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DIEP Flap vs. Implants

afillmore's picture
afillmore
Posts: 4
Joined: Apr 2013

Hi everyone - I'm new to the forums. I was diagnosed in October 2012. ER/PR+ Her2 - Stage 2B. I was positive in 3 nodes on the right. I had a bilateral mastectomy in December 2012. I'm working my way through chemo. Finished 8 weeks of AC - on week 5 of 12 of Taxol. Then I get 6 weeks of radiation.

Right now I have tissue expanders and they stink! They are uncomfortable - the muscle over them is sore all the time. When I try to read my son bed time stories or snuggle - if his head touches my expanders they hurt a lot. I'm so over these rocks.

I pretty much decided on DIEP flap reconstruction. I'm 5'7" and size 14.. so I've got enough stomach fat to do it. I had really large breasts before 38DDD so I'm not too sorry to have much smaller breasts now. They will make running in the future easier. (if they don't hurt like they do now)

I'm leaning towards DIEP because it's my own tissue and after all these surgeries and treatments. The thought of having implants a foreign thing in my body that may need to be exchanged or replaced in the future - is just not appealing to me.

However, having a second surgical site (my abdomen) bothers me. I had a c-section when my son was born (that was no fun). Every-time a surgeon gets into your body - it's never the same. There's always a weird pain or something that doesn't heal right. So by having implants, there's no additional abdominal surgery - so that's appealing.

Or I've even thought about taking out these tissue expanders and doing nothing! Flat chested and comfortable at this point sounds like an OK option to me.

So I'm wondering what others experiences have been?  

What type of reconstruction did you have?

How comfortable are you now? 

Do your breasts/implants hurt? can you sleep on them? get hugged by your kids? touch them with out them hurting?

I used to lift a lot of weights in the gym? Anyone working out again?

 

Thanks ladies for the replies. I really appreciate it.

Amanda 

 

mickeymom
Posts: 117
Joined: Jul 2009

I was diagnosed in April 2009 and had a bilateral mastectomy the following month.  That was followed up with chemo and radiation which wrapped up by the end of that year.  My surgeon didn't want to do any reconstruction at the time of the surgery so I waited for a while.  After I finished radiation, I went with a couple different kinds of prostetics for a year and a half and I absolutely hated it.  I finally decided to meet with a plastic surgeon and he told me that an implant wasn't an option because the radiation had really damaged the skin too much.  So I went with the Diep Flap surgery in July of 2011.  I have never regreted that decision for even a minute.

The first surgery was long - 7 hours - and yes I do have quite a scar across my abdomen. The scar is kind of hard in places and there is one place where it sort of pinches sometimes, but mostly I don't even notice it anymore.  I was in the hospital for 5 days but I was never really all that uncomfortable.  The pain was very managable and other than fatigue and the drains (which came out about 2 weeks after surgery) the recovery was really not bad. The nurse told me that the pain wasn't as bad because they didn't go into my body cavity. The flap was just removed.

I had two additional surgeries after that.  The first one was about four months later to do some tidy up work on the flap and do a breast lift on the other side. I'm in my 50's and they didn't exactly match. That surgery was about 2 1/2 hours and I really had no pain or problems with that one.  And now they match beautifully.  Surgery was on a Wednesday and I went back to work the following Monday. The third surgery was to create an artificial nipple.  That only lasted about an hour. The procedure was on a Friday and I went back to work on Monday.

It was quite a few months later that I had the nipple tattooed to give it color. That was an office procedure and took less than a half hour.  It looks very realistic now. I need to go in and have the color adjusted a little, but I just haven't done it.

I love how the flap looks.  I've had people ask me what I had done because they say it looks very natural. It feels good, although it isn't exactly like my original. As time has passed I have even regained some sense of feeling across the bottom part of the flap.  The surgeon says the nerves do whatever they want and he can never predict how that will go. Sometimes it doesn't happen.

I am completely comfortable. I don't even think about it anymore.  I go to the gym and have no problems at all. I can sleep in any position. I'm also glad that I don't have to go back to have an implant replaced.  However, the surgeon did say that I may want to have a second breast lift as I get older because the flap won't start to sag exactly the same as the other side.

