DIEP flap belly shape

Thanks to "So Hard Being Me" for reviving this thread (is it really that difficult? Your picture looks cute). Maybe that's the name of a pop song and I'm just too old to get it...

I've been complaining that my entire wardrobe was dependent upon having the 'muffin top' to hold up the pants! One friend suggested suspenders. I find drawstrings work the best. Even belts tend to shift/gap over the flat expanse. This is part of the reason I'm still on leave from my job=nothing to wear.

My surgeon showed lots of pictures of the top but not the belly. I did not use binders. Two months since my big operation and the next procedures are waiting until after chemo. Tightness & abdominal numbness still present although seems to be less than some weeks ago. Couple of little dog ears on the sides, not too bad.

I had DIEP done last February.  My only non-boob request was about my pelvic pouch.  You know, the one you get when you are in your 60's.  My ps did a great job on the tummy.  It is as flat as I could possibly want it.  the pouch disappeared entirely at first, but is now slowly creeping downward again.

I have 2 pouches on either side of the scar which the ps is unwilling to do anything about.  He said to lose weight!  I was rippin'.  Before the recon, his nurse told me not to worry, that he would continue to take care of all the problems that might creep up.  And my insurance told me that they would pay for anything that was created by the surgery.  (I.e., did not exist prior to the surgery.)  So I don't know what his problem is.  I have stage 2 set for this month, but I just booked another appt with him to be sure we were on the same page.  If not, I am going elsewhere! 

So Ladies, check with your insurance companies before you take no for an answer.

And about the bloating....

Nothing until 2 1/2 months after the surgery.  Now, wothout any reason why, my belly blows up from my sternum to the scar.  I look 6 months preganant.  There is no pain.  Sometimes it goes a way after an hour, sometimes it lasts for days.  The ps says it is fluid and to put "the belt" back on.  But I find that has no impact on the condition.

i would love to know whether anyone else has the pregnant look.

BJB1

Pinksea, possibly if you plan to lose a lot of weight or if you aren't completely healed.  Otherwise, I don't see any advantage to waiting longer.  If all of the swelling is gone by four weeks out, I think that would be very unusual.   Asking about contouring after stage I would be a really good idea when you are interviewing surgeons.  There is a lot of variation in what the docs are willing to do for us.  I figured that as long as my insurance was willing to keep paying and Dr DellaCroce was willing to honor my requests, I would pursue the very best result possible.  In fact, I noticed that I can pinch a bit more fat on one side of my waist than the other, and asked the other day about a little more lipo to fix that, and he said no problem!  I have scoliosis and am somewhat crooked to begin with, so I would like to appear to be more symmetrical through the waist area.  When the fat harvested during lipo is used for grafting (adding fullness, filling hollows, etc), it can be billed so that insurance covers it as part of reconstruction.  I would encourage all women to go to a surgeon who aims to please, even if that means a couple of revisions or more.  Having the lipo resculpting after DIEP is really important so that you don't end up with a boxy waist and pants that don't stay up.

I am 7 months after DIEP and my tummy never went down, numb and bloated.  I had revision 1 about 2 months ago and still need another breast revision.  Problem now, I have developed a stomach bulge, not hernia, but bulge.   I could lose some weight, but it is hard - my walking for exercise ended abruptly due to knee problems (need a knee replacement).  PS says there is not much that can be done for the bulge; I'll see him on July 15 again.  I did get a second opinion from a general surgeon who said there is NOTHING that can be done for a bulge.  It actually hurts at certain times.  Yes, and my pants fall down too.  When I tell my PS about that, he didn't say others had the same issue, but now I know different.  I wonder if lipo would help the bulge.

@Sandyinparadise.  I did get a second opinion and he agreed it was a bulge, not a hernia.  I see the PS next Fri.  He said he could do something about it, but didn't say what.  He also said he could not guarantee anything.

Hi,   Thank you for sharing your experience.   I have an 11 year old saline  implant that is uncomfortable. - tight and mis-shaped I was thinking of an ELECTIVE DIEP Flap.   Are you satisfied with your long term result from your DEIP Flap?  I am wondering if I am making the right decision.  Thanks

Sue

Failed DIEP last September.....just had revision surgery done on abdomin three weeks ago. I had the buldge and a lot of pain and tons of fluid along with the tightness below the incision. They thought it was a hernia turns out it was necrosis along with a muslce tear. The pain is gone,  buldge is almost gone and while I no longer have a belly button I have plenty of skin above and below the incision line now.  Huge Relief.  I was told by PS that the buldge swelling is a result of the lymph system getting itself back in working order and can take a year or two to get back to normal.

Hi. This is Morgaine. I actually had my DIEP in late 2007 for left breast. Since that time, my waist has gotten thicker. It really annoys me. I was short waisted before but now I look like a box. And I'm pretty much skinny except for my waist. I have the dog ears that make my waist look fat from the back. What can i do now about it? I'm actually getting a mastectom and reconstruction for my right breast. 

