DIEP 2013

Cuetang, our situations sound very similar. I was diagnosed in early November, and it took until Jan 18th to get the BS and PS together. I have had no other treatment for my BC either (other than BMX). I am meeting with an Onc early next week, as my cancer was ER/PR +, so I will probably have to take something for that ..... Seems like a walk in the park compared to what some of our sisters are having to do. :-(



Namaste and God Bless-Jackie

Kimdy - I'm happy to share why I waited. There were several reasons. First, when I learned I needed to remove a breast (and I chose to remove both), I was pretty devastated emotionally - really scared b/c this was a recurrence. I had had a lumpectomy and rads in the same breast two years earlier and now it was back. I was terrified, as my mom had died 2 yrs after her recurrence. So I really didn't have many emotional resources to deal with a big recon on top of the mast - I just wanted to get rid of the cancer.



Second, I was really overwhelmed with all the recon choices and disappointed that I couldn't get the kind I had been hoping for (at that time my same PS said I wasn't a candidate for DIEP and he didn't do GAP or TUG type surgeries, nor did any other well-regarded surgeons in my area). So I decided just to separate the two surgeries, and hope that a better option appeared later (and it did!).



Finally, I realized I didn't know how I'd feel without recon and decided to see if that would feel ok, esp. since it would mean a smaller surgery and it seemed like plenty of women went this route quite happily. Also, I had fairly small breasts anyway, so maybe being "breast free" wouldn't feel so different. Frankly, I was really hoping this would be true for me. I decided to give it two years. But it just wasn't ok, and it got worse over time. I felt very self conscious and it affected my sexuality too.



So I met with the same PS again in December, and here I am. It feels like the right thing, but I'm also glad I waited. It made me strong going into this surgery, both physically and emotionally, and that has been so helpful.

Faith - 

I think you sound normal. Or should I say, you sound very much like me. I'm pretty scared out about the changes in my body, and the upcoming surgery has me pretty freaked out. I go from feeling really strong one minute, to crying in the shower. At yoga this morning I was  lying on my tummy, and was overcome by sadness that everything I've ever known was all going to change. I wanted to cancel the operation. 

But - I try to remember what one woman said. That when she got to the OR she was 'so excited she almost leapt up on the table'.

I have no doubt that we all go through "stages" of emotion, no matter what timeline we are on before this major surgery. My DIEP is a super duper delayed procedure, having previously gone the implant route unsuccessfully for many years. I have a surgeon who I am thrilled with, personality and skill-wise. But as my date gets closer, I find I am getting more emotional. Yesterday I had a true meltdown, tears and fears, that hit me completely unexpectedly. I am not scared of the surgery itself, but the day of surgery things like leaving my husband in the "holding area" and entering the OR itself, as well as the early days of post-surgery bring on the fears, tears and emotions like crazy. I think it would be unnatural not to appreciate the seriousness of such a procedure, and I would actually be more concerned if I wasn't getting some emotions and apprehension rising to the surface. I am in awe of the ladies who go through this complete bodyparts "reassignment" at the same time as dealing with their actual cancer diagnosis. 

I wish you could hit *like* on the posts - that was a good one, Seagan.

Wintersocks, many women notice after DIEP that their waist is less defined.  I think it's probably because as everything is pulled downward, the skin and fat from under the rib cage ends up at the waist.  This is why the NOLA docs are so generous with liposuction for us.  They are artists and their goal is the optimal female form even after the surgery.   One of the reasons I wanted to go to them was that I'd heard about how they make breasts that are conical in shape, more like Playboy bunny breasts rather than the flat hamburger bun breasts that so many women with reconstruction settle for.  My first surgeon gave me exactly that--flat hamburger buns.  I couldn't really even wear a bra because none of them have cups shaped like that.   I was a mess after my stage I DIEP and needed the best to fix up what had been done.  I got online, did a lot of research and all signs pointed to the NOLA docs as being the guys to go to when things go wrong.  I knew from previous medical malpractice I'd suffered that most doctors will not even touch a patient messed up by someone else, and that it requires the highest level of skill to do so, because they're not starting off with a clean slate.    I talked by phone to many women who'd gone to NOLA, and then attended a FORCE meeting in my city and saw their results in person.  I then knew NOLA was the place to go to repair what had been done to me.  I had several revision surgeries, and Dr. DellaCroce worked miracles for me.   He was willing to do everything I asked him for and then some.   After he worked on my front and got that all situated, I felt that my backside was out of proportion and he lipoed about half my butt off.  I was deliriously happy when I saw the result in the mirror, and insurance covered all of it.   The thing to remember about DIEP is that it's really not as invasive as you might think.  It only involves the superficial skin and fat layers--no intrusion into the abdominal cavity.  There's no as much pain as you would think because muscles are not cut.   I feel that it is such a GIFT to those of us needing reconstruction...but the key to a great result is to choose surgeons who do it day in and day out, who've done thousands, who are leading the way with innnovating the techniques utilized...and the NOLA docs invented the hip flap, invented the body lift method....they are nothing short of geniuses and had I realized that, I NEVER would have started my reconstruction anywhere else.  My journey was a long one because I didn't make the right choice of surgeon.    I went the university teaching hospital/chief of plastic surgery/locally recommened surgeon route and boy was I sorry when I started having complications and realized that he was not a top DIEP expert.  However, the meticulous and artistic revisions Dr. D did for me have made me very happy that I chose DIEP.  Any reconstruction requiring the use of muscle is outdated and compromises abdominal strength and quite possibly your posture as you age. 

sandyinsocal

Thank you for replying. I am in the UK so NOLA is not an option: although it does sound great. I am so pleased that you are so pleased with your results now. That's great to hear. 

martyj, I am pleased that you are also pleased with your diep. I do not have any kind of implants now, just an mx scar. 

