Diep flap: What did you look like one month after?

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Penner
Penner Member Posts: 12
edited November 2017 in Breast Reconstruction

I had a nipple-sparing mastectomy with immediate DIEP flap surgery in mid-October, and I'm a little depressed. My new breast looks terrible- it looks smaller than the other one and isn't anywhere near symmetrical, plus it's all full of dents and I have a big crevice In the armpit area. And I have a lot of extra flesh on the side, though I am not sure whether that is just swelling or what.

My breast surgeon says this is par for the course and the plastic surgeon will do fat grafting surgery to correct it. But none of the doctors that I talked to before the surgery told me I would need fat grafting (or any other surgery) after. They just showed me pictures of all these great-looking, symmetrical breasts.

Is this just the way it goes? I could use a little encouragement, I guess. Would appreciate hearing about other people's experiences - thanks very much

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  • Lula73
    Lula73 Member Posts: 1,824
    edited November 2017

    hi Penner- so sorry your team didn’t give you the full picture of how DIEP recon goes. There are 3 main stages: stage 1 = mx + harvest & transplant of tissue, stage 2 = symmetry + scar revision + fat grafting, stage 3 = Tattooing and/or nipple creation. Sometimes the different stages will be further broken down for various reasons into stage 1,2,and/or 3 a,b,c, etc. I had bmx with immediate DIEP recon in feb. just had stage 2 last Thursday where they lipoed, reduced and lifted both breasts, lipoed hips to correct the altered silhouette, used that fat to fill in the divots i had in the upper poles (bigger divot on right than in left), and lipoed the “side boob” down (think the side boob is important for tissue to “take” in stage 1 and is able to be altered later). Most stage 2s take 1-3 hours and depending on your surgeon may be outpatient or require 1 night stay. I combined a hysterectomy with oophorectomy with my stage 2 and ended up in surgery for 6 hours and didn’t have to extend my hospitals stay beyond the standard 1 night my surgeon requires.

    I hope this helps answer your question. The bottom line in all this is that you always have to wait to see how everything settles after surgery to determine if anything else needs to be done. And it’s not just natural tissue recon options that this is true for-implants often have the same/similar issues.

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  • aquilegia
    aquilegia Member Posts: 83
    edited November 2017

    At one month, my breast was still yellow in places from bruising and I had an area of necrosis (thick black scab) along the scar below the nipple. The shape was about what it is now at 4 months - what people here call a "paddle" - a smooth oval shape on the sides and bottom and fairly flat in profile. I think the breast might have drooped a bit over the past 3 months. There's some lumpiness, but it doesn't show on the surface. There were/are divots on my chest where the rib piece was removed and near the armpit, and an area at the bottom where the skin wrinkles when I raise my arms. But I'm hopeful the divots will be taken care of in Stage 2. The PS said he could add an implant to make the breast have more profile, but the main reason I wanted DIEP was no implants. I'm fairly happy with the result, although it doesn't look quite natural.

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