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Reconstruction implants or DIEP flap: How did you choose?
I had mastectomy on 9/27/2022 with nipple sparring and expanders. I’m currently going thru radiation and will do reconstruction after skin is healed. I don’t care much about implants and more inclined for flap.
After mastectomy, I had anxiety on whether I should have opted for no nipple and skin sparring and how much that would impact recurrence. I was assured it wouldn’t make a difference but learned there are some breast tissues left as they can’t remove everything. Since I’m yet to do reconstruction, part of me wants to remove the nipple/skin and do diep flap.
I would appreciate to hear from those that have done implants or diep flap. Also thoughts on removing the original nipple and skin? Not sure if I’m being too paranoid about the nipple sparring.
I had her2 positive stage 2, did 6 treatments of herceptin and perjeta. Mastectomy, had 7 positive lymphnodes, currently doing 15 sessions of radiation and going thru 14 treatments of kadcyla.
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I need to add. Driving you can start after you are off narcotics lightly.
No caffiene (coffee or chocolate) for a month post op. Constricts the blood vessels.
For first 2 weeks it takes a lot of energy to stand.
I lived in a recliner for a month. I slept in an electric recliner so it was easy to get up.
Can’t sleep on your sides for 4 weeks. It took me almost 6. It takes a lot of effort to turn in bed.
Restrictions are adjusted based on how you are doing. Ask your surgeon about yours.
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2 ReactionsOh my....Very intense recovery. From your comment above it sounds like you had radiation which led to to decide on the DIEP. As of now, I will not need radiation or chemo which will be finalized with Oncology at the end of Jan. For now, I go back and forth on which procedure I want to move forward with. Thank you for sharing your experience, it gives me a deeper understanding of what to expect if this is the option chosen. You are a warrior in all that you have gone through.
I had the DIEP flap over implants because
I have a few friends that got implants and now they are getting them removed/exchanged because of leukemia risk issues with the implants.
One big surgery for diep flap vs many with implants as they have to be exchanged over your life
DIEP flap is using your own tissue so it feels more natural and is warmer than implants. Implants can be cool to the touch.
I asked my surgeon, if it was her what would she do. She said DIEP flap and why. She also does implants so she isn’t just one type of surgeon.
I also relied on Mayo saying radiated breasts have a 40% rejection rate for implants. I didn’t want anymore issues.
It is a harder recovery. I had good timing with my surgery and work so I could do it. I have flat abs and am happy with the results. I should say I was not in the best shape before surgery cardiovascularly and I did get a plural effusion on the right side which didn’t help the breathing post op but it’s gone now. I am confident things are just going to keep getting better and better as days go on.
It’s not an easy decision at all. Implants are easier. DIEP flap is a time commitment for sure.
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1 ReactionI 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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1 ReactionSuch 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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3 ReactionsI'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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2 ReactionsHad 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.
Sharon, did you do DMX or SMX? I am planning SMX with some fat transfer to opposite side.
I had a double mastecomy a year ago. Skin and nipple sparing.
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1 ReactionThank 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.