DIEP Flap Breast Reconstruction

Posted by catann @catann, Mar 4 1:50pm

I had a bilateral mastectomy last September. At that time, I was planning to have implants inserted after I healed. But then I developed an infection in one breast, and my tissue expanders had to be removed. Unfortunately, the infection destroyed some of the fat tissue, and so some of my breast skin is now very thin. As a result, it is not clear if implants would work well.
Given all this, I am now looking into flap surgery using my own tissue to reconstruct my breasts. I am very interested in connecting with women who have been through this procedure. I am also wondering if anyone knows about the best centers/surgeons to get this surgery done. Thank you!

I had bilateral mastectomy with diep flap reconstruction in July 2020. I had it all done in one big (10 hour) surgery. The only negative thing with the surgery is that I had a ferocious headache for a couple of days after. I believe it was from the anesthesia. I did not expect that at all as I have had a few surgeries and never had this problem. Needless to say it really affected my hospital stay. After the headache went away, everything was easy….Friday was surgery all day and I went home on Monday afternoon. I had no pain at all. Things felt different and strange, but no pain. Are you aware that you need some pudge going on to have that surgery using stomach tissue? Otherwise it can be taken from the fanny or back I think. I had four drains…one for each breast and one on each side of the stomach area. That was not a big deal, but kind of an annoyance. I had two wonderful plastic surgeons. Where are you located? I have no regrets about having the surgery whatsoever. It is a process though. It is not a one surgery deal. There are steps and I still am not totally done, but real happy.

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@sandyjr

I had bilateral mastectomy with diep flap reconstruction in July 2020. I had it all done in one big (10 hour) surgery. The only negative thing with the surgery is that I had a ferocious headache for a couple of days after. I believe it was from the anesthesia. I did not expect that at all as I have had a few surgeries and never had this problem. Needless to say it really affected my hospital stay. After the headache went away, everything was easy….Friday was surgery all day and I went home on Monday afternoon. I had no pain at all. Things felt different and strange, but no pain. Are you aware that you need some pudge going on to have that surgery using stomach tissue? Otherwise it can be taken from the fanny or back I think. I had four drains…one for each breast and one on each side of the stomach area. That was not a big deal, but kind of an annoyance. I had two wonderful plastic surgeons. Where are you located? I have no regrets about having the surgery whatsoever. It is a process though. It is not a one surgery deal. There are steps and I still am not totally done, but real happy.

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Thank you so much for your reply. I am in Arizona. While I have a good plastic surgeon, I think for this type of surgery it is best to find the surgeon with the most experience and who does this type of surgery all the time. I am willing to go out of state if necessary. I may stick with the surgeon I have because I think he is one of the best in Arizona. Where did you go for your surgery?

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@catann

Thank you so much for your reply. I am in Arizona. While I have a good plastic surgeon, I think for this type of surgery it is best to find the surgeon with the most experience and who does this type of surgery all the time. I am willing to go out of state if necessary. I may stick with the surgeon I have because I think he is one of the best in Arizona. Where did you go for your surgery?

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I am in NJ. I really feel like God led me to this man. He is excellent at what does as well as taking his time and answering all my questions. He told me exactly what he would do and was totally honest with me. He told me from the get go that he did not think he could make symmetrical but he has come darned close. I saw him at a lecture and he stated he does not take on a job unless he knows he will be successful. Best of all, he is kind. He gave me hope. Do you know about the place in New Orleans that is totally dedicated to breast cancer/reconstruction. I don’t know the name off hand, but it is on the internet. Please keep me posted.

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@sandyjr

I am in NJ. I really feel like God led me to this man. He is excellent at what does as well as taking his time and answering all my questions. He told me exactly what he would do and was totally honest with me. He told me from the get go that he did not think he could make symmetrical but he has come darned close. I saw him at a lecture and he stated he does not take on a job unless he knows he will be successful. Best of all, he is kind. He gave me hope. Do you know about the place in New Orleans that is totally dedicated to breast cancer/reconstruction. I don’t know the name off hand, but it is on the internet. Please keep me posted.

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Thank you again for your reply. Trying to figure out the best procedure is very anxiety producing. I have heard of the Center for Restorative Breast Surgery in New Orleans. I have a phone appointment with them next Tuesday. Who did you go to? Does he do this type of surgery all the time or does he do other types of plastic surgery as well?

