• Diep Flap reconstruction

    Asked by Debdawn64 on Saturday, September 27, 2014

    Diep Flap reconstruction

    Well it's almost here.......I will be having reconstruction done. I am getting really excited but nervous as well. Have any of you had this done and can you give me any advice? Maybe questions I should ask the doc at my preop appoint? The surgery is suppose to last 8 hrs and 4-5 days in the hospital.
    I just finished my last Herceptin trmnt on July 11, after chemo last fall, surgery and then 33 radiation treatments, plus a full year of Herceptin. I was going to wait a while and give my body a break, but I have met my out of pocket limit and this reconstruction should be paid for 100% by insurance. If I wait until after the first of the year, it will cost a lot of money. After surgery will I be able to drive? cook? I have no idea what to expect. I think that is why i'm a little anxious. Any insight would be appreciated.

    14 Answers from the Community

    14 answers
    • junie1's Avatar

      you have every right to be nervous, and anxious. And Yes,, to have the surgery done now,, while it is covered 100% makes a lot of sense,,( I my self am going thur that meet the deductables & it's a bear!)
      My daughter had the same surgery done about 3 yrs ago,, she is really happy now that it all done. time for surgery sounds about right,, I hope you asked lots of questions, as to how ,,what,, etc.. I know it is a long surgery, but they have lots of things to do before the even begin to build the breast, then even afterwards, so they need every bit of that 8 hours,, & sometimes it might last a bit longer.. My daughter was in the hospital for the 5 days, some of those days was with the therapist on how to do things at home,, first it was to learn how to get up outta bed, a chair, and she walked with a walker,, yes a walker,, you will be walking bent over a bit, for a while. I'm thinking it was a few weeks before she could drive,, or do housework,,
      Hope you have someone at your home to help you out..
      Good Luck!!! you are on you way girl!!!

      almost 7 years ago
    • mofields' Avatar

      Hey Junie1, I'm getting close to making some decisions about my exchange and reconstruction. I meet with my plastic surgeon in November (6 months out of radiation - 33 treatments. I have also met my insurance deductible and am looking at paying more out of pocket in 2015. Here are two things to consider: number 1 and probably the most important - is your body ready for this? After radiation your skin has to have time to heal - you say you finished about a year ago - that's good. My radiation oncologist says a year past your last treatment is best - I'll be about 8-9 months out because my son will graduate from high school in May and I would like to be done with all this - but if I'm not, I'm not. Number two - if you should need to wait until next year, just do your best to handle the insurance. Work out a payment plan with your medical providers. Would your insurance want you to have multiple surgeries because you went too soon? The main point is to get healthy - no matter what you have to do. Good luck.

      almost 7 years ago
    • Steph921's Avatar

      I was in a similar position last year. I had finished rads in July and all my out of pocket was met so I decided to go for it in Nov. I'm so glad I did! It was a rough couple of weeks after but nothing I couldn't handle. I live alone so my sister came from out of town to stay with me for a week. I got out of the hospital 2 days before she got here but I managed to get by. The hardest thing was getting up from a reclining position. A friend came over and tied a rope to a sofa leg and my bed frame so I was able to pull myself up that way. I really didn't do much housework or cooking for a while but I had cleaned the house really well before I went in and people brought precooked food over. Also, by doing it in November I was able to go in before the end of the year to have it tweaked (the non-rads breast sagged more than the other one so I had it lifted-very short procedure, in @ 7 out by noon). Best of luck to you!