I hope the rest of your chemo goes well.  I had Taxol too and it can be a bear. Radiation isn't too bad.  Just boring and tiring.  Hang in there!  Sounds to me like you're fighting the fight and winning!  I hope you have great luck with whatever you decide to do.

Debbie

McMarty's picture
McMarty
Posts: 200
Joined: Nov 2012

Hey!  I had a DIEP flap during the same surgery as my mastectomy in 2004.  I also had 3 c-sections.  The DIEP flap is different because they don't go into muscle.  It's all just right under the skin.  I love my flat tummy and that they used my own tissue.  I love that this flap does not compromise my abdominal muscle so there are no lifting restrictions.  There are some strange nerve sensations sometime - like when snuggling results in an elbow to the sternum or right where the abdominal scar crosses that hip bone.  Hula hooping can be uncomfortable but I really don't miss it :)  I don't sleep on my stomach but I think I could. 

I think you will be very glad you went that way if you choose DIEP flap.  I know I am VERY happy with mine!

Oh PLUS its a 'free flap'  which means they move it out side the body, the tissue is not moved through your body from one place to another.  That just sounds painful!

 

sea60's picture
sea60
Posts: 2601
Joined: May 2010

I had it done after a bilateral in 2007. They used the tissue and fat from my tummy and reconstructed both breasts. I also have a flat tummy so that surely is a positive. It's a long surgery and of course, you have the recupe time with drains coming from top (chest) and bottom (tummy). But once it's done, it's downhill. I feel I made the right decision for me. They feel natural. I do have a little numbness on the right breast that had the cancer which is normal and not bothersome. I pray you make the right decision for you. I did not have a c section so just ask any question of concern.

Let us know how it goes :)

 

Sylvia

lintx's picture
lintx
Posts: 456
Joined: Sep 2012

 

I had the Diep Flap last May at the time of my bilateral.  It was a really long surgery for me.  I'd choose the same again because of using my own tissue and no muscle involvement.  Recovery is about two weeks, and the drains are a huge pain.  After that part, it's smooth sailing for sure.  Good luck with your decision.  Linda 

Gabe N Abby Mom's picture
Gabe N Abby Mom
Posts: 2415
Joined: Sep 2010

I had a bilateral no reconstruction in Jan 2011.  I wear prosthesis now, they're very comfortable.  Even so, on rough days I go with out the prosth and let people wonder.  I can swim with my prosth too.  The only down side is there are some styles I choose not to wear, strapless or spagetti straps, don't work with my mastectomy bras.  I could get a strapless mastectomy bra but it seems like they would just flop around too much for me.

Overall, it was the right decision for me.  I wish you the same right decision for you.

Hugs,

Linda

 

afillmore's picture
afillmore
Posts: 4
Joined: Apr 2013

Thank you everyone. I appreciate the time you all took to respond.  I'm almost half way through chemo - then 6 weeks of radiation - so I'm going to have these tissue expanders in maybe for the rest of the year.. depending on when/if I want to have reconstruction.  They are so uncomfortable.. it's just frustrating   I want to be able to work out and lift weights like I used to. I just feel weaker and that stinks!  

I had large breasts before - that were annoying to deal with say running or working out. Now I have sore chest muscles because of the tissue expanders .. I'm just wondring if having stupid boobs is woth it.. they seemed to have casued nothing but trouble (and maybe attracting my husaband - which was a good thing) .. he supports me in what ever my decision is.. I just kind of feel like having reconstructed franken-boobs.. may or may not be better than no boobs. I wonder if they will ever feel normal like a part of my body. It's hard to tell since I can't stop thinking about them now becasue the expanders hurt.. so I think about them all the time.

