Will a TRAM FLAP/DIEP FLAP ruin my hips and my waistline????

Linda7
Linda7 Member Posts: 12
edited December 2018 in Breast Reconstruction

imageimagePics from internet


Seeking to connect with women who have been through the experience, both the positive and the negative.

A bit about me: 9/2014 Stage 2b, Triple Positive (Her-2 Positive), highest grade aggressive cancer, right breast, at 41 years old (42 now), 6 rounds of chemo (really, really tough for me), unilateral nipple-sparing mastectomy, immediate silicone implant reconstruction, no expanders.

Where I'm at now 3/6/16: I was super thin at the time of my mastectomy (3/17/15) for anything other than an implant reconstruction (plus they wanted to see if I needed radiation first). I've since then put on 30 pounds. 15 just part of my recuperation, another 15 deliberately so that my PS could agree to a DIEP or FREE TRAM FLAP. Good thing that I've always had a "potbelly" and I gain a lot of weight on my lower abdomen though the rest of me stays relatively thin. People have asked me a few times if I'm pregnant because of this. Annoying, but now this fat might come in handy. My PS has given me two options: 1. Try another implant or 2. DIEP or Free Tram Flap (he won't know for sure till he's in there). Only need it for the right breast.

Why do I dislike my implant: It doesn't move with me, it's just this stiff lifeless object held up by my skin and muscle, it is always uncomfortable and it sometimes hurt. It's been a year and it does not feel like it's an integrated part of my body, it is a constant reminder of everything I've been through. After a year I feel like, nevermind that it's unattractive, no reconstruction will give me back my breasts as they were. I made it through this illness, I made it through this treatment, I'll never forget what I've been through, but I want to really start living my life already, nice breasts or not so nice breasts. I'd keep the implant but it hurts sometimes and it feels really tight and uncomfortable and I hate how I feel the muscle move with minimal use of my arm. My PS is suggesting I try another one, better looking, but will always feel a degree of discomfort.

FLAP Reconstruction: This is what I always wanted but was not a candidate a year ago. Now that I am, I have a lot of concerns which are bringing me to reach out to other women who have gotten this procedure. I hear the result of the breasts is great, a lot like a real breast. I understand the surgery, scars and the recovery period are intense, I've lived through cancer, I'm not afraid of the surgery and recoop if It means I'll be able to move on with my life sooner than later.

What I am afraid of is that in trying to fix one thing I'll ruin another part of my body. I've heard women get those "dog ears" and that they lose their waist (see pics above). My PS says these things can be fixed with a follow up surgery but I'm afraid of ruining the remaining parts of my body that I still very much like. I like the shape of my hips and the definition of my waist, whether I'm thin or not so thin as I am now, I really like the shape of my body. Will getting this procedure alter my figure permanently? I'm already getting used to the fact that my pretty breasts had to go, but I still very much like the rest of me, if I lose that, I'll lose even more of myself. For one breast, it's just not worth it.

I'd like to hear from women who have gotten the DIEP or Free TRAM Flap. Was the shape of your hips altered? Was the definition of your waist altered? Did the shape of your stomach change in a negative way? Was it temporary or despite follow up surgeries, your hips, waist, or stomach are now changed forever and not in a good way? If so to what degree and is the result of your flap reconstructed breast worth all of this?

Thanks for taking the time to read.

Edited by Mods to remove picture.

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Comments

  • New-girl
    New-girl Member Posts: 358
    edited March 2016

    I have only had DIEP so my thoughts are from that perspective only.

    I was not thin when I had my BMX/DIEP . I was 5"4" and weighed 148. I had two pregnancies so I had a small belly round but a very small waist. If I wore an A-line dress, I wore a size 8. I was much smaller on top and never carried my weight up there but rather down south as in a classic pear shaped girl.

    From the get go, DIEP gave me a rock hard stomach and tight middle. Never ever had dog ears or weird sections on my middle. Breasts had feeling almost immediently and still have amazing feel to them. I was only able to harvest about a small C cup which shrank down to a B cup when I lost weight.

    I started exercising super steady about a year ago and have never been happier with my body. DIEP scar is very low and just a thin red line. If I was crazy wild and had thinner thighs, I would rock a bikini. My belly button looks a little funky but my previous one was downright darling so I might be somewhat picky. Overall I am thrilled I went this route over implants. Sexually they just feel like me and it helped me feel whole again.

    I would highly suggest looking at pictures of finished work from the surgeon you choose. Get someone good and very experienced. NOLA was my dream team and I so wished I had started there first.

    Good luck!

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  • Moderators
    Moderators Member Posts: 25,912
    edited March 2016

    Linda7, thanks for joining us here, and for posting your story. New-girl, your insight is really appreciated. So many different stories, and so important to hear. Linda7, do you feel good about your surgeon?


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  • Linda7
    Linda7 Member Posts: 12
    edited March 2016

    Thank you New-girl, for answering my question. It was very helpful. Sounds like it was a positive experience for you, I hope that it will be for me too.

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  • Linda7
    Linda7 Member Posts: 12
    edited March 2016

    I feel pretty good about my surgeon. I've sought second opinions only to be told by the new surgeons that my PS is the one who taught them how to do the DIEP. I want to think that the discomfort of my implant has nothing to do with my surgeon.