Is there anyone on this site that can direct me to a diep ps in southern cali... a good one of cours Help !!! 

So I understand the feeling of the pants rolling down.  It's not really the tummy area but how far it goes in under the belly button.  Causes its own pooch.  The area under the skin in hard, I can feel the muscle under there so it is not fat.  It looks strange and I an always wearing a very tight belt to keep my pants up!

On March 27-13 I had a DIEP flap but it failed. In July I will be having phase 2 please tell me that my implants want be all under my arms and I will get some lipo and some in my tummy because my tummy is not flat at all pants falls down when they want to please tell me I will get some kind of lipo she keeps telling me I will look a lot better in my clothes well I look a hot mess right now I don't want to go to work because my expanders are not the same in size

First pic is 9/25/14 - 2 days after stage two. And second pic is day before stage one 4/09/14. . Hello lovelies. I have a ? I just found out that my upper stomach was not liposuction during stage 2 9/23/14 because my insurance didn't pay for it and also I had previous hernia repair during stage 1. Lower abdomen was liposuction and and more tummy tucked. Does this make sense? Did anyone encounter such a situation before? Any suggestions?

Edited by Mods to remove photos. Please remember that posting pictures is not recommended. You
are encouraged to seek advice from a medical professional in the event
of any concerns.

I too have had phase one of a bilateral DIEP flap surgery (after having had reconstruction with teardrop shaped cohesive gel implants which ultimately made me sick after 4 years. They had to be removed on a rather urgent basis as I developed an acute massive seroma in right breast accompanied by dramatic night sweats/fevers. But that's a topic for another thread altogether!).

After my recent phase one of DIEP surgery (November 6, 2017) I was thrilled to see my lower abdomen was so reduced in size! However I quickly discovered that my new physique posed a problem with my pants staying up. My belly above the abdominal incision is still larger and projects out further than my lower belly. When I wear pants that fit on the larger part of my belly, they quickly ride down, no matter how snug I make them with drawstring or a belt. Once they get to the lower, smaller part of my lower abdomen, they literally fall down to my crotch. If I wear smaller waisted pants that fit around the smaller part of my belly, it just feels unnatural and uncomfortable. (Think a man with a small waist but a big "beer gut" above his waistband). That's kind of how I feel. Yuck. It's an exaggeration, but it is the best way I can express my situation.

I am a daily "power walker". I walk 2.5 miles daily with trekking poles. It is a real nuisance having to hoist the elastic waistband of my nylon wind pants up REPEATEDLY throughout my workout. Especially now, in winter, when I am so layered up wearing under armour, cardigan, jacket, gloves. It's a pain having to find somewhere to rest my trekking poles to free up my hands to reach up under my jacket and cardigan to locate the waistband of my pants, with gloves on, to hitch them up like twenty times during a walk. No matter that they fit correctly AND have a drawstring that I tie snugly, they just ride down incessantly.

I don't want to sound ungrateful, I am thrilled that my lower abdomen is so much smaller now but my clothing dilemma is so frustrating. My husband keeps telling me to get suspenders. I keep telling him if he suggests that one more time I'm going to strangle him with suspenders! Lol! He's right, suspenders WOULD address the problem, just like it does for those men with the big beer guts, but really?! I have no intention of resorting to that!

I did tell my plastic surgeon about my pants falling down and he said he can take care of some of the problem with the phase 2 surgery, but not entirely. I lost 22 pounds pre operatively, attempting to be at my best for such a challenging surgery. I am continuing to TRY dropping weight post operatively now, but without much success. I seem to have plateaued. I'll continue trying though. Could it be that this might be a case of truncal edema I've read about? It's as if there's a whole pants size difference between my upper and lower belly.

In any regard, I'm interested in hearing about anyone else out there with a similar "falling down pants" issue following DIEP surgery. How do you deal with it? Was your plastic surgeon able to address it in phase 2? Can it be lipo-contoured into a more gradual transition from upper to lower belly? Am I destined to a life of constantly having to hoist up my pants?

PS: This is kind of personal, but related. Another result of my DIEP surgery is that it my pubic area seems to have gotten lifted up higher. The pubic hairline sits right below my abdominal incision. So when I say that my pants feel like they are falling down to my crotch, it's really not an exaggeration.

PPS: I notice that most of the posts in this thread are several years old, why is that? Hasn't anybody besides me had this problem recently?

I'd be so appreciative to hear from anybody out there with a similar issue. I'm ESPECIALLY interested in hearing if phase 2 surgery improved the issue. Thanks so much.

I'm seeing your post from 2008, but it's 2017 now and I don't see any recent responses. Wondering if this thread is still viable?

When you have questions regarding Diep or Tram-free reconstruction, the current dedicated thread...like Diep 2017 will be the most active, most informative and most supportive source for you. I'm sure you will find a warm welcome there.