Confused, 

Amanda

kdawg
Posts: 7
Joined: Apr 2013

Hi Amanda

You sure do sound like you are doing wonderful all things considered. I have to tell you I too HATED my expanders. I had them in for 7 months during chemo treatment. I have implants that were put in December 2012. The relief was immediate, those expanders felt like body armour. I absolutely love my implants, they are in their proper place, they are soft, they make me feel very confident and I sleep on my stomach. I know you feel like there is no end to being uncomfortable and all the treatment you have ahead of you. Please know and trust that the end result you choose, will be the right one as long as you believe in it. So many of us are so fortunate for many different reason. I look at your beautiful smile and the sparkle in your eyes and know you will be OK and even an inspiration to others. Think about pros and done of each and trust yourself.

Best of luck to you and I look forward to your future nposts.

Kathy

kdawg
Posts: 7
Joined: Apr 2013

Hi Amanda

You sure do sound like you are doing wonderful all things considered. I have to tell you I too HATED my expanders. I had them in for 7 months during chemo treatment. I have implants that were put in December 2012. The relief was immediate, those expanders felt like body armour. I absolutely love my implants, they are in their proper place, they are soft, they make me feel very confident and I sleep on my stomach. I know you feel like there is no end to being uncomfortable and all the treatment you have ahead of you. Please know and trust that the end result you choose, will be the right one as long as you believe in it. So many of us are so fortunate for many different reason. I look at your beautiful smile and the sparkle in your eyes and know you will be OK and even an inspiration to others. Think about pros and done of each and trust yourself.

Best of luck to you and I look forward to your future nposts.

Kathy

kdawg
Posts: 7
Joined: Apr 2013

Hi Amanda

You sure do sound like you are doing wonderful all things considered. I have to tell you I too HATED my expanders. I had them in for 7 months during chemo treatment. I have implants that were put in December 2012. The relief was immediate, those expanders felt like body armour. I absolutely love my implants, they are in their proper place, they are soft, they make me feel very confident and I sleep on my stomach. I know you feel like there is no end to being uncomfortable and all the treatment you have ahead of you. Please know and trust that the end result you choose, will be the right one as long as you believe in it. So many of us are so fortunate for many different reason. I look at your beautiful smile and the sparkle in your eyes and know you will be OK and even an inspiration to others. Think about pros and done of each and trust yourself.

Best of luck to you and I look forward to your future nposts.

Kathy

afillmore's picture
afillmore
Posts: 4
Joined: Apr 2013

Thanks Kathy!

Yes these tissue expanders are driving me nuts! They hurt all the time.. and I just want to rip them out. It's funny that you mentioned they feel like armor... I told my friend that even when I'm in the shower naked.. I have to look down from time to time because I feel like I have a shirt on.. it's weird. 

Since your exchange surgery you feel more like yourself?   How is your muscle strength? 

I want to be able to get back into the gym and do pushups again.. I'm frustrated because I feel like I've already damaged my muscles by having these expanders put in.. and if I decide to have them taken out my muscles will never recover.

Because these expanders are so annoying, it's all I can think about.. I'm just wondering if implants feel 'normal' ever and I guess by normal.. I'm just wondering if you ever don't think about them. 

That's what I really want after this - either diep flap, implants, or no reconstruction. I want to have hours.. where I don't think about my boobs and breast cancer.  

Twingey pain and being uncomfortable just make me think about it all the time. It's been four months since my surgery and it's going to be another four months of chemo and radiation.. I just want this part to be over.. 

I'm not having a great day.. and friends that haven't been through this try to help.. but until you've had a bilateral mastectomy... you just don't get it down deep.. you know?

 

(and yes..that is a photo of me with my son Charlie.. he will be four in July)

 

good news.. I think my hair is starting to grow back now that I'm not on A/C anymore.. 

jnl's picture
jnl
Posts: 3873
Joined: May 2009

Amanda, you are so beautiful!  Is that your son in your picture with you?  A real cutie!  I had a lumpectomy, but, want to wish you the best in whatever you should decide to do. 

Hugs, Leeza

Angie2U's picture
Angie2U
Posts: 2993
Joined: Sep 2009

You are so pretty and what a cutie with you!  Wishing you all the best also in what you do.

Hugs, Angie

Ritzy's picture
Ritzy
Posts: 4384
Joined: Aug 2009

Bumping up for smilingdeb!  Hope it helps!

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