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DIEP Flap after Bilateral Mastectomy, happy with the results?

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#1 MummyHILI

Posted 01 September 2016 - 08:57 AM


It is looking likely that I will have a DIEP flap surgery after a bilateral mastectomy later this year.

Initially most the advice I was receiving was to have an implant reconstruction as the doctors/nurses were concerned that I may not have enough stomach fat to reconstruct my breasts, however after speaking to my head oncologist/surgeon he feels that the DIEP flap is a good option and will give me the best long term result.

I am obviously also going to see a couple of reconstructive surgeons but I am interested in other people's opinions.

So have you had a DIEP flap reconstruction and are you happy with the results?

Edited by MummyHILI, 14 March 2017 - 12:40 PM.

#2 HoneyMurcott

Posted 01 September 2016 - 12:09 PM

I've elected to not have a reconstruction post mastectomy and am very happy with my choice. The collateral damage from surgery, chemo and rads has been significant enough without returning to hospital for further - and much more significant surgery. From the point I was told I could not have a simple reconstruction with an implant I decided I would just learn to live happily lopsided and with my prosthesis. The choice to have a reconstruction is intensely personal - I'm not trying to discourage you. Just that I know plenty of young women who have chosen to 'live flat' and avoid further very major surgery and the complications and recovery it requires. Also know you can wait a year or 2 after you've finished treatment before having a recon. That can give your body a year to heal and a year for your family and children to see you healthy and 'back to yourself' before you return to hospital. Just a thought.

#3 MummyHILI

Posted 01 September 2016 - 03:13 PM

Thanks for responding HoneyMurcott. I admire your decision to not go ahead with reconstructive surgery however for me i feel very strongly that this is what i would like to do. It has been a very difficult time and adding surgery to the mix is a big ask but i feel that doing it now and 'getting it over and done with' is the best thing for me and my family.
Thank you again for taking the time to respond and sharing your experience.
I wish you many, many years of good health.

#4 toomuchmess

Posted 01 September 2016 - 03:35 PM

Mummyhili like honeymurcott i have not had reconstruction.
Initially i was going to, i went for the consult and once he explained that implants werent an option, i would need the full chop shop recon i backed off. I went on the 12 month public wait list anyway while i thought it over more. I had pretty much decided that i wasnt ready for that kind of surgery, then i got news that the cancer had returned and spread which meant that surgery was out of the question anyway. Then i got the call for surgery weeks later, which i had to decline. After 3 years flat ive just got my first pair of prostheses. Im happy the decision was out of my hands, i really didnt want such a big surgery but felt like i should.

I hope you get some responses and advice from people who have experience you are looking for. Good luck.

#5 Fright bat

Posted 01 September 2016 - 03:40 PM

Ask how many your surgeon does a year. If they do less than 25/year, I would be seeing someone else. This is highly technical surgery with great rewards but also great risks - it's a 6-8 hour operation (with an extra hour or two for the mastectomy), and the risks include not only losing the entire transplanted fat, but also some of the fat melting away so that you are left with less volume than you had hoped for, or asymmetry that needs further surgery later. The best results come from those who do these a lot.

No one can comment on how much volume you will get except your surgeon - everyone carries their fat differently, even for similar height and body weight.

ETA - if it was only one side, then a c cup might be feasible, but women rarely get as much as they are hoping for with bilateral reconstruction, as the tummy fat is shared between the two. You may find that if people are already suggesting you might not have enough tummy fat for this, then you may struggle to get a big A/small B cup. And putting on weight temporarily isn't an option - the fat will behave as it did where it was taken from - if you then lose the weight, it will be lost off your new bust as well.

As others have said, you may decide that such a major operation is not worth the effort for small returns. Don't underestimate implant reconstruction either - implants (whether doe for reconstructive or cosmetic reasons) are rarely a lifetime 'purchase' and usually need further surgery down the track.

This is why, as PPs have said, many women choose not to have reconstruction in the first instance. And in fact, the most satisfied women are those who have the reconstruction later - after they have lived without it for a period of time THEN chosen to go ahead. No reconstruction will look like the breasts you have when naked - the best they manage is to fill out your clothes a bit.

I am sure your surgeons have talked to you about this at length, and it is a very very personal decision - but it's one YOU have to put your body through and then live with. You should proceed with reconstruction, by whatever means you feel right, only if it's something YOU want to do and understand the benefits and downsides of - not because your husband, your sister, your breast care nurse, your best friend, your oncologist, your neighbor, or anyone on EB tells you you should or shouldn't. Take time to speak to people, understand that can be achieved and its limitations, and then decide.

Edited by Fright bat, 01 September 2016 - 03:50 PM.

#6 MummyHILI

Posted 02 September 2016 - 07:53 AM

Thanks everyone for your responses, it certainly gives me plenty to think about and some good questions to ask the surgeons.

#7 toomuchmess

Posted 02 September 2016 - 10:44 AM

View PostFright bat, on 01 September 2016 - 03:40 PM, said:

No reconstruction will look like the breasts you have when naked - the best they manage is to fill out your clothes a bit.

I was coming back to mention this. My surgeon was very very specific about this. He drilled this into me to make sure i understood.

I dont want to scare you off, sorry.

Also the surgeon told me i had a decent enough amount of tissue to use yet he said he would only get an A or small B cup at best.

I went into my consult with very unrealistic expectations, but at the time i thought they were very reasonable.

Again, good luck OP. Sorry if it feels like we are just picking out the negative, it just really is such a massive thing.

#8 Snorkmaiden

Posted 02 September 2016 - 11:11 AM

Hi OP,

I had a single mastectomy earlier this year and expander inserted at the same time.

I'll be seeing my surgeon in a couple of weeks to talk about the next step - replacing the expander with an implant and possibly lifting/reducing the other breast to match.

I am really happy with the way it looks. Fright bat raises some really good points - I had it done because of the way I wanted to look (no one else's opinion mattered).

Happy to chat on pm if you want more information (and name of my surgeon if you're in Sydney)

#9 Tinkerbell74

Posted 02 September 2016 - 12:49 PM

I have had a double mastectomy, expanders and then implants put in. I am very happy with the results and even went as far to have had 3d tattoos done for the nipples :rolleyes:  ... It was a big decision for me but one I don't regret.

#10 MummyHILI

Posted 01 October 2016 - 06:06 PM

Sorry, I just saw the later responses to this.
Thanks everyone for taking the time to respond.
I met with the surgeons and they both said I don't have enough fat to do the DIEP flap  (which I guess is a compliment) ;-) They both agreed at best I may end up with a cups using this method.

I'm in Melb, so if anyone has any experience with surgeons I would be interested to hear, via PM.

Edited by MummyHILI, 14 March 2017 - 12:41 PM.

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