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  • Jacklin
    Jacklin Member Posts: 162
    edited March 2016

    Hi Linda7, I will also ask the moderators' question again: are you comfortable with your PS? I have read a number of times that there shouldn't be any question about whether it will be TRAM or DIEP.....

    This website was very informative for me and might help you: http://members.boardhost.com/plastic/index-1.html

    All the best,

    Jacklin

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  • lessharp
    lessharp Member Posts: 122
    edited March 2016

    Hi Linda, just had DIEP in October and have had one revision. I did initially have a dog ear, and I am not yet symmetrical. However; I love my replacement Breasts....they are very pert, natural feeling and I have no discomfort. They really do feel like they belong!


    I love that my belly is more slender (after 2 pregnancies) as you basically get a tummy tuck. I was a bit too slender, so got a B cup...but am working on getting the size closer to my original DD's with some fat grafting. It is a process, and you can expect at least 1 revision, maybe two...but well worth it in my opinion. My belly scar is still fairly fresh, ( a bit red)but was told by the nurses in the hospital it will fade to a thin white line...which it seems to be doing in some places. Here is a photo of my abdomen right after the original surgery, so that bruising is not there anymore.


    image

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  • Linda7
    Linda7 Member Posts: 12
    edited March 2016

    Hi Jacklin,

    Thanks for looking out. That website you referred me to, are there specific articles you recommend dealing with this topic?

    The reason why I trust my PS is because well, he's the chief of the department in one of the main cancer centers in the country and when I went out seeking second opinions, it turned out they had learned how to do these surgeries from my PS.

    He believes he will need to use a little bit of muscle to make a breast to match my real breast, almost a D cup. I collect a lot of fat in my belly area, but I'm still on the thin side so I might not have enough fat to make a breast as large as my own.

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  • Linda7
    Linda7 Member Posts: 12
    edited March 2016

    Hi lessharp,

    Thank you, thank you, thank you for answering my question. Your pic speaks a thousand words (you look great) and I love how you say they feel like they belong, I hope that I can say this in a few months about myself.

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  • Pinkwings
    Pinkwings Member Posts: 4
    edited March 2016

    hi I have decided not to take a new breast from my tummy or my back as I didn't want to ruin another part of my body to get a new breast it is not that I do not want a breast that looks fantastic I just don't want to ruin another part of my body to achieve this so I am having an implant replacement with an uplift to the other side hope this helps

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  • Jacklin
    Jacklin Member Posts: 162
    edited March 2016

    Hi Linda7, sorry, i wish I had flagged the articles I read, but I can tell you that Dr D responded more than once to people who indicated that their PS said they wouldn't know if their surgery would be DIEP or TRAM until 'they were in surgery'. I found reading the Dr's response very interesting. Again, apologies, I don't remember exactly which articles were the ones.

    Jacklin

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  • JMA2824
    JMA2824 Member Posts: 1
    edited December 2018

    2016 I found a lump - stage 2 HR+ . (46 yrs old) I weighed 110 at the time 5'7" so very thin and had had prior implants - I went through 8 rounds of chemo, but didnt want to deal with the genetics testing - I was already reeling from the diagnosis- that was my mistake - after the chemo I went on to do the radiation 33 days. They did not want to replace the implants until they saw what damage the radiation did to the good side. That brought us to 2017 when my younger sister went for a mammogram. They noticed something and did biopsy - she did the genetic testing and it came back with BRCA2 gene. So I went for the testing - BRACA2 and Chek 2 gene. So I decided to go for the nipple sparing double mastectomy - despite having radiation damage. The operation didnt work the skin started dying, I had to have the implants removed and expanders put in with nipples removed. It would not heal and the skin still dying. So they decided to do the DIEP surgery, was told it was the tightest one they ever did. They replaced the implants - smaller than I was because the radiated skin wouldnt expand. They also did fat transfers ( I also had a complete hysterectomy because of the CHEK2 Gene) Had more healing issues with the DIEP - when it finally healed they did the nipple reconstruction which didnt work well either - still need to have it redone. As for the area of the DIEP I was/am still very very uncomfortable. The only way I can describe it is like a balloon twisted - top and bottom of scar. I did have the dog ears but they did fix that. My hips look nothing like they did. Not being conceited but I had a very nice shape boobs waist and hips prior to all this now - on top of weight gain because of some of the hormone inhibitors and the scar - I feel like I look like someone put a body back together and one part is the wrong size. They are trying again to fix things.... now to the main reason I am posting. If you are thinking of a double mastocomy do it BEFORE the radiation - If I had known that I wouldnt still be going through more surgeries 3 years later.

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  • Meow13
    Meow13 Member Posts: 4,859
    edited December 2018

    I was 123 pounds 5'3" with excess skin and fat in my abdomen I did a single side DIEP. I have a flat stomach like when I was 16 years old and a scar line from hip to hip. I was so please that it is below bikini line. I could wear a 2 piece bathing suit if I wanted too. The scar is a line but it is nice and flat. So very happy with results.

    My hips and thighs look good with my new stomach area. I never carried the weigh in my hips in was always the belly.

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