DIEP 2013

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  • Morningsun1
    Morningsun1 Member Posts: 649
    edited March 2013

    kuka21, I had bilateral nipple sparing mastectomy with immediate DIEP recon surgery on January 28, 2013. I did not have a smooth recovery due to the ab-incision reopening. It basically pushed my recovery back by two weeks. With the complications, I was back to to work after 6 weeks. My ps was able to produce two very nice looking breasts in this one surgery, so my next surgery will most likely be mainly for the smoothing out of the ab-incision line. I have not discussed it with my ps yet, but I imaging that it can easily be pushed back to whenever I am ready for it. Each ps has his/her way of approaching it. Some insist on moving the tissue as the first surgery and shaping the breast as the second surgery even for prophylactic MX as yourself (and my rightie) or stage 0 DCIS like my rightie. My ps did everything in one 11 hour surgery. It would have been less than 10 hour had it not been for the difficulty in finding good blood supply vessels for my leftie. The one step approach suited me perfectly. Hope this helps.

  • emilyj67
    emilyj67 Member Posts: 21
    edited March 2013

    Oh! I meant to ask -- I am not allowed to wear a bra until 6 weeks out, but I have a fancy work event at 4 weeks (in one week). Has anyone found a one-boob stick-on or other option? Help! :)

  • kuka21174923
    kuka21174923 Member Posts: 427
    edited March 2013

    TammyT, what did your surgeon say about leaving your nipples in? I've read you only increase your risk of breast cancer by 1%. Is this true? I go talk to my ps on Wednesday and just want to have all of the questions I should ask him about. If you don't mind me asking, what size was your plastic surgeon able to do from the DIEP? And what do you mean by a second surgery to smooth out the scar from your belly? What do they do to be able to smooth it out? I always get very anxious before surgeries and start having really bad anxiety, so I'm just trying to figure out if I can just have one surgery and put all this behind me. I just started a protein diet 4 weeks ago, before I found out that I was going to have a DIEP. Now I'm worried about how much fat I need to have and maybe I need to start eating carbs and sugar. But then I read that the plastic surgeons like for woman to have a BMI of 25 or less for this surgery. Mine is 24.7. I'm not skinny by all means, but not obese either. My height is 5.4 and weight 146. This is the biggest I've ever been and now I think maybe God had a plan for me all along and that's why I got this big.

    I'm sorry you had complications with your an incision and wishing you the best from now on!

  • MartyJ
    MartyJ Member Posts: 1,859
    edited March 2013

    Kuka - it really might help you to get on some Zoloft to help reduce the anxiety levels.  It really helps.  Promise.

    sbelizabeth - My cardiologist is double board certified in cardio and integrative health.  He suggested I add the following before my next surgery to help with skin healing:  15 mg Zinc w/ 2 mg Copper; 1000 Vit. C; turmeric and green tea extract.  My PS had me stop the turmeric and tea 1 month before surgery.  

    Kuka - My bmi was about 26.  My doc assured me I would have plenty available for DIEP.  At this point, I am a large B or small C.  Not sure where I will end up.  My original equipment was a 32DD.  Having smaller boobs can take 10 pounds off visually.  Do not start eating sugar and carbs, you will be fine.  High protein, good carbs from fresh fruit and veggies, good fats.  When I am behaving fairly well, I tend to lose about 1/2 to 1 lb a week.  I can live with that!  If I eat white carbs, I bloat.  I am also very sensitive to sodium as many chefs use way too much.  

  • Cuetang
    Cuetang Member Posts: 575
    edited March 2013

    kuka21--I too had a nipple sparing and skin sparing bilateral mastectomy.  I asked my breast surgeon several questions about the risk of leaving my nipples in, and he also gave me about a 1-2% additional risk by leaving it in.  However, he said my tumor was far enough from the nipple for me not to worry too much about it.  Both he and my PS said that for younger women, they liked to encourage the nipple sparing and skin sparing if they were confident that it didn't need to be removed.  You'd be amazed at what they can remove to make your breasts, as long as you have a skilled surgeon that can do it.  You should ask your PS what size he thinks he can make for you.  The surgery is not nearly as bad as I thought it would be.  I'm about 3 weeks out, and I'm walking fairly upright, driving, going out to run errands, and so forth.  I think I could go back to work now, but I'm giving myself time to make sure I don't overdo things and don't feel like dealing with work stress just yet.  I don't have kids, so can't comment on that part, but I'm also being careful not to lift things that I don't think I should be lifting.  I was a B cup prior to surgery, and now that I'm allowed to wear bras again, oddly enough I find that I fit pretty well back in my old bra (lucky me).  I would also suggest seeing if you can get some anti-anxiety meds (I used some before surgery too) to help relax you some. 

