TRAM Flap or DIEP Flap

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  • 20questions
    20questions Member Posts: 24
    #22
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    Balentine said:

    Thanks sea60
    I will talk to my plastic surgeon again on 7/13 and see what he says but I know the last time I talked to him, he wanted to do the muscle sparing free tram flap on me after examining me. I am also considering having my other breast removed since I am a poor metabolizer of tamoxifen. I will be discussing this with a 2nd onc tomorrow to get a 2nd opinion before we take off for the weekend to St. Louis so I will try to check in with you again over the weekend if I get some wifi where we are going. Thanks for the information and I will definitely consider all my options and do my research before I make a final decision.
    Lorrie

    Balentine.....
    Where are you located and I will try to find you a surgeon who does DIEP. Even just for an opinion, it is worth talking to a surgeon who actually does the DIEP surgery so you get a complete picture of all of your options.

    "G"
  • jk1952
    jk1952 Member Posts: 613
    #23
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    20questions said:

    Balentine.....
    Where are you located and I will try to find you a surgeon who does DIEP. Even just for an opinion, it is worth talking to a surgeon who actually does the DIEP surgery so you get a complete picture of all of your options.

    "G"

    I may be confused, but I
    I may be confused, but I think that the muscle sparing free TRAM flap and the DIEP are almost identical. When I had my surgery, I had to have one breast reconstructed using a DIEP procedure and the other using a free TRAM procedure (because I had a compromised blood supply in my breast from previous radiation). I don't really notice a difference between the two sides...in fact, I have had more problems with the side of the abdomen where I had the DIEP than the one where I had the free TRAM. But, I'm extremely happy with the results from each of the procedures.

    That being said, I know that the team in San Antonio has a good reputation, and I refer to their website often.

    Joyce
  • Balentine
    Balentine Member Posts: 393
    #24
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    20questions said:

    Balentine.....
    Where are you located and I will try to find you a surgeon who does DIEP. Even just for an opinion, it is worth talking to a surgeon who actually does the DIEP surgery so you get a complete picture of all of your options.

    "G"

    Killeen, TX
    I live in Killeen, TX...it is about 2 hours from San Antonio. I am not planning on doing the reconstruction until next summer. I am going to Scott and White hospital in Temple, TX which is just 20 minutes away but the plastic surgeon I talked to said he did not recommend the DIEP for me....he said he could do it but he thinks I am a better candidate for the muscle sparing free tram flap for some reason...you know...chemo brain....cant remember exactly why....I think he said he has had more success with this one and has seen alot of infections with the DIEP.
    Lorrie
  • seof
    seof Member Posts: 819 Member
    #25
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    Balentine said:

    Killeen, TX
    I live in Killeen, TX...it is about 2 hours from San Antonio. I am not planning on doing the reconstruction until next summer. I am going to Scott and White hospital in Temple, TX which is just 20 minutes away but the plastic surgeon I talked to said he did not recommend the DIEP for me....he said he could do it but he thinks I am a better candidate for the muscle sparing free tram flap for some reason...you know...chemo brain....cant remember exactly why....I think he said he has had more success with this one and has seen alot of infections with the DIEP.
    Lorrie

    I had bilateral DEIP done in
    I had bilateral DEIP done in Dallas by Dr. St. Cyr at UT Southwestern Medical center. He did a great job and handled some rare complications I had very nicely. Look on the American Cancer Society website at their online bookstore. There is a book that Dr. St. Cyr recommended which I found very useful. I think it is called, "a guide to breast reconstruction", or something similar. DIEP is a muscle-sparing free flap procedure, but there may be some other procedure that fits that description too. Scott and White is probably a great place to go. M.D. Anderson in Houston, UT Southwestern, and some place in San Antonio, the places I'm aware of in Texas for the DIEP procedure.

    Live as well as you can for as long as you can, seof
  • New Flower
    New Flower Member Posts: 4,294
    #26
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    seof said:

    I had bilateral DEIP done in
    I had bilateral DEIP done in Dallas by Dr. St. Cyr at UT Southwestern Medical center. He did a great job and handled some rare complications I had very nicely. Look on the American Cancer Society website at their online bookstore. There is a book that Dr. St. Cyr recommended which I found very useful. I think it is called, "a guide to breast reconstruction", or something similar. DIEP is a muscle-sparing free flap procedure, but there may be some other procedure that fits that description too. Scott and White is probably a great place to go. M.D. Anderson in Houston, UT Southwestern, and some place in San Antonio, the places I'm aware of in Texas for the DIEP procedure.

