • Sociologist
    Sociologist Member Posts: 237
    edited July 2012

    Two weeks out from stage 2 and all good. Stitches came out Wednesday. Still a bit bruised on my sides and a tiny bit sore but nothing I cant handle. Still have some healing left to do from stage 1 on the thigh area. Found an unattached stitch last night that was keeping an area from scabbing over and healing. The compression garment comes off for good Friday but to be honest, I feel better with it on. I will probably find something else a bit less constrictive but supportive to wear. Any thoughts? Margaret

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  • amac645
    amac645 Member Posts: 51
    edited August 2012

    Hello all just checking in.  It has been quite here.  We need updates!  I hope everyone is doing great.

    I have my stage 2 surgery on Aug. 31st and, of course, am a little nervous but excited too.  I just LOVE my new boobs, so it's scary to mess with them, but I trust my doc and am looking forward to sucking as much extra fat from anywhere possible to put it toward my boobs!  And of all things getting nipples--I honestly didn't think it would matter to me.  I was fine with a 3d tattoo with my implants, but damn it I feel so great and "normal" that it turns out I want as close to the real thing as possible.  The hope is I will not need a stage 3, but we will see.  Keeping my fingers crossed. :)

    I truly hope everyone else is doing well and having success.  I'm also on the YSC boards and received a post from a woman whose doc told her a lat flap is her only option for recon to save the implant on her radiated side and have a "boob"--otherwise known as a "breast mound."  Gezzz I hate that term!  She has been told that if she doesn't do this she will have to go boobless.  I want to scream NO!!!!!  There are other options!  Keep looking, because you really don't have to settle for that.  I am also feeling incredibly blessed and so thankful for my docs who have never given me that kind of news or options.  I want the same for everyone else.

    Take care :)

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  • Catie2013
    Catie2013 Member Posts: 1,023
    edited October 2012

    Hello all. I have a PAP scheduled for the first week of January. Have just finished hyperbaric oxygen treatments - 20 dives spanning a little over a month, to give me a boost when I go in for surgery as this will replace a failed flap from the Sgap I had done on both sides in April. The side that took was the radiated old lumpectomy side from 18 years ago, the side that failed was the new cancer side found in late Feb of this year.



    Any tips, any words to get me through this part? I have read most of what I can get my hands on to enlighten myself going into this. I had some bumps in the Sgap road with stitches opening up, but past that and ready to have the prosthesis park permanently in my drawer. It hurts if I wear it too long.



    Thanks in advance for your input.



    Catie

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  • amac645
    amac645 Member Posts: 51
    edited October 2012

    Good luck Catie!  I've never heard of your treatments, but wow!  I suspect you will be ready for this.  The PAP causes a lot of leg pain and tightness in the front (around your hip flexors).  The incisions are also painful, making it diffcult to do "sitting" things--like peeing!  So maybe get one of those old fashion toilet assists with handles, or some ladies have found some hiking gear that allows you to pee standing up Surprised.  Overall it just takes a while to stretch everything back out and get moving again.  Have some help at the first (as in the first 2 to 3 weeks).  And LOTS of spandex ready!  Spanx, workout pants, sports bras, etc.  They really help.

    Good luck! 

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  • MommaGin
    MommaGin Member Posts: 28
    edited July 2018

    This is a really good post for PAP flaps. I hope PAP friends will post some updates here. I had a successful stacked DIEP in February 2018, following a unilateral Mx. Now considering a PAP on the other side (to replace an implant) to make both sides more symmetrical and to get away from implants. I'm finding that there's not as much info out there from PAPsters.

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  • Lexica
    Lexica Member Posts: 259
    edited June 2019

    BUMP - thinking about PAP or TUG and would like to hear more stories. Thanks to all who have shared :)

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  • MommaGin
    MommaGin Member Posts: 28
    edited August 2019

    I wanted to update this thread for the benefit of anyone considering PAP. I did have a stacked PAP performed last August (2018). I have also had a stacked DIEP (to my other breast), which was performed February 2018. I've been happy with the outcome from both procedures and do not regret going down either of these paths. Each one has its pros/cons in terms of the recovery process and donor site aesthetics. As compared to the DIEP, my PAP scars are not hidden as much under clothing (e.g., when I wear a bathing suit or shorts), but the only donor site issue I deal with for PAP is the scar, whereas the DIEP has the scar as well as other things (such as pulling my pubic area up higher, having less of a waist curvature -- meaning I feel like my trunk profile is more board-like now -- and having an artificial belly button, etc.) -- my abdominal area just looks different and less natural following DIEP than I was expecting. My thighs kind of look exactly like what I had expected following the PAP. I'm happy to answer any other more specific questions about the PAP procedure.

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