  • kuka21174923
    kuka21174923 Member Posts: 427
    edited March 2013

    MartyJ, thanks for sharing! It helps me knowing other women's real stories ending up in success. I guess because my mom's process hasn't been very successful. She had the expanders and then implants. She's had contracture for quiet some time, but she's too weak for the surgery she will need to take the implants out. She's in pain a lot, but decided to keep her implants as long as she can handle the pain due to the risks of the surgery.

    I've always had a sweet tooth, but since I started this diet I don't really crave sweets and I've been doing really good! My weigh always goes to my belly and my boobs, so that's why I was asking about quitting the diet. I've also been taking Paxil and Xanax for some time. But I tend to over think things a lot, and I don't like change. That's my biggest problems. It takes me a while to get used to new things, unless it changes very slowly, which this will not be. All the reassurance I read here helps me so much to calm my nerves, so I really appreciate all of the input I get.

  • kuka21174923
    kuka21174923 Member Posts: 427
    edited March 2013

    Cutetang, thank you for sharing your story. When leaving your nipple and aureola, where do they do the incision? I didn't even talk of that possibility with my bs because I thought I had to have my nipple removed as well. But the more I think about the more sense it make to leave it. Do you also need to go back for stage 2 surgery or was your ps able to do it all in one surgery?

    One more thing I haven't asked is insurance. Does health insurance cover all of this? My plan is not very good this year. I have a 80-20 until I meet the family deductible, which is like $9,000. After that I believe I'm covered at 100%. I'm not sure if the reconstruction part is covered or not, and if you need more procedures done later on if is also included. I would think that health insurance would want to cover this type of procedures, since ultimately you're saving them a lot of money!

  • Cuetang
    Cuetang Member Posts: 575
    edited March 2013

    kuka21-- my incision is vertical line from the bottom of my nipple downwards.  I have small "paddles" in the spot underneath my nipples, and it looks kind of awkward right now, but the way the PS explained it was that he had to put some paddles in for the dopplar readings to ensure that the flaps were viable.  Yes, I will need a Stage 2 where he removes the paddles and sew the skin together so there will be just a "line" going down from the nipple.  Unfortunately, I do have some mini-dog ears that he will remove as well. My Stage 1 surgery was about 12 hours, but my PS already gave me the heads up that he doesn't do everything in one stage, and his focus this time was to ensure that the flaps were viable and that cosmetic tweaks would be for later.  As for insurance, I would suggest asking to see what is covered and what is not, since even the same insurance company can have multiple flavors and types of coverage.  I had a nurse navigator with my insurance company that explained my coverage to me.  My PS was out-of-network, so I had to go through some pretty crummy hoops to get him approved to do my surgery.  I jumped through all the hoops because I felt strongly that the PS I had had the experience and qualifications to work on me (and spoke to a few BCO members that used him for DIEP in the past about their experiences as well).  Good luck!

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

    Kuka... I had DIEP and GAP flap and was back at work at 8 weeks... Had I only had one of these I would have felt good at about 4 weeks... So I would say 8 weeks is the outer limit for stage I... But stage II is much less invasive and you will feel almost normal one week post op... But docs will ask you to not lift more than 10 pounds for 6 weeks. That is probably the biggest challenge. About scars, they fade. I just had another revision, but before that it had been 14 months since my stage II, and my scars were nearly invisable. About nipples, I spared one and had one taken... Whatever you do, I would just do the same on both sides.

    My biggest suggestion is to go to a very experienced microsurgeon, a doctor who does DIEP a few times a week. And I would ask to see pictures and perhaps even meet with former patients who might show you results. I met a woman locally and let her see and touch mine. She was very happy to have the opportunity for this. If your doctor can't give you names or show you pictures, I would look elsewhere. IMO.

    This is nearly as bad as you might think, and having two surgeries for this is a drop in the bucket compred to a cancer diagnosis... really.

