DIEP 2014

Options
14142444647227

Comments

  • goldie4040
    goldie4040 Member Posts: 2,280
    edited February 2014

    Options for improving the appearance of scars include the following:

    • Steroid Injection – Steroid injections are often used to treat hypertrophic scars and keloid scars.  With a series of steroid injections, the inflamed raised scar should flatten out and become less inflamed and less irritated.  Although steroid injections may be used alone, combining steroid injection with laser treatment enhances scar treatment.
    • Vbeam Laser  – The Vbeam laser is an excellent choice for hypertrophic scars and keloids.  In research studies, there has been significant improvement in scar redness and in reduction of bulk following Vbeam laser treatment.  Generally, after three or four treatments, the scars are flatter and less red.  The Vbeam laser procedure is very well tolerated, with patients only feeling a mild snapping sensation.  There is no downtime after a Vbeam laser treatment.
    • Fraxel Lasers – The two Fraxel lasers will improve all types of scars and they are the most commonly used lasers to improve the appearance of scars.  The most common scars treated with the Fraxel lasers are atrophic acne scars and surgical scars.  However, even traumatic scars resulting from injury to the skin can be improved with the Fraxel lasers.  Often, Fraxel laser treatment is combined with steroid injection to provide optimum improvement of the scar.

      Patients undergoing Fraxel laser treatment of scars may choose between traditional Fraxel laser treatment and Fraxel Repair laser treatment.  With traditional Fraxel laser treatment, patients undergo a series of 4 or 5 Fraxel laser procedures at monthly intervals, with no downtime, to improve the scar.  The improvement in the scar results from the new collagen that is formed as a result of the laser treatment. This procedure is FDA approved for the treatment of acne scars and surgical scars, and it will also improve all other types of scars as well.

      With Fraxel Repair laser treatment, patients generally need only one or two treatments; however, depending on the size of the treated area, there may be a few days of downtime with Fraxel Repair laser treatment.   The improvement in the scars following treatment with the Fraxel Repair laser results from immediate shrinkage of the scar tissue followed by new collagen growth.  Like the traditional Fraxel laser, the Fraxel Repair will improve all types of scars, including acne scars, surgical scars, keloid scars, and atrophic scars.
    • Surgical Scar Revision – Occasionally, a scar that healed poorly needs to be surgically removed and stitched using very precise and careful surgical technique.  In properly selected patients, this will result in a much-improved scar.  However, surgical scar revision is only rarely necessary, and nearly all patients can have their scars improved without surgery, using lasers and steroid injections.
  • jmb5
    jmb5 Member Posts: 532
    edited February 2014

    jazlaumir, congrats! Glad you're doing well. 

    I know everyone is different, but approximately how long can I expect the abdomen swelling to last? Like Donna, I am swollen in the abdomen, but don't notice swelling in the breasts. Went to church for the second time today and am limited to yoga pants. How depressing. I tried on a pair of pants that used to be a little big in the waist, thinking maybe they'd fit. They were too tight. I don't want to spend money on clothes I won't be able to wear later, but I hate having such a limited wardrobe. Five weeks until we go to Florida and I'm afraid none of my shorts will fit. Jeans are probably the true test. How long until you were back in jeans?

  • Sharon1942
    Sharon1942 Member Posts: 272
    edited February 2014

    Gosh, Goldie, I'm just glad my 2 IPL laser treatments lightened my scar's redness.  Now that he has had her tattoo all around them for skin color, I wonder how they are going to end up looking?  I'm his guinea pig on this. 

  • nihahi
    nihahi Member Posts: 3,841
    edited February 2014

    jmb.....The tummy swelling can be an up and down thing. Just when you feel it is starting to be less of an issue, it may surprise you and return. Often related to getting back to being more active. Very, very frustrating, but, part of the healing process. Are you wearing any kind of support garment? If not, check with your PS, and if you get the ok, maybe try that. Also, ask if it's ok for you to be massaging your abd area, as that will help move fluid too. Are you sitting alot??? Being bent at the hip doesn't help the drainage/circulation in the tummy area. Hang in there.

  • nihahi
    nihahi Member Posts: 3,841
    edited February 2014

    sharon....I bet you're looking great! Has the nipple/areola tattoo faded at all?

  • goldie4040
    goldie4040 Member Posts: 2,280
    edited February 2014

    Sharon, do you like the way the tattooing looks?  The scabbing should be gone, right?