      almost 7 years ago
    • cartertd's Avatar

      Hi Debdawn64, I had the Diep Flap reconstructive surgery on 4/29/14. I'm not going to lie to you; it was the worse pain I have ever experience of all the procedures and surgeries I have had. I'm not trying to steer you away from it not at all. I think maybe you should look up a video on it or something. I wish I had. Anyway I was on the table for 12 hours, I was hoping to have my side boobies removed at that time(fat left over from mastectomy under my armpits) but, the doctor said I was on the table for far to long and now I have to have an other surgery to have them removed.
      My reconstructive boobs I have now are even and proportion beside of the two patch works squares I have on them. It is kinda of weird to see my stretch marks from my belly on my chest. It don't look bad just different. Oh, by the way are you going to have reconstructive nipples done or tattoo ones. I don't believe I'm going to bother with either one.
      Then you have that tremendous scar from one hip bone to the other hip bone. It's nice not seeing a big gut down there (mine wasn't all that big from the get go) however that scar....
      and remember they don't take any fat above your belly button so if you have fat above that than it will still be there.
      As the girl said above, you will be using a walker bc you will be hunch over for awhile until your muscles loosen up. The hardest part is trying to get up from lying down. So, lie on your side and use your elbow to push yourself up. I'm still doing it now. You are going to be numb in some places for a while if not permanent but, you will get use to that. Lifting still is a challenge for me even now so make sure you get PT it is really important so you can get back in the swings of things. About 12 weeks out of surgery for stomach PT. I hope I was helpful and not scary telling you this stuff; I wish someone would have told me something about the pain that comes with it. I hope you have good pain pills bc you are going to need it and like all things as women that we go through you will get through this I guarantee. Good Luck and get back with us when you are up to it.

      almost 7 years ago
    • niborflamingo's Avatar

      Hi Debdawn64. Good for you to be going ahead although it's a complicated procedure. It's not particularly dangerous but I was also in the hospital for 5 days. There is no way to anticipate pain, but my doctors and the hospital staff did a good job of helping me manage it. The drains in my abdomen were a real pain as I could not wear underwear until they came out as underwear pressed on the drain site. I had to go commando for a few days. After I got home I was depressed for about a week, then I turned the corner. It's so frustrating for me not to be able to do ordinary things. You will need some help getting around, showering, etc. so I'd suggest you call on your family and friends. Getting up is a very difficult thing; the PT will show you how before you go home. I had a walker at home due to balance issues when I was going through chemo and after the mastectomy. I suggest you have one also. The really interesting thing for me was how much it boosted my spirits to see an actual breast where there was only a big scar. I wasn't prepared for how positively it would impact me. I hope you have the same reaction!

      almost 7 years ago
    • junie1's Avatar

      DebDawn64,, you and only you can make those decision, or ifyour doctor's say to wait, then yes the body has to heal,, I know that my daughter was at least 2+ years out before they did the first part of the DIEP surgery,, and another year before they did the final nipples,, so maybe if it's possible to wait,,
      Good Luck to you,,,

      almost 7 years ago
    • banditwalker's Avatar

      I am having the DEIP done Oct. 21st. My PS gave me 3 numbers of women who have been there. All 3 told me they used a walker and one of them told me they also used a toilet chair because it still hurt to use her arms to pry herself up. No one was in bad pain but it was there and meds did the trick. I have a lazy boy I know I will be using but even that will be hard to get out of. My hubby does not have any days off coming to him so I think I will have to ask one of my friends to stop by every day in case I don't feel comfortable taking a shower by myself. I also plan on cleaning my house well and cooking and freezing food beforehand. From what these girls told me the tummy drains came out much sooner (7 days) than the breast drains, so, that's something. Oh, and one of them told me it has been 2 yrs for her and she still does not like wearing anything around her waist. I think they have come a long way in that time (hopefully). My surgeon has done almost 600 of these so am pretty sure he should know what he is doing. I am doing it before the end of the year for insurance reasons too. I will miss the holidays again I think but I try to think of it as not having to do the cooking!!! I am excited and nervous also. Good luck to you and please let us know how you are fairing.

      almost 7 years ago
    • MelanieIIB's Avatar

      Keep in mind that everyone is different. Your health, how limber/active you are and weight have a lot to do with how well you will do. You and I seem to have a lot in common. I was also HER2 positive and took Taxotere, Carboplatin and Herceptin as well as radiation. I had bi-lateral diep flap July 21 so tomorrow will be the beginning of my 10th week out from surgery. I had a very hard time deciding whether or not to have the surgery because of everything I had already been through. I just couldn't decide how badly (or not) I wanted to have breasts again. I just didn't know. I think it was my way of accepting my flat chestedness. I was self conscious going into public without a prosthesis and I felt less feminine. For those who do not have these hang-ups, it is great. Everyone is different.

      My surgeon's practice is only breast reconstruction because of cancer and he has a surgeon who helps him. My surgery was only 5 1/2 hours long, and both breasts were done. I did not have or use a walker. You do walk hunched over for about 2 weeks and my back hurt alot because I already had back pain issues and walking hunched over made it worse. I had no pain in my arms (I did have pain in my arms after my mastectomies). Your stomach will be tight for a while. In fact, my stomach is still pretty tight from under my rib cage all the way down.