    Live as well as you can for as long as you can, seof

    Lorrie
    I had DIEP and than 6 cycles of Chemo followed by radiation.I was in excellent shape excluding that I had BC. It took me at least 12 month to recover from Chemo and radiationI and I cannot imagine myself going into major surgery before complete recovery from Chemo. Plus after Chemo immune system is still compromised and needs time to come back.

    Wishing easy time with your decision and luck with whatever reconstructive surgery you choose to have.
    New Flower
  • Balentine
    Balentine Member Posts: 393
    #27
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    New Flower said:

    Lorrie
    I had DIEP and than 6 cycles of Chemo followed by radiation.I was in excellent shape excluding that I had BC. It took me at least 12 month to recover from Chemo and radiationI and I cannot imagine myself going into major surgery before complete recovery from Chemo. Plus after Chemo immune system is still compromised and needs time to come back.

    Wishing easy time with your decision and luck with whatever reconstructive surgery you choose to have.
    New Flower

    that is exactly the other reason why I wanted to wait until next summer to do the reconstruction but now they are telling me since I am a poor metabolizer of tamoxifen and should not take it that I need to have my ovaries out and then take arimidex so I still may have to have surgery soon. I am not ready to go through surgery again. I will find out more in the coming weeks when I get back in town and get an appt with a GYN doctor.
    Lorrie
  • 20questions
    20questions Member Posts: 24
    #28
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    Balentine said:

    that is exactly the other reason why I wanted to wait until next summer to do the reconstruction but now they are telling me since I am a poor metabolizer of tamoxifen and should not take it that I need to have my ovaries out and then take arimidex so I still may have to have surgery soon. I am not ready to go through surgery again. I will find out more in the coming weeks when I get back in town and get an appt with a GYN doctor.
    Lorrie

    Ok... so in Texas you have wonderful great options!!
    Houston - Aldona Spiegel MD - www.breastrestoration.org

    San Antonio - Minas Chrysopoulo MD - www.prma-enhance.com

    Both practices do DIEP and it is worth asking about that procedure before undertaking a TRAM.

    Best Wishes - G
  • Balentine
    Balentine Member Posts: 393
    #29
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    20questions said:

    Ok... so in Texas you have wonderful great options!!
    Houston - Aldona Spiegel MD - www.breastrestoration.org

    San Antonio - Minas Chrysopoulo MD - www.prma-enhance.com

    Both practices do DIEP and it is worth asking about that procedure before undertaking a TRAM.

    Best Wishes - G

    Thanks
    I will be looking into this. I have until next summer to decide.
    Lorrie
  • jnl
    jnl Member Posts: 3,869 Member
    #30
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    Balentine said:

    Thanks
    I will be looking into this. I have until next summer to decide.
    Lorrie

    Wishing you good luck Lorrie
    Wishing you good luck Lorrie when you can have your surgery done.

    Hugs, Leeza
  • Kitchy111
    Kitchy111 Member Posts: 2
    #31
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    jk1952 said:

    I had a bilateral mastectomy

    I had a bilateral mastectomy and DIEP reconstruction in April 2009, and I would definitely have it done again. I was very fortunate to have the mastectomy and reconstruction done at the same time and I did not have chemo. I'm not sure what I would have done if I had needed to wait for the reconstruction: I can see why you are on the fence right now. It would be hard for me to go through one recovery period and then do it all over again. It might be better for you to wait for a period of time until you have peace with having another surgery.

    A Connie metioned, the surgery is long, and the recovery is 6 - 8 weeks. I have a high pain tolerance, and didn't take any of the narcotics after the second day post-surgery, just Tylenol or Motrin. My biggest problems were with my abdomen also, with a slight infection of my belly button and the last drain becoming plugged and having to be removed. Fortunately, I only had to have fluid aspirated a couple times and then everything was fine.