  • Morningsun1
    Morningsun1 Member Posts: 649
    edited March 2013

    Had a nice long walk in the park with dh in the afternoon. Such a beautiful day.

    kuka21, your ps will be able to tell you what cup size he/she can achieve for you. If you want, i can pm you. I believe they can pretty much do anything you desire, if you give them enough freedom to work on you. There are other donor sites beside you ab where tissues can be harvested. cuetang is correct about the percentage. My breast incisions are on the folds so even now they are not obvious. Once the color fades, you won't be able to see them at all. I don't know what my ps will do exactly, but he said that he will be able to make my ab-incision looks like the incision lines on my breasts which are very smooth. I'm very lucky these great docs, both my bs and ps, are in-network docs so there is no insurance issue for me.

  • kuka21174923
    kuka21174923 Member Posts: 427
    edited March 2013

    What type of undergarment should I get so that it won't hurt my incisions? What was easier for you to wear after the DIEP? I was thinking 100%cotton hipsters underware and not sure what I would do for the top. Do they provide you with any of it after surgery? What about clothing? What was easier? I'm a stay at home mom, so I don't need to look fancy, just want to be comfy while I recover😄.

    I'm very glad I found this board and read about everyone's journeys. It has eased my mind tremendously, and for the first time I'm feeling ok about doing this to my body. I'm luckier than my mom and get to do something to prevent having to go through what she went through. So I'm starting to look at the positives instead of the negatives. Thank you so much ladies!

    I will keep you updated about my MRI and my ps visit next week.

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

    Kuka.. All PSs are different. Some have you wear compression and give it to you and others don't. Some have you wear a surgical bra and give it to you and others do not. So you need to ask your doctor's office. I wore loose tops and bought lounge pants at Target (Gilligan and O'malley) Full legs and soft elastic waist. Very comfy. I bought higher cut undies in a size or two larger, so it didn't sit on the hips. I wore these over the compression garment as they are crotchless. Some women go commando.

  • PinkHeart
    PinkHeart Member Posts: 1,193
    edited March 2013

    Betsy,

    just got discharged from hospital today and have on my Target G & O lounge pants right now. First thing i went to in my suitcase!

  • MartyJ
    MartyJ Member Posts: 1,859
    edited March 2013

    I am wearing my G O lounge jacket, pants and a tank to the hospital for my stage 2.  That way I have them to wear home.  Looking right spiffy with sunglasses to cover the mascaraless eyes.  6 more days.

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

    When I put mine on after stage IIb, with a flowy sweater, my daughter commented that I was pretty stylish for a patient. Love those pants!!

  • sbelizabeth
    sbelizabeth Member Posts: 2,889
    edited March 2013

    What a great tip!  Target G&O pants.  I wondered what I was going to wear.

    MartyJ, when I was bald as an egg from chemo, the time I saved every morning NOT doing my hair, I spent learning how to put on eye make-up.  First time ever I wore eyeliner, and I've since become pretty good at it.  

    Bald, with no eyelashes or eyebrows (and none drawn on!), I looked like a fat, white, alien.  

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

    I felt like Uncle Fester

  • PinkHeart
    PinkHeart Member Posts: 1,193
    edited March 2013

    LOL, took me a minute though...

  • faith729
    faith729 Member Posts: 244
    edited March 2013

    Kuka I feel the same ! I get the omg I'm jealous I wish I could get a tummy tuck and boob job reaction all the time and many other similar comments also. I still don't know how to react to that since clearly I wouldn't just want to do this without breast cancer as deciding factor..



    Anyway ladies tomorrow is the big day ready as I'll ever be I guess.

  • nihahi
    nihahi Member Posts: 3,841
    edited March 2013

    Faith....you are in my thoughts....all will go well, and you'll be one of the "veterans" I can get support and words of wisdom from when it's my turn. 

    I certainly don't use it very often, but I have found the "perfect response" to the occassional people who seem to freely offer repeated inappropriate or unwanted comments about how envious they are about the boob lift, tummy tuck scenario. My response (again, to the few who REALLY just don't get it) is: "I really just need a breast transplant, so, thanks, it's so great of you to donate your breast, and since I only need one, you'd still have one left.....", they then seem to get the point of the whole journey!

