Are implants comfortable? To DIEP or not to DIEP??

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JulieAggie03
JulieAggie03 Member Posts: 71
edited March 2016 in Breast Reconstruction

I am trying to decide between the flap and implants for my final reconstruction. I have some time to decide and want to make an informed decision, PS says May is the earliest we can do swap and I meet with the nurse to discuss my options this week. One thing I know for sure is that I want these TEs out! It's like sleeping with 2 softballs on my chest. I have always been a stomach sleeper and that has been impossible. Now that I am 6+ weeks out from surgery I get through the night turning from side to side, but it feels like I haven't slept a full night restfully since before the BMX!! For those that have opted for implants are they comfortable, can you sleep on your stomach? Is there a difference in feel between silicone and saline? I know they won't feel natural like the flap procedure would produce but I like the idea of having an easier swap surgery! I have a 5 year old to chase and full time job and just don't feel like another major surgery with lots of recovery right now! My PS said I am a candidate and I also like the idea of the flap (thinner belly and after possible initial revisions no future surgeries)...very torn right now!

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  • warriorwannabe
    warriorwannabe Member Posts: 66
    edited February 2016

    JulieAggie - Im in the Dallas area and am new to all this and have the same questions!!! I just got my ILC Dx. Im still interviewing PS docs, and once I pick, will be having node biopsy and 1 week later BMX. Id love to know who your docs are. Im using Grant at BUMC as BS, and having a helluva time picking a PS. I too will have TEs and have time to decide between silicone implants (gummy bear anatomical) and DIEP. Im leaning towards implants. Im gonna follow this post. :)

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  • JulieAggie03
    JulieAggie03 Member Posts: 71
    edited February 2016

    Hi Warrior! I live in Paris (1.5 hours NE of Dallas) but have done all my treatment and surgery in Dallas. My BS is Dr. Anglin in Plano and PS is Dr. Ricardo Meade at Dallas Plastic Surgery Institute. Dr. Meade has been great so far and he sees a lot of BMX patients. He lays it out straight and does not sugar coat he and I discussed briefly the flap 2 weeks ago and said that while healing and recovery take longer and have more potential for complications after the initial surgery and revisions he never sees his flap patients again unlike implant patients who will be back sooner or later due to the nature of the beast! He is very busy and I often wait quite a while in the waiting room but he is worth it! His staff is very attentive too which I think is important when we have some questions and decisions to make.

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  • warriorwannabe
    warriorwannabe Member Posts: 66
    edited February 2016

    Ive heard of Meade. Found him on realself.com. Had many great reviews which I thought may have been too good to be true!! How did you find Meade (and why did you pick him)? Which other PS docs did you see? (I dont think I can handle the DIEP, but I dont have to decide that yet. Im leaning towards simple implants). I cant wait to hear from the others on this topic. I posted a similar question and got no response :(

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  • Meow13
    Meow13 Member Posts: 4,859
    edited February 2016

    Warriorwannabe, I never had any kind of surgery, my abdomen was a clean slate so to speak. I was so scared of the 10+ hour surgery but I just went for it. Incredibly no pain and healing went really well, the 3 drains did not keep me home. I only had one side done came out with a great look and flat stomach. I had mine done at UW Seattle.

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  • JulieAggie03
    JulieAggie03 Member Posts: 71
    edited February 2016

    Dr. Anglin highly recommended him. I did not meet with any others actually, Anglin and the other doctors, my MO Taboada @ TX Oncology Plano, and even my Gyn-Onc Heffernan @ Medical City (met him due to my BRCA1 status) all said Meade was best when I mentioned who I was meeting with, so I scheduled a consult and did not look elsewhere.