    Joyce

    Would love your input
    Hi - I see you are from Syracuse... I am from the Binghamton area. I had stage 2b invasive ductal carcinoma back in 98, and went through lumpectomy, nodes removed, chemo & radiation. I have had a few scares and biopsies since then and am now awaiting results from stereotactic biopsy in 2 places on my cancer breast. I am seriously considering a bilateral mastectomy with DIEP reconstruction. Would you mind sharing your doctors name and any thought you have on going forward with this. I am 45 and it seems I am looking to a lifetime of 'questionable' mammo's if I don't do this. Thank you!
  • sal314
    sal314 Member Posts: 599 Member
    #32
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    If You're Not Sure...Maybe You Should Wait
    I waited 4 years to have my reconstruction. Just couldn't handle going through one more procedure! I looked into the DIEP and TRAM, but ended up getting a LAT Flap instead. I didn't have enough tissue tissue in my belly area so they say. (I tend to disagree!:)) But the more I read about core muscle issues and how long the surgery was, I was too nervous about that.

    The LAT flap was for me the right choice. The surgery recovery time was shorter and I couldn't be more pleased with the results. At first I was worried and didn't want one because I read all these stories of losing strength in my arm, et. But I've had NO problems.

    Anyway...what I really wanted to say is take your time. There is no rush. If you're feeling even a little bit unsure, maybe that means you need to wait.

    And whatever you decide...go to at least two different surgeons! Make sure you're seeing someone with LOTS of experience. Ask to see pictures of his/her work and if there are previous patients that would be willing to talk with you!! I did all that and my doctor was more than happy to refer past clients to talk with me. THAT'S were you really find out what the "truth" is!

    My gyne warned me about all that because she said she has seen more horrendous outcomes than good ones with all kinds of breast reconstruction! Thankfully for me, she said mine was the best she's ever seen!(Whoo-hoo. LOL.)

    Good luck with whatever and whenever you decide to procede with! :)

    Sally
  • CypressCynthia
    CypressCynthia Member Posts: 4,014 Member
    #33
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    In 1987, my brilliant young
    In 1987, my brilliant young surgeon did a TRAM because that was all that was available at the time. The TRAM was a long and difficult recovery. The results were good, but I was out for about 6-8 wks.

    That same young surgeon then practiced on cadavers until he was able to figure out how to do the "free" flaps. He was the originator of the DIEP, SGAP, IGAP. He now has offices not just in New Orleans, but also in New York and South Carolina.

    When I had to have another mastectomy years later, he did an SGAP (couldn't do DIEP after TRAM) and wow what a difference! Much less pain. Can you believe I was lucky enough to stumble into surgeon who "invented" these procedures?

    As others have said, it is critical to find a surgeon who is really skilled in this complicated procedure. Ask to see photos, talk with nurses at your hospital, ask other doctors who they would recommend, etc. If you can only find someone skilled in the TRAM, I personally would do it again anyway. Once the recovery is over, it is over and I did feel better having a breast again. Just me--we are all so different, but that is my 2 cents ;-)
  • jk1952
    jk1952 Member Posts: 613
    #34
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    Kitchy111 said:

    Would love your input
    Hi - I see you are from Syracuse... I am from the Binghamton area. I had stage 2b invasive ductal carcinoma back in 98, and went through lumpectomy, nodes removed, chemo & radiation. I have had a few scares and biopsies since then and am now awaiting results from stereotactic biopsy in 2 places on my cancer breast. I am seriously considering a bilateral mastectomy with DIEP reconstruction. Would you mind sharing your doctors name and any thought you have on going forward with this. I am 45 and it seems I am looking to a lifetime of 'questionable' mammo's if I don't do this. Thank you!

    I just sent you a PM with
    I just sent you a PM with info about my doctors.

    Joyce
  • Xlom
    Xlom Member Posts: 1
    #35
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    Kitchy111 said:

    Would love your input
    Hi - I see you are from Syracuse... I am from the Binghamton area. I had stage 2b invasive ductal carcinoma back in 98, and went through lumpectomy, nodes removed, chemo & radiation. I have had a few scares and biopsies since then and am now awaiting results from stereotactic biopsy in 2 places on my cancer breast. I am seriously considering a bilateral mastectomy with DIEP reconstruction. Would you mind sharing your doctors name and any thought you have on going forward with this. I am 45 and it seems I am looking to a lifetime of 'questionable' mammo's if I don't do this. Thank you!

    Diep in Syracuse area
    Do you know a plastic surgeon who is experienced in diep reconstruction in the Syracuse area?
  • sagocat
    sagocat Member Posts: 1
    #36
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    sailing?
    Hi there, I saw your picture, and wonder if you sail? I have just had a DIEP in the UK, and we have a 37' sailboat in Greece which I hope to sail this summer. How did that go for you if you are a sailor?

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