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Just a little background. First cancer right breast 2007. Second cancer left breast 2018. Lumpectomy and radiation both times…tamoxifen the first time, anastrozole the second. Tested positive for genetic mutation. The genetic test results came back 9/2019. I immediately started looking for a surgeon and plastic surgeon. That was a nightmare. I found a surgeon who came with good reviews that was crude and obnoxious. I told her that I wanted nipple sparing mastectomy with diep flap. She said no to both. She had a setup with a plastic surgeon and she said I had to have implants because of my age…69 at the time. She kept saying “another nipple in the bucket” referring to the mastectomy. She was obnoxious the whole appointment. I was at my wits end as to how to go about getting this done. Then there was a lecture by a plastic surgeon. He was all business. He brought pictures and went into detail about how he did the surgeries. I made an appointment with him and I felt like I was home free! At our first appointment I told him I was at the lecture and I told him about the other surgeon and he asked me what I wanted done and I told him bilateral nipple sparing mastectomy with diep flap. He said he could not do the nipple sparing surgery as I had had radiation and my tissue was damaged. He asked to see my belly and told me he could do the diep. He had his associate come in…the diep usually takes two microsurgeons and not all plastic surgeons are microsurgeons (be sure to check that out when you do your research) and he took a look and they said yes. Then I had to find a surgeon for the mastectomies and he gave me a name. It just happened to be the partner of the obnoxious surgeon. I was not wholly impressed with her, but realized that the bigger surgery and the most important and involved was the diep. I went with her and everything was set up for April 17, 2020 and then covid shut everything down. I had the surgery in July and everything was like clockwork. He was totally honest and everything happened just as he said. During my last surgery I did not want anesthesia and he was ok with that, so we talked the whole time he was working I just could not see what he was doing. I asked him how many of these surgeries he does and he said about 200/year. I am not sure if that is the diep or all of his breast surgeries. He also does other plastic surgery and does microsurgery if you have lymphedema which is a worry for a person that has had breast cancer. My advice to you is to focus on the plastic surgeon and he/she will probably refer you to a surgeon that he/she works with. The plastic surgeon is the most important. Just understand that this takes quite a while. The doctor will want you to be totally healed before proceeding with the next stages of the process. I had told him before the surgery that he was the doctor totally in charge of my surgery and he was and when I saw him before the first and second surgeries I just knew that everything was going to be ok and it was. The third surgery, as I said I was awake and we talked through the whole thing. At no time was I afraid of any of it with him in charge. First surgery mastectomies/diep flap. Second surgery was revision of the work done in the first surgery and removing scar tissue. Third surgery was forming the nipples. You will have some feeling in your breasts but not much in the nipple area as that is transplanted skin.

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@catann, you may also want to read the experiences of @jenni17 @vivlaj @meliss @tana @sandyjr @dianamiracle @cathyhand @bomashisha @betsyk and others in these discussion. Loads of good stuff shared.

– Diep Flap Procedure https://connect.mayoclinic.org/discussion/diep-flap-procedure
– Bilateral mastectomy and DIEP flap reconstruction experiences https://connect.mayoclinic.org/discussion/bilateral-mastectomy-and-deip-flap-reconstruction-experiences

REPLY
@sandyjr

Just a little background. First cancer right breast 2007. Second cancer left breast 2018. Lumpectomy and radiation both times…tamoxifen the first time, anastrozole the second. Tested positive for genetic mutation. The genetic test results came back 9/2019. I immediately started looking for a surgeon and plastic surgeon. That was a nightmare. I found a surgeon who came with good reviews that was crude and obnoxious. I told her that I wanted nipple sparing mastectomy with diep flap. She said no to both. She had a setup with a plastic surgeon and she said I had to have implants because of my age…69 at the time. She kept saying “another nipple in the bucket” referring to the mastectomy. She was obnoxious the whole appointment. I was at my wits end as to how to go about getting this done. Then there was a lecture by a plastic surgeon. He was all business. He brought pictures and went into detail about how he did the surgeries. I made an appointment with him and I felt like I was home free! At our first appointment I told him I was at the lecture and I told him about the other surgeon and he asked me what I wanted done and I told him bilateral nipple sparing mastectomy with diep flap. He said he could not do the nipple sparing surgery as I had had radiation and my tissue was damaged. He asked to see my belly and told me he could do the diep. He had his associate come in…the diep usually takes two microsurgeons and not all plastic surgeons are microsurgeons (be sure to check that out when you do your research) and he took a look and they said yes. Then I had to find a surgeon for the mastectomies and he gave me a name. It just happened to be the partner of the obnoxious surgeon. I was not wholly impressed with her, but realized that the bigger surgery and the most important and involved was the diep. I went with her and everything was set up for April 17, 2020 and then covid shut everything down. I had the surgery in July and everything was like clockwork. He was totally honest and everything happened just as he said. During my last surgery I did not want anesthesia and he was ok with that, so we talked the whole time he was working I just could not see what he was doing. I asked him how many of these surgeries he does and he said about 200/year. I am not sure if that is the diep or all of his breast surgeries. He also does other plastic surgery and does microsurgery if you have lymphedema which is a worry for a person that has had breast cancer. My advice to you is to focus on the plastic surgeon and he/she will probably refer you to a surgeon that he/she works with. The plastic surgeon is the most important. Just understand that this takes quite a while. The doctor will want you to be totally healed before proceeding with the next stages of the process. I had told him before the surgery that he was the doctor totally in charge of my surgery and he was and when I saw him before the first and second surgeries I just knew that everything was going to be ok and it was. The third surgery, as I said I was awake and we talked through the whole thing. At no time was I afraid of any of it with him in charge. First surgery mastectomies/diep flap. Second surgery was revision of the work done in the first surgery and removing scar tissue. Third surgery was forming the nipples. You will have some feeling in your breasts but not much in the nipple area as that is transplanted skin.

Jump to this post

Thank you so much for your reply. This has been very helpful.

REPLY
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