      I can say I am glad I did it. I did not realize how much I really wanted to have it done. There is no feeling in the reconstructed part of the breast but when you touch that area, it is warm, just like the rest of your chest. For me, the radiated side is smaller than the other side. In about 3 weeks I'll meet with my surgeon again to discuss what he will do to make that side larger. (we had talked about fat grafting in the past).

      You will have limits on picking up nothing over 10 lbs for at least 6 weeks, some surgeons may say longer or may have restrictions less than 10 lbs. Then you can lift a little more, but still not whatever you want until at least 12 weeks out. No abdominal exercises until the surgeon says okay, usually after 12 weeks.....I am still not allowed to do abdominal exercises. My surgeon had no restrictions on my lifting my arms. He told me I could do arm stretching exercises as soon as I felt like it.....just no weight on them or stress on my abdomen. My abdominal incision was and is not overly painful. Just like when I had my mastectomies, the actual incision is sort of numb. More of my pain came from my muscles. But it is not excruciating pain.

      To sleep, I bought foam wedges to prop up my knees and trunk. I slept on the sofa with them for a while and then had them in bed until I could straighten my legs all the way.

      I had 3 drains, one in each breast and one in my abdomen. I was in the hospital 3 nights and when I left, I only had one drain.

      Make sure your surgeon does these surgeries all the time. It is good if he is "fellowship trained" which means he has had extra schooling. Also it is important if he is a member of the American Board of Plastic Surgery. I would also talk with your surgeon's patients, with your doctors, nurses, Nurse Navigator, etc. on what they think about your plastic surgeon. I asked all these people in my care and they all had very good things to say about my surgeon and his work. Since they see breast cancer patients all the time, they would know if certain surgeons have a higher rate of infections, complications, etc. The Breast Care Navigator at the hospital told me one surgeon took over 20 hours to do the surgery and there is no way she would ever recommend him.

      Does your surgeon have a website? Sometimes they have a list of questions and answers that are helpful to read. I would also suggest looking at other diep flap websites because that may stir some questions for you to ask. Your surgeon should give you a list of restrictions at your pre-op appt., if you have not already gotten it.

      Let me know how your appointment goes and if you have any specific questions.

      almost 7 years ago
    • MLT's Avatar
      MLT (Best Answer!)

      Think of you and upcoming surgery often. Everyone reacts so differently. I was diagnosed 5 years ago, had lumpectomy, chemo, and 33 rads. Feb 2013 I had unilateral Mx due to changes in scar tissue, was squamous cell carcinoma in my breast. Surgeon also removed some tissue that was scarred from rads. By summer I was ready to search for a PS after researching the different procedures and deciding I wanted a prophylactic Mx and DIEP. I was not comfortable with one boob and wearing the prosthesis. After finding my PS, 99% success rate, I was thrown into a tizzy when I found out he would be leaving a few weeks after my scheduled Nov surgery. I spoke to his nurse and she said it would be best to have him do the major surgery and then one of the others could do the tweaking, if needed. So that was my plan. I was also in the insurance time crunch and wanted to get this done before the end of the year.
      I cleaned thoroughly, moved things to lower levels, stocked up on paper plates, frozen meals, etc. Prayed so much about this being the right decision.
      The morning of surgery, I was very calm. Knew this was the right decision for me. PS told me he was going to Ft. Worth, TX, to work with one of his 'fellows', Melanie's surgeon!:) Mx was finished in an hour, total surgery was 8 hrs. Went right to a room, staff was trained very well for my care. Absolutely loved hearing the "whoosh" of the Doppler every time I my breasts were checked for blood flow. I had 3 drains. Don't remember pain being horrible, altho sitting up was very difficult. I finally remembered to push the button for pain meds when I knew I was going to sit up or get up. I didn't need a walker. I could slowly stand up. Got out of bed the 2nd day and sat up, walked the next day with help. Day after that, I was walking independently around the halls and getting to the bathroom by myself. Released the next day. I went to my son's for 6 days, until I got my drains out, then home the next day. Someone stayed with me overnight and checked on me during the day. Slept in my own bed with pillows behind my back and did stairs right away. Wore surgical bra 2 weeks, then sports bras all the time for 6 weeks.
      Lifting limit was 2 lbs until drains were out, then 10 lbs for 12 weeks. I was allowed to shower once home from the hospital. Did so with help from family for a couple times, then on my own at home. I think I started driving a little by 2 1/2 weeks, then an hour trip after 3 weeks for Thanksgiving. Was able to shop a little at a time for holidays. Hardest part was loading the car 10 lbs at a time! Same thing for the grocery store. I told baggers all bags had to be no more that a gallon of milk (8.6 lbs.) I was exhausted after busy days for Christmas and New Years, but felt good.
      I did have some trouble with inside stitches healing (1 breast and ab), but I usually do. Once those were removed, my incisions healed. My breast on the rads side is a little smaller, but not noticeable with clothes. Don't think I'll have anything adapted, but not sure. Not getting nipples. I do have a belly issue, have an abdominal bulge.( In looking thru my notes, this was mentioned.) Either tissue was not pulled as tight on the right side or inside sutures didn't hold. No muscle was taken. I look like I'm 6 months pregnant. Even more so after having ovaries out in June. So, on to another surgery since I've met deductible and copay again. Go for presurgery in a week, then scheduled for Nov 3. Belly is tight and numb, breasts are warm, rounded, and also numb, and none of this affected my Lymphedema. Still praying about this surgery. It will be outpatient, but another long healing period.
      As with the others, please let us know if we can answer questions.
      Just remembered, I had mostly male nurses and aides at the hospital! My biggest challenge when I got home, was finding mice in the pantry since I had been gone for 1 1/2 weeks. Yikes!
      I recently watched a DIEP video. Whew! So intense. The naval was saved, just relocated. I'm sure mine was made.Ask how many surgeries PS predicts you will need, how many he has done and success rate. Oh, yeah, make sure you have Miralax and take it right away while on pain meds. Eat lots of protein before and after surgery to help,with healing. I made a notebook for all the info I was given and had it at the hospital with me and always available. Was very helpful! Hugs to you!

