Frustration deciding on a ps for DIEP

Welcome! Sounds like a "win/win" to me! Both sound great, you are blessed to be in a great location for excellent doctors. Which one are you leaning toward? I did not have that recon procedure, hopefully you will get more responses soon. My best to you as you continue treatment and recovery.

Both sound good.  For me, with both choices, I would consider the more convenient location.  You will be seeing your PS a few times after surgery and down the road for any follow-up surgeries like nipples etc.  You also might need to be seen quickly if problems develop after surgery.  My PS arranged for a visiting nurse and OT to stop by my home a few times to check on the surgery site and help me get back on my feet.  I liked that the nurse knew my dr and sent her reports to him after seeing me. It just felt better having everything close and convenient.  I wasn't afraid to stop by the office to have the nurse or dr look at anything that was bothering me.

You want someone who had done multiple hundreds of DIEPs -- a thousand would be even better. (There are very experienced ps who have done 1000s.) Importantly - you want someone who does these surgeries on a regular basis - once or twice/week is a good number. Sometimes these total numbers of DIEPS include surgeries done when they are in training. You want someone who has done high numbers if DIEPs on their own. Ask to see photos of their work and contact prior patients. Try to arrange to see former patient results in person if possible. It is usual for a ps doing reconstructions to show potential new patients photos and offer then contact info for former patients. If a ps doesn't agree to this it is a red flag. Anyone who is good will have a large following of happy "customers" that will be happy to talk to you.

I had a very problematic DIEP done locally by a well trained (ivy league schools, impressive microvascular fellowship) but relatively inexperienced ps. Turns out that the number of DIEPs this ps gave me included the ones done while in training. She had done only a handful one her own (when finished with her training). I later traveled to a much more experienced ps (NOLA) to have a contralateral prophylatic sGAP and revision (with much improvement) of my original DIEP side.

As farmerlucy said - in Texas PRIMA in San Antonio has the reputation of having very experienced, high volume DIEP surgeons.

Hi,

I share your frustration. I have a consult with a BS and PS for June 16 for immediate DIEP following MX with superstar surgeons, but am afraid when I get there they will tell me surgery will be another month out. And it's already been 7 weeks since my DX. Do I get a MX and TE now, delayed DIEP later, or wait for an excruciating month and have it all done at once? (I'm only guessing on the timing, but I can't imagine they would move me ahead of others with worse conditions, and mine are not relatively bad). They may recommend delayed DIEP.

Thing is, you need all the information up front after you get the initial diagnosis. Wish I knew to book appointments two BS, two PS the day I knew I needed MX. Would have allowed faster fact-gathering and scheduling. This is taking way too long.

When selecting my surgeon, in addition to about 50 procedure specific questions, these were the ones I found helpful to ask when selecting a surgeon:

1. Can I see before and after photos of your patients who have had the same procedure? A good surgeon should have photos of his work and SHOULD take photos of your breasts now so that he can recreate them as closely as possible. Mine just does them from the neck down, no privacy issues.

2. What are the possible complications? How will you handle each of them? How often do they happen?

3. How many people my age have you done?

4. How often have you had to do secondary surgery to fix or repair a complication?

Good luck!