DIEP 2013

Hi! I'm having my DIEP surgery on Valentines day. I am trying to get my house ready for when I come home. Trying to get myself ready too.



I'm going back to read this thread and the 2012 one as well. My surgery is being done at Mayo in Jacksonville FL. My surgeon is Dr. Perdikis.

Nihahi so sorry I totally missed your response to my post ! Just read it and that does help thank you so much. I don't meet with my anesthesiologist till March 14th so in the mean time everyone's responses were a tremendous comfort to me.

Janet it's a bit of a rollercoaster but for me the decision to get the surgery is the best option and different things help at different times sometimes it's this site sometimes it's writing in a journal and other times just talking to my husband or a friend. Making packing lists and going over my plans tend to distract me a little too. Looking on the bright side we can nix those crunches and sit ups

A pink sister from another site calls the DIEP/TRAM recon "frontend realignmentront." For me, that's the best way to look at it.

@ Hockeymom1, so encouraging to hear that you are doing well. I hope to follow your steps.

I am going in Monday for bilateral BMX w/DIEP recon. Don't know how to describe what I feel, but have been camping on this site for the last few days...

Hockeymom - You are one day ahead of me and we are just about in the same place.  Only I lost just two drains at post op and, while I'm sure I could do it if I was totally off the pain meds, I really don't feel like I would want to drive yet.  My belly is still quite sore and the incision pulls so I just don't want to go there.  My "new girls" are still hugely swollen but at least they aren't aching too much anymore...just feel so dang heavy. My DH says he doesn't think they are that much bigger than my original "girls" but I swear they are almost twice the size. I couldn't even being to think aobut fitting into one of my old bras even if I wanted to do so. I do wish the bras they gave us at the center had more support though...that would take care of some of the extra weight discomfort.

Glad you are doing well too.  We are still amazed at how well I've done and am doing.  I wasn't really "expecting the worst" but one would really think after what I went through I would be having a much tougher time.  The first thing anyone says when they see me is that they can't believe I just had all that done in an 8 hour surgery.  And as my little boy said, they "aren't just saying that to make you feel better."

And good luck on Monday Tammy.  I was never terribly worked up or anxious about the surgery.  I knew God (and Dr. D.!) was going to take care of me.  But I also just chose not to "go there."  Because if you think about it too much, it could easily get you worked up.  My husband took the same route I did...and he could have easily gotten worked up with worry.  In the end, we are both so glad we didn't "go there" as it wasn't necessary.  And then to have me do so well since...is just icing on the cake.

Prayers for you and everyone else. Peace and Grace, Nancy

Nihahi--great news about your early date--I remember they called me with a cancelation, but I couldn't drop everything and get ready in time--glad you can accommodate. April is not far away. I am getting my nipple for my DIEP breast in late March--then I am done--everything my PS did looked fine to me and he agreed. I hope you are equally happy with your result.

Hi All, I do not typically post just tend to check-in frequently and gain comfort and knowledge in all your stories. I thought it was time as I am 5 days out from my stacked diep to share my story in the hopes it will help those ahead. I was diagnosed with BC in 2005, 3 months after marrying the love of my life. At that point I was so overwhelmed I just did the suggested routine of lumpectomy, radiation and did not need chemo due to Oncotype of 17. I was on tomaxifen for 5 years and had yearly MRI's and bi-yearly mammo's due to inconclusive BRCA test. I had a scare December 2011 and they watched me closely for 6 mos until a biopsy came up benign. I have dense breasts so the false positives were a constant. I realized the toll of constantly being scared was not worth it and my oncologist agreed and we scheduled a MXS for December 2012. Well that turned into a disaster due to infection and previous radiation. I went through surgery, expanders, exhange and removal on the cancer side from Feb until July of last year. It was then I began exploring my limited options of Diep. My current surgeon only did pedicule tram flap and due to my experience with them was not confident that was the way or he was the one. So I began my research, and due to my job of supervising 16 schools I was not able to put my whole life on hold and go the NOLA route althought I have been so impressed with so many of your experiences there. I live in Upland California and there were no in network providers who did the diep so I researched and ended up at Loma Linda University about 45 minutes from home.