      almost 7 years ago
    • MelanieIIB's Avatar

      So MLT, you decided to have your surgery? I'm glad for you and know you will do fine. I was praying that God would let you know what you should do.

      almost 7 years ago
    • MLT's Avatar

      Just remembered: Depending on how much belly you have, you may end up with bigger breasts than expected. PS wants to do minimum to flap at the time, adjustments later. I had just enough to give me B's. Something to ask about. And bulge only happens 1-2% of the time.
      Not positive about surgery. It was scheduled in March. Keep up the prayers for a definite decision.
      Thanks! Let me know how your check up goes.

      almost 7 years ago
    • Debdawn64's Avatar

      Wow, great replies, thanks everyone! Thanks for the indepth reply MLT. I pray your surgery will go well and your recovery time short. I go for my preop appoint. on Oct. 29th, I will fly into Ks City and stay with a daughter. I had no idea what to expect, now I know a little more. I realize everyone is different, but it sounds like I could possibly need a walker and getting up and down is difficult. I will certainly have Miralax and pain meds on board! I feel a lot better, thank you all so very much! Much luck and love to each of you! May we all live our lives and not our cancer!

      almost 7 years ago
    • savingrace's Avatar

      Totally natural to be nervous. Write down everything that comes to mind and ask your doctor when you go. Everyone is different but find out what your limits will be following the procedure. Try to have someone to be able to help you once you get home. With having the drain tubes and a sore belly you may be a little out of commission for a week or so. Like it has been said getting up and down, mostly up will be a problem. I slept in a chair for about the first week. Nothing was unbearable just mostly uncomfortable. Pain for me was very minimal. Constipation was the biggest problem I encountered, (worst than the surgery) so you may want to ask your doc about that prior to. I had my reconstruction approx. 7 years ago and have not regretted one minute. My prayers will be with you for a successful surgery and a speedy recovery.

      almost 7 years ago
    • MelanieIIB's Avatar

      Since you are flying for your surgery, you could fly here to Texas and have the surgeon MLT and I both had.:) MLT made reference to this and I just have to share "what a small world it is.". MLT is in Ohio, I am in Texas. She told me her plastic surgeon moved to Texas after her surgery. She asked me if I by chance had heard of him. It turns out my plastic surgeon recently got a partner, and it is MLT's surgeon. So when I had my diep flap in July, the surgeon who assisted my surgeon was the one who performed MLT's diep flap.

      almost 7 years ago

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