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  • JulieAggie03
    JulieAggie03 Member Posts: 71
    edited March 2016

    Ugg! Met with the nurse and PS today and discussed the ins and outs of the DIEP vs implants and still can't make up my mind! Scheduled the flap just to get on the calendar, PSonly does flaps once a week and has to coordinate with his partner/co-surgeon and is booked for them into September. I can get in for the implant swap much sooner so I still might change my mind. They did say the implants will feel much better than the TE's and is a 2 hour and 2 week recovery vs 8-10 hour surgery but 50% of implants need some sort of revision or even replacement within 4 years. On the other hand the flap surgery will require 2 days in ICU and 1-3 additional days in the hospital then 3-weeks off work assuming everything takes and heals. They also said the chest part usually heals fine it's the hip to hip stomach cut that has trouble healing sometimes and I am at higher risk due to my higher BMI. I am working on lowering that but I have to take a break from exercising since my BS says I have beginnings of lymphedema and need physical therapy. All in all PS thinks I will have good results with flap and be happy with it since I'm so young and won't have to come back every few years to fix or replace implants. Decisions decisions!

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  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited March 2016

    I have implants but am not a front sleeper however I do an exercise dvd that does one move that has me lay on my front and it feels like there are two bean bags or plastic balls in there one is higher than the other so that feels weird too. A 50% revision in four years sounds a bit high to me. My PS made some adjustments at the exchange and that is all I've had although I know fat grafting has become quite popular so that may be what they are talking about. If I am out all day in cooler weather the implants become like cool packs on my chest and it can be quite chilly. I have no pain but if I think about the implants I can feel them. Also there is a funky distortion of the implants since they are under the pecs. Over all the implants are fine. I would not like to have another part of my body numb but a flat stomach would be nice. I never wear a bra, don't even think about it and that is awesome. Good luck with your decision! My BS referred me to Prma in San Antonio in the event I wanted DIEP since they do a lot of Dieps and my PS felt that was really important.

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  • JulieAggie03
    JulieAggie03 Member Posts: 71
    edited March 2016

    Thank you Farmerlucy for the insight! I do like the idea of not having to wear a bra, it's the one "perk" of these TEs! I had D borderline DD cups before and wouldn't have dared walking out of the house without a bra, not even to get the mail, lol! With the flap breasts he says they are more natural and will not sit as high and perky as implants and they will age like normal breasts. So another reason I can't decide

    The 50% figure included minor touch ups like fat grafting all the way to complete rejection/replacement which is not often but he just wanted me to know what the risks are with both options and neither is perfect.

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  • warriorwannabe
    warriorwannabe Member Posts: 66
    edited March 2016

    hey girls, the more I think about it, the more prone I lean towards implants. I just dont want to put my body thru that DIEP flap stuff (some have a helluva time, others breeze thru it, so IDK!) But I am, and have always been, a side and stomach sleeper, so IDK again. I go back and forth. Right now, I just want my BMX and nodes biopsy done, and a plan of next steps, so I can get this show on the road. The waiting is killing me (I hope not literally).

    Farmer Lucy - I never thought about the cold thing. And thanks so much for the bean bag description :)

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  • Meow13
    Meow13 Member Posts: 4,859
    edited March 2016

    my DIEP feels like my real side, I'm happy.

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  • debiann
    debiann Member Posts: 1,200
    edited March 2016

    I didn't consider implants, I knew I would not like them. I had BMX with immediate DIEP recon. It is a big surgery (mine was 13 hours) and recovery is longer than implants. I went back to work 1/2 days week 5, and full days week 6. I believe most need at least one revision surgery following DIEP. I had two revisions surgeries to lift and shape. I took a week off work with each revision. I did not get the nipple reconstruction yet, tired of medical procedures! Maybe next year.

    The flat tummy is a bonus, but its pretty numb. I don't like that, but it seems to be less noticeable with time. I'm not a tummy sleeper, but when I do lay on my stomach its still a little weird, like I'm laying on a pillow.

    I'm happy with the outcome, but to those considering this reconstruction, you will be out of commission for weeks and you need to have help getting through recovery. Good luck, the decisions are so hard.

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  • JulieAggie03
    JulieAggie03 Member Posts: 71
    edited March 2016

    Thank you Debiann! Weird about the numb tummy, hadn't thought of that. It's the long surgery (my PS said expect 8-10 hours) and the long recovery I am afraid of the most-I just don't know if I can be out of commission that long with a 5 year old who starts kindergarten in the Fall. I'd have help from my mom and my husband of course but still, it's the healing of the stomach opening that worries me. PS said that if any complications happen that is where he sees most. My job would understand and I get up to 8 weeks of full paid medical leave so that isn't a concern.