Dr. Derek Cody was my surgeon and I have been so grateful so far. I am fairly thin, and he was a realist about the size he could give me but did make me feel confident that he could do something. My first consultation was in October, and due to how busy he is my surgery was scheduled for January 21st, this was quite a blow as I was so hopeful I could include my two weeks at Christmas as part of my recovery and not miss so much work. He did a CT scan and we met to go over the results. He showed the the images from the scan and pointed out where my vessels were and said I was a candidate. I decided to give him a christmas present of 10 lbs. by January which was quite doable over the holidays. I checked in Monday morning at 5:00 am, was wheeled into pre-op around 6:30 and surgery at 7:30. When I awoke in post op and could finally see clearly enought the clock read 10:00 pm! My surgery was a full 12 hours. He was able to do a stacked diep using both sides of my stomach and stacking them which is like a double procedure. The hospital staff was amazing, kind, gentle and knowledgable and made me feel very confident in their skills. They checked the flap every hour with the doppler to hear the blood flow for 3 days and every two hours until I was released. They said the flap is going great. Althrough not large it is really beautiful and I realized how much I dislike the implant on the other side. Dr. Cody said we will deal with that later and mentioned we might be able to do a smaller implant and fat grafting...but one step at a time. The implant looks really unnatural to me and is cold! My flap is natural and warm. The surgery team said it was tough to close me due to my thinness but so far I have not popped open. The most important thing for me was as much as getting up filled me with dread every time I did I felt better than the last. I got up on Wednesday after they took the cathater out. The PT was a godsend and was impressed with my leg strength although I am not very athletic it felt good that something was good on my end. At 5' 11" I needed my legs strong to get me to sit. I do have stairs at home and love my master bedroom so the thought of not being able to recover there was unacceptable so by Thursday I told the PT to take me to the stairs...I was able to climb a small flight and go back down she was very impressed and it felt awful and great at the same time. I was released yesterday morning and had a pretty smooth time getting up to my room and settled into this stage of recovery. My husband is an awesome nurse as well. The drains are awful but doable. One really hurts when it is stripped twice a day. I have four two in my breast and two in abdomen. I have not really focused on my abdomen yet. The binder is uncomfortable but doable and the stitches are not too bad, they sting at times. I am on norco every four hours and take a benedryl at night as I have some intense itching. Let me know if I can answer any of your questions for those of you coming up...yes it was worth it so far.

Christina00.....I am booked for a diep on the right side, (with removal of implant) and removal of implant on the left side which will also have a "tweak" done to the left natural breast. The "tweak" will likely be a combination of lift and reduction, as I don't have lots of tummy to build much on the right side. I told the surgeon that size doesn't matter to me, but symmetry is very, very important. I have a second appt. for further preop/discussion on Feb 27, and surgery is booked for April 12.

Christina my diep 5 days ago was unilateral I have an implant on the other side. We will deal with symmetry at stage 2.

Just wondering if any of you have been told that you may end up with a tram free flap with minimal muscle taken(instead of a diep) due to very small or few perforator vessels? Also, I have read a few articles that are concluding that a tram free with minimal muscle results in less fat necrosis occurances than a true diep flap. Any feedback on this would be appreciated.

@ nihahi, yes, I was told that a tram free flap with minimal muscle taken (to preserve the integrity of the very small perforator vessels harvested) might be a safe option for me if my perforator vessels are small. Also, Where did you read the articles you mentioned? I am going in tomorrow morning. Will let you know what I come out. Tammy

Tammy, found the article. Published in the American Society of Plastic and Reconstructive Surgeons Journal 

"Breast Reconstructionwith the Free TRAM of DIEP Flap: Patient Selection, Choice of Flap, and Outcome"

Authors are: Drs. Maurice Nahabedian, Bahram Momen, Gregory Galdino and Paul N. Manson.

I believe they are affiliated with Johns Hopkins University.

Hi guys!  Just got home from the hospital with four drains.  I feel like a home grown terrorist.  My husband has really manned up and is not freaked out by all the scars.  It will take time and revisions to where they are prettier, but I have hope that in the end it will be a good finished product.

Hospital visit was horrible.  That's really all I want to say. Really wish I could have afforded NOLA

BTW, I made a wonderful discovery about taking care of the drains.  Get a bag as big as a make-up bag that has a strap on either side of it - hang it around your neck with all the drains inside.  It is a wonderful solution.

Get all the help at home you can, someone to cook, clean, etc.  I can take care of my personal needs, but that is about all. 

BTW. WE NEVER HAVE TO WORRY ABOUT CANCER AGAIN. 

Gentle cyber hugs to all, it is worth it, even with the crummy hospital!

Thanks for the article nihahi. Interesting read.

gotoel: I am in Moreno Valley, not to far from you.  I am scheduled for DIEP May 24.  Thank you for posting your experience.  I will be watching for updates.  Like you, I manage a large organization and am worried about time away from work.  However, I have to put my health first and have decided to have the DIEP regardless of the time away from work.

nihahi:  I, too, see all these posts about NOLA and wonder why everyone feels so compelled that they are the gold standard and somehow their own local physicians may be less qualified.  I feel blessed to have awesome medical coverage through Kaiser.  I have a wonderful team of doctors, and my PS is well qualified. I have been asked to sign authorization to convert to TRAM with partial muscle, if necessary, at the doctors discretion during surgery.  I trust him.