DIEP 2014

I'm scheduled for a left diep flap on Jan.20. I'm getting a little nervous because my dr. told me he may have to take a small amount of muscle and also might have to take out a small piece of rib. I've been reading these posts and haven't seen anyone mention this. I read about something called a diep II where they don't take any muscle at all. I am wondering if I should get a second opinion. I'm having a ct scan of the abdomen on Jan. 6. I don't have an appointment to see him again before the surgery. He did not even discuss size or show me any pics.  I am wondering if I should get a second opinion.

Beck... DIEP II is just a different way of doing DIEP, but both DIEP and DIEP II do not take muscle. If muscle is taken its called a TRAM or free TRAM. I agree that you need another opinion. Not discussing size or showing pictures would concern me. And as Marty said experience is very very important. This is a very technical operation in microsurgery, and your PS should be performing at least a few per month. Like a minimum of ten I would say.

I researched my ps thoroughly.  When I asked the # of dieps she does - she said about 150 per year.  I am happy with that amount.  It also took me 3 mos to get on her surgery schedule.  Hopefully she will be good! 

Taking the small section of rib on either side is very common, I had this done. 

A failure rate of 1-2% is common.  A flap can fail up to 2 weeks after surgery.  You are closely monitored in the hospital post op to ensure good blood flow.

You have to trust your PS and have them answer any and all questions that you may have.    I definitely discussed size with mine as I wanted mine reduced, having had large clunky breasts all my life...this was my opportunity to get something in return.

Ask your PS about how they handle revisions if you need them.  To fix dog ears if they happen and any other adjustments you may want done.  I was extremely lucky that I didnt end up with dog ears (they are an extra flap of skin that sometimes appear at the ends of the ab incision on either side or the sides of your breasts).

Michele

Maggie--I had Dr. Trahan!!  He did my stage 1 diep on Nov. 12th.  I really loved him! Very compassionate.  He really knows what he is doing.  If you are on the picture board, I posted my before and afters--same username

ALSO--can I be added for stage 2 on Feb. 10th at NOLA? Thanks!

Thanks to all of you ladies for all the info about this surgery. You have answered my questions and given me more things to think about. I will call my ps's office tomorrow.  I definitely need to meet with him again before my surgery. Then decide if I need a second op

Kasey, you look awesome.  Congrats!!!!  I know you must be very happy with your results.  How are you feeling?  And, how was your recovery?

jmb, a few woman came up with the idea of maternity pants (you can get them cheap at Target.  They have the soft panel that comes over your scar and they come up to your waist and then you just wear a cute long top and you are good to go. I think I am going to try that.  I forgot to ask my daughter in law if she had any left.  she had some really cute maternity jeans!!!  Also, soft yoga pants and sweats work well I hear.

I am having guilt about leaving my original surgeon.  Being half Jewish and half Italian,  this is a common phenomenon. I just have to keep reminded myself of all the mistakes he made, and that I am doing the right thing.  Even thought I like him as a person doesn't mean he is the right person to do my surgery.  I have a problem with thinking I might have hurt anybody's feelings. 

Yesterday was a very full day.  Did more than I have in one day in a long time.  I helped my BFF with her critically ill mom, (she is very demanding and needy), spent the evening the with the grandkids, and then stayed up way to late.  Today I slept in.  Took a long hot shower, actually did a full blow out and style on my hair, the I went back to bed for a nap...lol.  Oh, I did clean on bathroom. 

I hope you all had a great New Year.

Nihani, I will probably end up with the tram free one side.  I am not worried about it because you have given previous encouragement about that scenario. I have a friend who had one of the first tram flaps ever.  It was over 15 years ago.  She has no abdominal muscles, and then her flaps failed.  The whole thing was barbaric, but they had to start somewhere, unfortunately she was a guinea pig. She lived in LA at the time and it all happened at UCLA.  She now has no tummy muscles, but she did end up with saline implants and has lived with iron bra all these years.  She is the best.  So upbeat and optimistic all the time.  I am going to have her see my PS and see if she might consider GAP flap. It's time for her to replace the old implants, and how great would it be for her to get rid of iron bra after 15 years?!!!!!!!!!