  • Sharon1942
    Sharon1942 Member Posts: 272
    edited February 2014

    Nihahi, I got a tattoo touch last week  & they also tattooed my natural nipple to give them the same color.   First he deadened it with lidocaine. Ouch!  Both are darker right now, but should fade just fine. I had an area in my cleavage that was part of the stark white tummy flap, which showed in a swim suit or low cut top. So, they experimented with tattooing that area with color to match my chest - the color was "Princess" - lol! That part still needs to fade & it will. PS offices use medical grade vegetable tattoo ink because they don't want to use the lead based. They do probably fade more, but that's okay. 

  • Sharon1942
    Sharon1942 Member Posts: 272
    edited February 2014

    Goldie, I had practically no scabbing & we are just waiting for the color to fade. She rubbed a couple of colors on my flap cleavage with her finger (looked just like makeup) & we chose a color to match my chest - "Princess" - ha, I need to get me a tiara!  

  • goldie4040
    goldie4040 Member Posts: 2,280
    edited February 2014

    LOL, Sharon.  Maybe, your boob should wear the tiara.  Now, that would be something.  Hehehehehe

  • MartyJ
    MartyJ Member Posts: 1,859
    edited February 2014

    I had laser on my 13 year old incisions and it worked very well - reduced the pinkness, smoothed them. Definitely looked better.

    Donna - you will have abdominal swelling for many months - it won't be constant, but it will come and go.  You are only 4 weeks out so give yourself plenty of time to heal both inside and out.  Re the Ativan - that is a fast acting med, but I sure wouldn't want to drive or do anything else when taking it.  I have to take it to have an MRI.  If you have anxiety issues by all means try the lifestyle stress reduction, but know that some people are predisposed to having anxiety issues.  There are other meds (like Zoloft) that will help a lot. 

  • goldie4040
    goldie4040 Member Posts: 2,280
    edited February 2014

    Sharon, a few minutes of topless sunbathing every once in a while might have solved the problem without any tattooing....just saying. LOL.  Imagine if you tried to do it in your backyard.  LMAOOOOOO

  • Sharon1942
    Sharon1942 Member Posts: 272
    edited February 2014

    Marty, what type of laser did you have?  

    Goldie, I already know I can use sunless tanner if need be instead of nude sunbathing. I think you're supposed to keep scars out of the sun or they get darker.  Now, I could get some of those press on rhinestones for along my scar line - ha!

  • Jeannie57
    Jeannie57 Member Posts: 2,144
    edited February 2014

    I'm not a wild woman or anything but when we lived in So.Cal.with a pool, before bc of course, I enjoyed topless sunbathing for a little while in our very private backyard.....others have been known to go topless in the moonlight.....I don't even know why I am sharing this! Goldie, you started it, lol!

  • Donna2012
    Donna2012 Member Posts: 201
    edited February 2014

    re: ativan....  I just took my bottle of ativan & cut every pill in 1/2.  Whenever I feel the need to take 1 (usually 1x each day), I will just take 1/2 for awhile.  As I said, I never took or needed anxiety meds before bc!  I understand about the lifestyle change suggestions, to reduce stress - and I totally agree.  The problem is the 2 things that help me reduce stress are exercise & bubble baths (complete with candles & music), and I can't do either for another 2 weeks.  So until then, I will just work on taking 1/2 a pill instead of a whole.  Also not being as active, while I recover, gives my mind plenty of time to go to the dark places!  Once I can do more and am busier I think it will help.  

  • MartyJ
    MartyJ Member Posts: 1,859
    edited February 2014

    I believe it was the V-Beam laser.  The initial study that I read recommended a Pulse Dye Laser.  I went to my dermatologist and she said 3 - 5 treatments, several weeks apart might help, but since it was an old scar it might not work.  Worked!

  • goldie4040
    goldie4040 Member Posts: 2,280
    edited February 2014

    LOL, Jeannie.  I love it!!!!!  Ah, to be young again. 

    Marty, the Vbeam laser is a miracle laser, and the head of the dermatology dept at UTSW said it's the work horse of her practice.  I have had it done to my face for broken blood vessels from bad sun damage, and I have two girlfriends who had it done to "fresh" stretch marks, while they are still red.  Voile, hardly any sign of those pesky stretch marks.  When I had the broken blood vessels done, I had them do a small scar on my temple where I had a precancerous lesion removed, and that scar is virtually undetectable.

    Sharon, have you ever used Tan Towels?  I love them. I use them all summer long, which as we know in Texas is about 8 months long...lol.  If you are interested, let me know.  I will send you the link.

  • Sharon1942
    Sharon1942 Member Posts: 272
    edited February 2014

    Send me the link. Goldie! Never heard of Tan Towels!