    Thinking of everyone today - (((((x)))))

  • sbelizabeth
    sbelizabeth Member Posts: 2,889
    edited March 2013

    Faith, I know those fetching hospital gowns have no pockets, but if they did, we'd all be in yours tomorrow.  You'll be in our thoughts and prayers tomorrow morning, when you have a long nap and then wake up to your new model.  

    I'm right behind you...two weeks to go...

  • Morningsun1
    Morningsun1 Member Posts: 649
    edited March 2013

    Good luck tomorrow, faith. See you on the other side.

  • Cuetang
    Cuetang Member Posts: 575
    edited March 2013

    Thinking of you for tomorrow Faith!  Laughing

  • Cherrie
    Cherrie Member Posts: 1,423
    edited March 2013

    Sending healing hugs your way Faith. You will do wonderful. 😷

  • MartyJ
    MartyJ Member Posts: 1,859
    edited March 2013

    Faith - thinking about you. Sleep easy!

  • seagan
    seagan Member Posts: 166
    edited April 2013

    Go Faith go! Like sbelizabeth said so well: We'll all be in your pocket, cheering you on & holding you in our hearts. Wishing you the best!

  • nihahi
    nihahi Member Posts: 3,841
    edited April 2013

    Seagan, good to hear from you....how are things going for you?

  • seagan
    seagan Member Posts: 166
    edited April 2013

    Hi, Nihahi and all! I'm doing well, thank you for asking! At just about the 6-week mark, I'm feeling pretty good. I still get tired in the late afternoons, and I still feel tight and sometimes a bit sore when I get up after sitting for long periods, but for the most part I'm able to live fairly "normally" (whatever that is!) now. I'm not quite full time at work yet, but have been gradually increasing my hours and expect to be full time by next week. I can wear most of my usual clothes and move around OK. Sleep is still not great, though, as my back still doesn't like my sleeping in anything but a "V" position still.

    Tomorrow I see my surgeon, the first time since he pulled my drains the week after surgery, and I'm hoping he'll say I can resume more intense exercise and lifting beyond 5 pounds (amazing what a limitation that is, especially with two young boys and a dog running around!). I expect we'll also talk about a Stage 2 surgery - what he calls "revisions" - which at this point I'm a bit conflicted about, though I think my hesitation is largely from Stage 1 still being so fresh...I'm just not into the idea of getting still more surgery. On the other hand, one side is looking a bit different from the other and has a bit of a crease or something...I wonder if this is what folks mean by a dog ear? Though it's not excess skin or anything, more just like the incision on the bottom of the breast comes in above a sort of fold of fat. Agh, I can't describe it. And there's also the issue of the smallness of my new girls, smaller than I was but still cute and maybe enough? I just don't know. 

    Anyway, I'll see what he has to say and maybe just give it more time. I know many women get Stage 2 at the three-month mark, but I'm inclined to wait longer anyway. I still feel raw! And really, for the most part, things look good, once you get past the Frankenboob aspects - and certainly fine under clothes. I can't believe it, actually. And I love not having to wear a bra, btw!! In that sense, small has been beautiful!

    Someone asked how common Stage 2 surgeries are. My PS claims to only have to do them in about 20-30% of his cases, but it sure seems more common than that on these boards. We'll see what he says in my case.

    Sorry I haven't been more active in the discussions! I look forward to having a bit more energy at the end of each day to read and contribute. I so appreciate you all. And a very warm welcome to the new gals!!

  • nihahi
    nihahi Member Posts: 3,841
    edited April 2013

    Faith......just can't stop thinking of you...your pants must be falling off, there are so many of us in your pockets right now. This time tomorrow, you'll be well into "the other side". Wish I could just reach out and give you a huge hug ((((x)))) !

    Seagan....my gosh, girl, no apologies needed for not posting much! Sounds like you're doing so well, but also sounds like you're still healing. I haven't gotten to where you are now yet, but I imagine it takes more energy than you realize to get through a day, with working AND a young family. Your mind likely tells you that things "should be better by now", but your body is still doing the job of adjusting, healing and strengthening. I doubt if I'd be jumping at the thought of another surgery soon so either, so give yourself the time you need to be ready for it. Just the reality of still not getting restful sleep has got to be hard too. Hope your PS has some thoughts on how to help you with that. Be proud of how far you've come. 

  • kuka21174923
    kuka21174923 Member Posts: 427
    edited April 2013

    Good luck tomorrow faith!!

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