DIEP flap in Kansas City @ KU Med?

I am having DIEP with Dr Buescher on November 8th. I'll let you know how it goes. Glad to see some more of her patients here! 

Dr Buescher did my delayed bilateral DIEP almost 3 months ago.  It is a huge surgery but I am glad I did it.  I saw my oncologist today and he asked for her name to give to other women looking at reconstruction options.  I wake up every morning so happy that I have boobs again.  My Phase 2 will be in December, need to tweak a hard area on the right.  Honestly though I really could just get nipples done and later tatoos (both as office procedures) and I would be pleased.  My husband is also pleased. 

Dr Buescher spent over an hour with me for my consult and fully answered our questions. I never liked the way the portacath felt under my skin so knew implants were not for me.  Plus I had radiation so implants would not be a good choice.  Months earlier I had a phone consult with Dr Marga Massey in NOLA and she told me what to look for in a surgeon if I did not come to NOLA.  On the way home from the consult at KU I had confidence in Dr Buescher and decided then to choose her.  My nursing care was good at KU.  Dr Buescher pts go to the Burn ICU.  Those hourly checks keep you from getting much sleep but I had a big smile every hour when I heard the Doppler swish of the blood flowing thru the flaps.  I was in the ICU for 48 hrs and then to a regular (private) room on the Burn floor.  There it was every 2 hr checks and then later the checks were every 4 hrs.  I had an epidural for pain control for 3 days and a PCA pump to push for pain.  Then I went to pain pills.  My call light was answered fast and the nurses were very kind to my husband.  Dr Buescher's office staff has always been helpful too.  During surgery there are frequent updates to the family.  My daughter jokes that her grandpa now  knows more about my boobs than he ever cared to.  Hope this helps. 

Angelrose, I had the same experience last April with Dr. Buescher, KU and the Burn ICU.  Just AWESOME, AWESOME care.  Faith, I hear you on the doppler swish!!!  It was like listening for the babies' heart beat every two hours!  I just had my stage II (nips-yesterday).  I am so happy with them.  Can't wait for the tattoos.  I just know you are going to love her and her crew. 

Steiner, a really good PS who does these procedures makes all the differencein the world!  Don't get discouraged.  I think there are enough flap options out there that even the smallest of ladies can get one IF you have a doc who knows what he/she is doing.  I know Buescher is booked--that's because she's really, really good, and she's worth the wait.  But there are a number of others.  I suspect they are booked too for the immediate future, but you really want to find a good one for a flap.

If it helps I basically ended up doing what you are facing (TE, implants and then flaps).  I didn't exactly choose to do it that way.  I had chemo first, then surgery.  I knew I wanted immediate recon (skin sparing mast with TE)--I just didn't want to have nothing there.  But because I needed rads I couldn't do a flap (and I'm not all that big either so I got some of the same "there's really not enough here" talk.  I tried to make the implants work for a year and then decided to do a flap (a TUG/PAP which is inner thighs for boobs plus fat grafting).  I'm three years out and a few months from done (I just need my tattoos now), and I am soooooo happy with the results.  They look good, the feel great.  Honestly, I look better than when I started. 

It was a long road, but it didn't feel as long as it was.  In the end, I think I would have done it the same way--maybe skip the implants and just keep the expanders for a bit to hold the pocket??? That would have cut off about a year.  I was just in such a rush to get everything done and be through it!  I think everyone is.  But the reality is this takes time. Now I wish that, although I wouldn't have wanted to hear it, someone had told me to just "slow down."  "Here's what you can expect...."  "You will be happy in the end, but this will not be a 6 month or an 8 month thing...."  You get the drift.  Plus, although I have absolutely no medical/scientific basis for this, I think that when you do the flap after all the stress of treatment is over, your body handles it better.  You are asking a LOT of your body, your immune system, your vascular system, the list goes on.  Give it the time and steps it needs to get through everything, and you will be pleased in the end.  But don't get discouraged.  You can do it!!!

Take care

By the way, where are you being treated?

Steiner - I didn't have my DIEP at your center, but I wanted to let you know that a staged DIEP can be done.  I had a skin sparing bmx with TE placement which I had through the months of active treatment.  I was originally going to have an immediate DIEP, but came up with a positive node which put the possibility of rads on the table, and the PS preferred to wait to do the DIEP later after all treatment.  Once active treatment was over, I had my DIEP. 

The reason for placing the TE at the time of the bmx is to keep the skin stretched out so you keep the benefit of the skin-sparing BMX.  So it's definitely possible to get your bmx with TE now and go for your flap later.  As amac says, doing it this way isn't bad.  I had the TE to get me through active treatment - they weren't the most comfortable things in the world, but I never woke up flat, and with clothes no one would have ever guessed I had a bmx.  Once active treatment was over, I was able to schedule my DIEP at a time when it was convenient for me and for my employer.  I agree that having the DIEP after active treatment ended up being better for me - I was better rested, I was less stressed, I was a lot stronger, and it was more convenient.

That was over 4 years ago and I honestly forget most of the time that they are not the original "girls".  Maybe the PS you want will at least consult with the breast surgeon who will be doing the BMX with TE to let the bs know exactly what he/she can do to help maximize your aesthetic results. 

Good luck!

Amen Kim!  I didn't count on the difficulty in bending over.  I used my tongs for EVERYTHING.  Thinking of you Angelrose.  I hope you love KU as much as I did.  I wouldn't call it a 5 star resort, but pretty close.  Steiner, I think Holding is the new doc.  They are VERY excited about this addition.  I think you are in great hands.

Hi Becky:  In April, 2013, I will be 3 years post DIEP reconstruction (bilateral mastectomies) secondary to my breast cancer diagnosis in November 2009.  Dr. Teresa Buescher was fairly new at KU when I had my surgery. I cannot say enough about this truly gifted, skilled surgeon.  She is one of the most caring and compassionate individuals I have come in contact with during my breast cancer journey.    I had my surgery at KU-was in ICU on Burn unit for 2 days and then went to regular room.  I was in for 6 days because post surgery, they went back and did a node dissection.  DIEP flap reconstruction (mine was immediate-I was in surgery for 14-1/2 hours) is not for sissies, but neither is breast cancer.  The end result is unbelievable.  I flash these breasts to anyone who is contemplating reconstruction and speak to women on a regular basis about it.  I would do it again in a heartbeat.  If you have specific questions you would like answered, I would be happy to talk to you.  Good Luck to you.  nancy

I'll be having my DIEP at KU MED and I've decided to go with Dr. David Chandler. I had my tissue expanders placed by Dr. Korentager, but he does not do DIEP and also has been off work lately due to illness. While I was in his office for a fill last week Dr. Chandler came in and drained my seroma. It turns out he is just coming back to KU after working in Alabama for the past several years and has done many DIEPS. I talked to my nurse about him and she says she remembers working him back when he was the chief resident and that he is an excellent surgeon and a truly good person. He's coming back and going into practice with Dr. Korentager and I have a consultation with him on 4/4. He did kind of a mini consultation with me when he drained my seroma and I got a good feeling about him. His schedule is pretty open. He's going back to Alabama for the next 2 weeks to tie up loose ends there then he'll be back.