  • Rosebud14
    Rosebud14 Member Posts: 18
    edited February 2014

    Thanks everyone for the good wishes and prayers for me. I am nervous about tomorrow but as you say..all I have to do is show up! I feel confident that everything will go well thanks to the positive posts on the DIEP 2014 thread. Its great to know that all of you will be in my pocket tomorrow. Good luck to you Kat-ski...hope all goes well for you.

    I will plan to logon later this week.  Thanks again!

  • lemon68
    lemon68 Member Posts: 684
    edited February 2014

    Hi

    I am new to post here but have been reading daily for a long time. I have been posting actively on other threads since my DX in Jan. 2013. I have a couple questions, hope that is okay. I am currently planning my DIEP at the Cleveland Clinic, no set date yet.

    Has anyone done nipple sparing? skin sparing? both? I am wondering what the criteria is to save the skin and nipples. I haven't been able to find much information on it. I understand by doing the sparing you can retain some feeling. I would love to hear from you all what your feelings are and if you chose to do this. I am having both done but I hate to lose the feeling, I had a hysterectomy in Sept. and I feel like cancer has already taken so much! Although I do feel like I am carrying time bombs I have always liked my time bombs.

    Lastly I cannot say Thank You enough for sharing your stories, advice and just being there. XO

    Lemon

  • maggie85
    maggie85 Member Posts: 53
    edited February 2014

    Hi, Lemon

    I had both nipple and skin sparing.  I believe it depends on where your tumor is.  I had DCIS, so it was contained in the ducts, and far enough from the nipple and skin that they could do that.  I was sure to ask the mastectomy surgeon about it, and based on my tests, he told me before surgery he felt I could do both.  Of course, its always up to what is found out when you're on the table. 

    I had surgery Jan 8, and I am still pretty sensitive and swollen, especially on the right, which is the side the cancer was in and where two lymph nodes were removed for testing. It will be a while before I think I'll know if I have any feeling come back.  I don't think they can tell you whether you will or not for sure, and I think they prepare most ladies that they likely will not have feeling return.  

  • aemcat313
    aemcat313 Member Posts: 20
    edited February 2014

    donna, 

    Just saw your pic, I cant believe how symmetrical you look at 4 weeks with one natural and one flap and no bra, you look great. My surgery was the day before yours, and my noob is about an inch higher and fuller than my natural breast, but my BS said it will drop when the swelling goes down. With a bra, I look pretty even. 

    Very impatient to see my PS this Wed and get the full scoop - first time since the surgery - I've only seen the nurses so far.

    I'm still hunched over after 4.5 weeks, sigh. Seems I start out taller in the am, but sink a bit lower as the day goes on, as my back starts hurting, and my stretched stomach feels like it wants to tighten up. Getting sick of it!  Good luck to those still stretching out!

  • lemon68
    lemon68 Member Posts: 684
    edited February 2014

    Hi Maggie

    thanks for your response. Did you have a lumpectomy originally? I did and rads, not sure if that will also be a deciding factor on saving the skin and nipple. Rads ended last April and skin looks good but I will have to ask. Are the risks raised when we do nipple/skin sparing or is it the same?

    Hope your swelling starts to go down and your feeling better each day. And that you are happy with your results. From your pic you look beautiful.

  • milkyway2
    milkyway2 Member Posts: 259
    edited February 2014

    tom i have appointment with my oncologist after recon is there any imp question to ask her i was wondering how she will examin me i have diep 

  • Jeannie57
    Jeannie57 Member Posts: 2,144
    edited February 2014

    Milky Way, my Onc checks my skin and nodes, listens to chest, bp, pulse and asks me how I am feeling, new pain, etc. Sometimes I have blood work done but my cancer center doesn't routinely check tumor markers unless there is a new symptom.So far, so good.

    Hi, Lemon!  You probably know my story from the ILC thread. Here are more details: I had skin sparing bmx, not nipple sparing after a LX. Delayed DIEP was in July and I have feeling around the outside of my new boobs, that's it. Like everything else, this varies from person to person. I had rads with tissue expanders in (non-cancerous side was partially deflated for rads then re-filled). I had DIEP eight months after rads, 5 1/2 months after chemo. PS said my skin was in good shape---it had fallen off after rads and is still pink to this day. I think Maggie is right about cancer location being a big factor in any "sparing" procedure but you are past treatment so I don't know. Maybe someone who had a similar experience will chime in. I liked my time bombs, too, but they had to go. I am happy with the replacements. I wish I had feeling in them but I keep telling myself that my mind is the most important erogenous zone and I still have that MOST of the time....Ask lots of questions here and in your PS office until you're satisfied, but know that there are lots of different protocols/procedures among PSs and you just have to decide to trust whichever one you choose. Maybe someone who went to Cleveland Clinic will comment. 