I am just concerned that this is such a big op. I am not overly vain, but I do not want some kind of 'ledge' that is the fat that they don't use for the diep. I.E the fat higher up above the belly-button. I am about 11 stone and 5 7" so not huge.

I have to have another op before this for prolapse of womb and bowel. I just don't want to feel exhausted with questions to docs before I start the diep!  I would rather find out from women who have been through it.

I will be discussing it maybe August with my bs, such major surgery is tiring me out just thinking about it! 

Hi Wintersocks,

I actually had my hysterectomy and a prolapse repair during my stage II revisions because I didn't want to undergo anesthesia more than necessary.  Can you wait a few months to have those repairs done and possibly combine them with breast revisions?   

 I got to know a gal on the FORCE boards named Lorna who traveled from the UK to NOLA, and I met another woman from Switzerland who did the same....it really is possible in some cases!  In any case, make sure you go with the very best surgeon you can find, a free flap specialist who has done many of the same procedure.  This isn't a surgery to trust to a rookie.

I agree with Betsy.  I haven't seen anyone come out of DIEP with a ledge of fat above their incision in all the years since my first surgery.

Faith - I have two boys too, ages 9 and 12! My guess is Easter will be no problem -- by that point you'll be so ready for the surgery, and tired of preparing for it, that you'll be glad to focus on enjoying the holiday. The Easter Bunny can still come!

I have two boys too. I also have a daughter who is the youngest. When I was first diagnosed 9 years ago my boys were only 11 and 9 and they took it very hard. My daughter who was 7 didn't appear to be as affected. Diagnosed again this fall and though more mature and having been thru it, I still think that the boys are the more sensitive ones. My daughter is always more practical. Not that she isn't effected. It's just int eresting.

thx to bdavis for posting how to get access to the picture forum!

thx to sandyinsocal!   i think i'm going to print out what you wrote and read it to the PS i'm getting a second opinion from!  i love that you were able to have someone who cared enough about you to want to do all that for you and have insurance pay for it.....nothing out of your pocket.   what a blessing!   

again.....you ladies are amazing!   my 2nd opinion appt is coming up this thursday and i'm excited to get in there with my list of things to ask!   and asking what he did exactly during stage II was a great addition!   i want to know it all!  i wish i could go to NOLA as well but it's not in the cards for me.   this is why i need to make sure the PS i AM going to see here knows what he's doing.   i've heard good things but i'll be the judge of that!  lol!

Ally

TinaHoff, 

Welcome to breastcancer.org.  We are glad you will have foung this wonderfully supportive community to help you on your breast cancer journey.

Best wishes, 

(((The Mods)))

So girls here I am, after a bilateral mascectomy with diep reconstruction, home and recovering well. My homecare nurse just left and she was very impressed with my reconstruction. Some ladies said the stairs would be difficult but I am finding with a small house they are my only form of exercise. I am feeling great!! I realized that my decision was a drastic one but knew that because I couldn't do the lumpctomy with radiation and felt my emotional and physical strength was not able to deal with a more natural approach that the bilateral with recon was my option.  I don't believe in everything that traditional medicine offers , will look at traditional and natural medicine and always do my own research to come to my own decision. I am sure that in the long run my self esteem will be better because it was my decision and it looks better than what I had.  My breasts will have more symetry and I have a flatter tummy. Must watch my diet though or that tummy will come back. Tummy is sore but not too bad, can't wait to get drains out and not using any painkillers right now, the incision is nice and slim with dissolvable stiches. The more I am up and walking the better tummy feels but then the back gets sore so I get up and down and up and down. My breasts are swollen and bruised somewhat tender and they feel soft. I can raise my arms but have to remember to not overeach for things. Cheers to all of us finding our way through this thing called cancer!!!!

Geralyn -- thanks for the update!  Good to hear the great news!  Updates like these definitely help me calm some of my nerves and worries down (my surgery is coming up Friday).  The input and experiences on this thread really matter and help those like me who haven't done it yet...so thank you all very much for all of the info!

Geralyn & Moviemanic, glad you are both doing well.

I am 4 1/2 weeks out and am doing great too. I can stand 100% upright.  I can sleep 100% flat. I no longer take pain meds.  I am also walking the dog, walking the girls to school, going to the grocery store etc.   I am being gentle on myself when doing these activities, just in case I hurt something.

I've also ditched the shower chair and am fine standing up in the shower now.

I am continuing to cover my stiches with Micropore tape, and apply oil over the top to help with scarring. I have a 6 week follow up with the surgeon next week and want to ask how long I continue this, how long I have to wear a bra 24/7 ... and what's next?  When will the swelling go down a bit on my waist? It's not sore, just swollen.

I go back to work next Monday, and to be honest, I could have gone back yesterday but I figured I may as well rest up and ease back into things.