I am having delayed, and the only reason it might be easier is the we will (did) not have our bmx's at the same time.  I think that cuts down on the upper body pain.  We had the pain already.  I had it to do all over again, and know what I know now, I probably would have opted to get it all over at one time, but since it is this way, I do think we are a bit of an advantage as far as not having upper body movement problems, and excessive pain.

Beck I would definitely get a second opinion.  You are so close to Cleveland Clinic.  Dr Djohan is well known for DIEP surgery.  He performs surgery at the main campus but would probably be able to see you at the Cleveland Clinic in Avon for appts.  I've heard nothing but good about their team at Cleveland Clinic which I'm sure jmb's surgeon is part of. Every doctor is going to be different but since you are so close I wouldn't go to any other hospital besides there or somewhere like NOLA where they are doing them everyday. I'm tentatively scheduled for a DIEP on the 29th of January at Cleveland Clinic.

Hi Maggie... It is completely normal to be nervous. You will feel very pampered in NOLA.. and I have heard great things about Dr Fuhrman. In the last year they have brought in (hand picked) breast surgeons from the local area. You will not be disappointed. It is also understandable to feel nervous about the after care. Who is going down with you? They insist you have someone with you for discharge. But once you come home, I think you will be self sufficient. I was doing everything for myself when I got home. Just plan now by moving things to a reachable location. Plan to have meals delivered or pre-cooked. Plan to have your home cleaned once a week... and don't be overly concerned about lifting arms. I could lift mine enough to get clothes on. Just didn't want to reach to top shelves for things. Have you checked out the NOLA in September thread?

Having two weeks in NOLA will be great. By the time you get home, you can drive yourself places and do most things short of lifting stuff... I will say plan to take your time with things. It used to take me an hour to shower. First, I got exhausted. So I would put a sock on and sit and rest. LOL... But seriously, showering was the hardest part of my day. It would take an hour with compression girdles and padding and drains... But it was fine. Where are you staying in NOLA?

They have re-done it since I was there... Be sure to request a hospital bed. They don't have them in every room.

goldie4040,

I weigh 150lbs. and I am 5'6". I am having both breasts done.I really am nervous about the DIEP surgery and the recovery process. I have TMJ in my jaw and I'm not sure how badly that will be affected by a 12 hour surgery. Never gave it a thought for the first surgery. That was about 4 hours. I didn't understand why my jaw hurt so bad the next couple of days, then it dawned on me about the TMJ! I don't want to have the "rocks" either. I still have the expanders and I really don't like how they feel either. I meet with my PS in February. I want to finish the school year before doing any other surgery anyway. I am on the schedule for surgery July 7th. The procedure itself has yet to be decided. I think I am leaning toward the DIEP though.

Acure, like Betsy said, 12 hours is more like a mx and diep at the same time, but just the diep should be around 5 to 6 hours tops if your doc works as a team, which most do.  

Don't worry too much about your TMJ.  I had a bronchscopy a  few months ago and my jaw hurt for weeks, but nothing permanent.  Just temporary soreness from them prying my mouth open for a period of time.  This too shall pass.  I get more worried about my shoulder from having my arm over my head for so long.  I am going to ask them to move it around once in a while this time.  

I feel you about the expanders.  You are a trooper to wait till summer, but sometimes we have to do what we have to do.  We are here for you anytime.  Just stop in.  BTW....I don't know how your weight is distrisbuted, so I can't speak to if you have enough belly at 150 pounds and 5'6", or not.  You need to go over that with your doc.  Also, what are your expectations for the size of your new breasts vs how much belly do you have, etc. 

4acure -

I am 5' 8 1/2" and about 148.  I am a C cup in my natural breast.  My ps said that she can give me a B cup, not a C.  I do not have enough fat for a C.  I think some of it has to do with how much was taken with the mastectomy.  My bs was pretty aggressive and took a lot out with the mx, since my cancer was aggressive.  

So, she will reduce and lift the natural side - making it a B cup to match.  I am happy with that - not a big deal for me in the scheme of things.