  • jmb5
    jmb5 Member Posts: 532
    edited February 2014

    lemon68, I had a lumpectomy and rads 4 years ago for DCIS. Because of a recurrence last fall, I needed a mastectomy. I decided to do a BMX. My breast surgeon said I could not do nipple sparing because the nipple on the rads side would not survive. Not sure if all surgeons have the same opinion or not, but I had both nipples removed. I figured I might as well do both so they'd match. Turned out to be a good decision. They found Paget's Disease on the skin of the nipple on the "healthy breast". I was able to do skin sparing though. That never seemed to be an issue. I also had my surgery at the Cleveland Clinic. Dr. Fanning is my BS and Dr. Moriera is my PS. Both women in their 40's, and they've been great. I have no regrets about the surgery or my surgeons. They are top notch. 

  • maggie85
    maggie85 Member Posts: 53
    edited February 2014

    Lemon, I did not have any treatment previously.  I was only diagnosed in August 2013, and I knew a lot of women get recurrence by doing the lumpectomy, so I decided on the double mastectomy and DIEP ... had no idea about the nipple and skin sparing when I made that decision, but I sure am glad I was able to have both.  

    Good luck to you - the ladies here are all wonderful with the information.  I read here for a few weeks before I started posting. 

  • lahela
    lahela Member Posts: 515
    edited February 2014

    aemcat - that's absolutely normal. Some women are upright quickly, others... 12 weeks! It's a spectrum. And starting out better then getting tighter is normal too - it seems like your tummy muscles get tired, I guess because they've been so shocked, so by evening you get the spasms and pulling. You will get there, though! Stay strong! {{{hugs}}}

  • GwennyMD
    GwennyMD Member Posts: 147
    edited February 2014

    Katski and Rosebud - prayers for a smooth surgery and a quick recovery

    Donna and Jmb5 - Patience is the key. I think that massaging really helped the most since I did not wear compression.  Fortunately most of my work clothes fit when I went back to the office in week 7.  I am 4 months out an still get occassional swelling.  Since my stomach was never flat, contol top hosiery has always been part of my winter wardrobe.

    Aemcat -When I complained to PS about the back pain from being hunch over he told me to just stand up straight.  This forced me to start stretching stomach by standing against the wall.  Unfortunately, I sometimes get the same type of tightness when I sit for a long time after a meal.  It often happens when I am at desk using computer. 

    Lemon - I had lumpectomy in Feb 2013 and then BMX with DEIP in Oct. BS said skin and nipple sparing are appropriate when tumors or cells are not near them. Since my tumors were at the back of my breasts, she said she would keep the skin.  She cautioned me about trying to spar the nipples because they don't always survive.  I did not keep the nips. 

    Curly - Stay strong. Taxaotere is horrible but you can make it through.  I tried to eat differnt foods everyday because Taxotere made everythg taste bad. I had to give up my favorite summertime food - steamed blue crabs.


     

  • Janet_M
    Janet_M Member Posts: 1,068
    edited February 2014

    lemon68 - Good morning. In regard to your question about operating on err irradiated breasts - I had BMX followed by immediate reconstruction. One side had been radiated, the other, not. My PS had said that he can almost always 'make it work', once the breast had been radiated, and had enough healing time, which is 6 mos to 1 yr. So I had a skin sparing BMX and the results were great. My left side is almost a perfect recreation of my original breast, as it it the same skin envelope. The right side is a little less like it's original. Same skin envelope, but the PS had to work with a lot more scar tissue. Once my bra is on it looks perfect, but naked - still has it's own personality.  I didn't have a nipple sparing surgery because it was not an option. Surgeons vary wildly on their recommendations, and Ontario doctors wouldn't offer it as an option for me. 

    I still have a bit of feeling. (I'm squeezing my boobs with one hand, and writing with the other). They're not quite numb, and I'd say that I still have an awareness rather than sensitivity. It doesn't bother me though. I'm six months post DIEP and they're starting to incorporate themselves into my body quite nicely!  At first it felt like I was wearing a big parka whenever I got dressed or hugged someone - but things have improved. Of course, living in Canada, I am actually wearing a big parka most of the time. Can't wait till spring so I can show off my little cleavage.

    It's pretty hard to get all the facts straight. There's so much information that it can be overwhelming, and PS's have different policies. Judging from the posts of the woman on these threads, most woman are pretty darn happy with their new and improved ' time bombs'. (Timeless Bombs). What you lose in sensitivity, you make up for in the sense of relief. 

  • Kat-ski
    Kat-ski Member Posts: 212
    edited February 2014

    I have very wide jogging pants on with very big pockets.  It is the time and I will be on the other side.  Love to all

Categories