Breast implant vs. DIEP Procedure

Posted by mkefighter @mkefighter, Jan 8 9:22am

Hello,
I have had a mastectomy on the left with a tissue expander placed for future reconstruction. Since my diagnosis I have been going back and forth between a breast implant and the DIEP procedure and still have not made a decision. I have some time to decide, however, looking to find out what others have experienced with these two procedures.

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Had diep at time of mastectomy - then my belly fat put it. all at same time. Really pleased.
I would not like a foreign object in there.

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@sharonemma

Agree DIEP flap is a major surgery. I just had it in December 2023. It looks great and was worth it. Mayo told me on a radiated breast there is a 40% chance of implant rejection, Here is my experience: No cooking, cleaning, laundry or lifting more than 5 pounds for 4 weeks. Slowly add things after 4 weeks So basically no repetitive movements. It can cause you to lose the flap or can collect fluid. Start lifting your arms above your shoulders after 8 weeks. My abs are still sore 6 weeks post op between belly button and bottom of rib cage. It took 3 weeks to stand up straight. Compression garments for 6 weeks. You’ll need lots of help with meals, garbage, pets, laundry. I had some fluid build up in my abdominal incision so I could only get up from chair and do a light 10 minute walk 2x a day for week 3-5. Also they said it would take 8 weeks to get stamina back, maybe longer. My surgery was 13 hrs, it just takes alot out of you.

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Sharon, did you do DMX or SMX? I am planning SMX with some fat transfer to opposite side.

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I had a double mastecomy a year ago. Skin and nipple sparing.

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@amypet

I had DIEP 4 years ago same day reconstruction on the day of my double mastectomy. I choose this surgery because I didn't want to have implants or any foreign items in my body. This is a very big surgery and you have to have a support team to help you for a good 6 weeks. Recovery was very rough as well. Bruised beyond words, 6 drains that I had to take care of and just a rough recovery. I unfortunately had some other medical issues following my surgery due to a previous Liver Disease. I had a stroke (no lasting affects) and then just two years ago a double transplant. My recovery has been a long process between all. I am happy to say I have just had one of the last two surgeries to finish/correct some final breast adjustments. Was a rough recovery as well and brought back many memories of my original surgery. I say do all the research you can for both and make the decision that is best for you. I wish you the very best and a fast healing and recovery when you decided. But always stay strong and postitive through it all :). That's what got me through my last four years.

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Thank you for sharing your experience. You have been managing multiple health issues, I can't imagine how challenging this has been. I appreciate your honesty about the recovery as this has been my concern with the DIEP.

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@rhongirl

Such a big decision. Women make their choice for all sorts of reasons. My DIEP flap was almost 3 1/2 years ago now. While it was the only decision for me (for a number of reasons), I am still working through shoulder issues from the procedure. I had more pain in my shoulder than the surgical area (after the procedure), and still do today. My procedure was done at Mayo in Rochester, and I had a wonderful surgical team. It has been my experience (and my PT's) that Mayo is not, however, well as known for their rehab. This has been my experience in multiple (multiple) surgeries. Having said that, I asked if I could begin therapy at 8 weeks, and was told I could not - leaving my arms down for the duration of 12 weeks. Being a rule follower, I did not see my physical therapist until after 3 months. Fast forward to today - I am still having PT even 3+ years later. It's been a challenge, one that I continue to work though and manage. I have an Endless pool, so water therapy is grand for rehab, yet I have periods where I can't even swim a stroke due to the one shoulder. I'd like to say I simply adjust, but sometimes I get discouraged. Mostly, I am able to realize it is one thing out of many things that can happen, and I move on with life.

All of our choices are a trade-off. There are always going to be things we have to give up, adjust to, be happy about, or be disappointed with. And in some cases, we feel like we don't have much of a choice at all. In terms of a DIEP flap, I am glad that I can go to bed every night not wondering if my ducts are hiding new cancer cells (because those ducts left with the double mastectomy). And I'm glad that I don't have to think about my body reacting to implants (because I did not have any, except for the original expanders that were removed during the DIEP flap). And I'm glad that my rebuild was done with my own flesh. Though my breasts will never be what my original set was, I honestly forget they are not my original, for they have become my new normal. I'm thankful that time has caused me to feel this way . . . even with the scar tissue, even with the loss of sensation. It's really all ok. My hunch is, whatever you choose, in time you will be ok, too. It's more about how we look at things than what the physical result is. I'm just glad to be here, and having an opportunity to live life. My DIEP procedure gave me an opportunity to live that life with the appearance of my old normal, which helped me move on. 🙂

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Thank you for taking the time to reply to my post. You are right in saying that it is how we look at things that makes the difference. What makes me nervous about the DIEP is the rough recovery. I am hopeful that after my consult, there will be more clarity. I appreciate what you shared about your shoulder, this will be something I will ask about. Like you said, I will make the right decision for me, it is getting there that is somewhat stressful.

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@chiara58

I'd like to add my weird experience. I had double mastectomy in 2018, I had chosen DIEP procedure. Before starting that, I had to recover completely from radiation and chemotherapy treatments. Almost a year later I was ready for the procedure, but unfortunately a second cancer, unrelated to breast cancer, showed up. I had to restart treatments, and I'm still on chemo. No DIEP surgery anymore. If I had considered the possibility that something else could have happened before the DIEP surgery, I would have certainly chosen implants.

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Oh my goodness....You have been through it...Thank you for sharing your experience, you have been persevering for sure. I wish you safe healing.

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