Traveling for Diep Flap

Pat,

I just had surgery for a bilaterial DIEP Flap at Mayo Hospital in Phoenix on 1/28/08.  I came home on Sunday 2/3/08.  So far everything is very good.  My new boobs look great. Dr. Rebecca is my surgeon and she did a wonderful job.  Every nurse at the hospital spoke very highly of Dr. Rebecca and they all had big smiles about her work.   I go in for my first post-op appointment on Weds and I hope to get some of my drains removed as I went home with 5 drains.  Yes, the surgery is not easy and the first 4 days were pretty rough but she kept me pretty much pain free during that time.  Now that I am home, I still walk hunched over and certainly don't have all of my strength but every day I am feeling better.  Their office also gave me a name of another patient that I spoke to who had this done just to ease my mind.  The Dr and her staff have been very easy to work with and very patient answering my and my family's questions.

I live in Mesa, AZ so it was alot easier to go to Mayo as it is 30 minutes away plus I know if complications arise, they are easy to get to.  Plus it was nice to have my family and friends around for support.  So far I don't have any regrets about the whole DIEP experience.  Good Luck to you and if you want to talk more about this, let me know.

Lucky JP

Pat, I read your question and am glad to see that you have gotten a quick response from someone dealing with the same doctor and hospital.  That means a lot.

I had a unilateral DIEP almost 2 years ago and am happy with the results.  I do not live anywhere near AZ, but just wanted to comment on evaluating a doctor's experience by the number of surgeries they've done.  In my opinion, doing 5 to 8 of them a month is actually pretty good, since DIEP surgery is usually long and complex.  The surgeons do not schedule more than 1 in a day.  It is not a "cookie cutter" surgery like gall bladder removal, etc., where a surgeon might be able to"line 'em up" and do several a day.  Even with joint replacements, which I consider a big deal,  the docs can schedule several over the course of a day. 

Also, surgeons need to spend some time in their office seeing patients, or possibly teaching classes if affiliated with a teaching university. and they usually deserve part of a day off as well!

Therefore, even if your surgeon wanted to do 5 DIEP surgeries a week, she probably couldn't, unless she had no other responsibilities.   Many p.s. are also required to do lots of other types of repairs and recons as well, not just on the breast.

I wonder if your internist looks at it that way.  I love my internist dearly, but found he knew absolutely nothing about DIEP.  It's not done locally and I had to travel a bit to get it done. 

Also, many of the surgeons around the country doing DIEP are relatively young, and it'll be awhile before they can say they've done thousands of these.  The exception would be the docs in places like New Orleans who may devote most of their practice to breast reconstruction.

So I guess if I were you, I wouldn't let what your internist said about the number of surgeries Dr. Rebecca has done bother me.  Continue to try and talk with past patients she's had.  That helps a lot.   And go with your gut feelings on your meetings with her.

Good Luck! 

Mary Jo -  don't let some negative feedback discourage you.  I think that good DIEP doctors are going to be the younger ones, it's a newer procedure that a lot of the old established plastic surgeons have never been trained in and wouldn't think of attempting.  I was surprised at the ignorance (for lack of a better word) about DIEP from all the established physicians I have dealt with.  But talk to a younger doc who's been doing them and they just light up about it!

Go with your initial impression of your consult with Dr. H.  I think his "numbers" are great!  Would you rather put off your surgery for a few years till he can say he's done 500 of them?  I know I wouldn't. 

Keep us posted. 

Unfortunately your internist most likely doesn't understand what a DIEP truly involves to say that 5-8 per month is not sufficient. Honestly it's possibly too many! A DIEP is an extremely involved procedure that requires a lot of time, knowledge and follow up care. My provider does DIEP's. He is well respected and has had patients referred to him from all over the United States and Canada.

We do less than 5 DIEPs per month and it's still considered a lot. WHY?... 1 - It's not just difficult for the patient it's mentally and physically exhausting for the surgeons as well. Your surgeon should be healthy and well rested before surgery. 2 - The recovery in the hospital takes about 5 days and my doctor rounds on his patients rather than just hand them over to a hospitalist right off the bat. 3 - We also do every other type of breast reconstruction as well as cosmetic procedures. 4 - He is actively involved in teaching, research, and updating his skills. 5 - He is careful to choose patients who are good candidates for DIEP. Some patients come to us thinking, this is great, I can get a free tummy tuck out of this. That is not a good reason to have this surgery. You really need to know what the risks are. This is a serious and complex surgery that has a much higher risk for complications, scarring and infection than just about any other surgery and not choosing the right surgeon can be a nightmare. If you have other health issues this surgery may not be right for you but for those who have tried and failed implant reconstruction or have radiation damage this may be the best option. We try to educate our patients on the safest surgery for each individual with the hopes of having good aesthetic results without putting them at undo risk. I can say that the surgeons at Mayo are excellent and if I didn't work for my doctor I might use them. Good luck.