    Really appreciate everyone who has commented here!

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  • farmerlucy
    farmerlucy Member Posts: 3,985
    edited March 2016

    Julie help me understand. What do the TEs do for an eventual DIEP? Is the tummy mound placed under the stretched skin and you get to keep your skin. The pictures I've seen of the DIEP are where they moved the skin and the tissue together and attach it in the breast area. Is that a different type of DIEP? What about nipples? Can they save the skin and the nipples and put the DIEP underneath? Just curious. That ship has long sailed for me, but I like to learn about new things. FYI my mx was not nipple sparing so I have 3-D tattoos from Vinnie Myer in Baltimore. Now that was absolutely, positively, the best thing to come out of all this mess. Even I have a hard time distinguishing them from the real thing when I look in the mirror, and there are no nubs, so bra less is easy. Take care!

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  • debiann
    debiann Member Posts: 1,200
    edited March 2016

    My surgery was long because there was a complication. They had difficulty getting blood flow to the right flap. It was touch and go the first couple days, but it did survive. I met a woman who lost both flaps! So hard to go through all that for nothing.

    All my incisions healed quickly, but some do have problems which require some wound care that sounds icky.

    I was physically knocked down going into surgery because I had just completed chemo so that would explain how fatigued I got

    For me it became an emotional roller coaster too. After the first surgery the flaps were huge, dangly and oddly shaped. I cried. PS said don't worry first surgery is just to get living tissue to the area, the revision is to make them pretty.

    Between surgeries I got used to my new look, oddly shaped as they were, they were me and it was my first time ever I had big breasts.

    Then the first revision. I came home from surgery and peeked into the binder and they looked so small! I cried and cried. PS said they will loosen up in time and be fine. Righty eventually took on a perfect shape, although slightly smaller than I would have liked.

    Lefty was a problem. Bigger than righty and still oddly shaped, so I needed a second revision. They now match in size. Lefty has a weird ridge at the side, but overall the appearance is good. The final size is a small C cup.

    The decisions became overwhemling: nipples/no nipples, go to Vinny for tatto/get tatto at doctor, areola tattoo/decorative tattoo (I had a peacock design made for me) ..So for now I'm doing nothing. This summer I want to be able to swim and enjoy the hot tub!

    Good luck to you on whichever procedure you choose

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  • JulieAggie03
    JulieAggie03 Member Posts: 71
    edited March 2016

    My PS does TE's for all his MX patients regardless of the final reconstruction you want. The shape of my new breast mounds are very close to normal just a few odd edges around my scars but those will be cleaned up later. Front what I understand the DIEP tissue and its blood vessels will go in the expanded area. Nipples were not salvageable for me during BMX as mine were too low on my large chest and he would not have been able to keep blood flow to them. I don't really mind the smooth look, I do like the idea of 3D tattoos or something decorative. Definitely not going for reconstructed nipples when this is done.

    I am starting to lean towards implants, if something goes wrong with them I could always do DIEP later when things aren't so hectic. My older sister was also diagnosed with TNBC in December and is halfway through chemo now, has her BMX in May. My mom is a saint and has taken care of both of us so much, I kind of want to give her a break even though she'd never ask for it. She wants me to do whatever surgery I think is right for me and she will be there for no matter what

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  • Shelly74
    Shelly74 Member Posts: 24
    edited March 2016

    I'm in Dallas, too. Just had my exchange surgery on Tuesday and am happy with my implants. I couldn't imagine any of the flap surgeries...way too long and staying in ICU scared me off...plus I have a three year old son. Recovery is going well, and my PS at UT Southwestern said some implants last 15 years or more now. Would much rather replace these a few times than go through the flap surgery once. Haven't worn a bra since 2/5/15...best part of having breast cancer for sure! PS did a great job at exchange, and I don't anticipate need for any revision surgeries. I have chosen to move on without nipple reconstruction or 3D tattoos. Just ready to get on with life, and put BC in my rear view! Good luck making your decision. I know it seems never-ending! Hugs!!

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  • warriorwannabe
    warriorwannabe Member Posts: 66
    edited March 2016

    Hi shelly, who is your PS at UTSW and what kind of implants did you get? Im heading down this road and collecting as much info as I can get!

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