Getting a Diep flap

[Redhill88]

Hi there..I'm about to get a Diep flap in a few weeks..and am a bit worried about it..because I do a very physical and demanding job and am a single parent..I'm worried will I get my stomach muscles back after surgery..they doctor never really give you a straight answer..its delayed surgery as I had a mastectomy six years ago..I'm very small and only want a small breast made up..they said they can do it with a diep flat only..but mabe would small implants be a better choice. I be so grateful if anyway body was similar to me..and could give me some of there experience.

Thanks so much.

[GrandmaofRose]

I had the flap surgery several months ago. I was told it was the best solution for me because I had radiation, which can cause issues with implants and because my remaining breast is large. A Diep flap doesn’t use muscle but because of damage from the radiation they had to take a small amount of muscle from my abdomen to assure the transfer would take. I don’t have a physical job and i am not in amazing shape, but when I do something that engages that part of my abdomen I feel an aching feeling and I definitely don’t have the strength I did. If no muscle had been required there might not be issues and it is entirely possible you will not have muscle removed. In any case it is a big surgery and I think you should consider an implant and discuss the pros and cons with your surgeon. I love the results of my flap surgery but it was a lot to go through and I am not happy that it will take so much time and effort to build up my core strength again. I think it’s all a matter of what is most important to you. I really wanted a softer, more natural looking and feeling breast and I didn’t want to worry about leaks and other issues that people sometimes have with implants so it was worth it to me but I know people who are very happy with their implants. I hope I haven’t confused you more but it isn’t a decision to take lightly. At the very least you should press your surgeon to give you an explanation of why he recommends the flap over an implant in your case. Best wishes to you on this journey.

[Redhill88 in reply to GrandmaofRose]

Thank you so much for your reply..he said becuase it was five years since I had a mastectomy..there is no skin for and implant. And it would cause problems also..well I'm going to go ahead now and hope for the best. Thanks again.

[beachlake]

I had the diep flap in October 2020. The mastectomy was 3 weeks before the diep due to covid issues so it wasn’t one surgery. The diep still took 8 ½ hours. They only used the skin and flesh for my flap. No muscle was involved. I could not have an implant due to radiation in 2006 for my first diagnosis of breast cancer. The doctor said that due to the radiation and that I already had some skin contracture that an implant would more than likely fail. The recovery was difficult. At least 8 weeks where I could not stand up straight. It wasn’t incredibly painful, other than the first week, which was managed well with some pain meds. The only exception were the back muscles spasming at times and having to sleep in a recliner for 2 months. Sleeping flat was impossible. I was told that I might need “some”OT or PT for range of motion and scar management. I that the scar management meant was the visible scars not the underlying tissues. I was not aware that from the lower ribs to the hip to hip horizontal scar was going to have issues with adhesions and mobility issues. I see an OT weekly to release the adhesions in the abdomen and the armpit area of my right arm. I have to do exercises daily to prevent/ release the adhesions. Also, my right shoulder and arm need help to keep it from pulling forward due to the abdominal scar tissue pulling it forward. The therapist said that the first year to year and half is when the scarring is more active but that everyone responds differently. Please keep in mind that we all heal differently and that my experience will be different than yours. I am very healthy and heal well but have to keep up with the therapy. I was able to start working out 3 months post surgery. My diep procedure did not affect my stomach muscles, however, my lower back had issues because if the constant strain on it for the 2 months. Things are so much better now. I did not like the idea of an implant because of the possibility of leakage, etc. I liked the idea of the diep and using my own body to reconstruct. My reconstructed side looks very good , however, the the reconstructed side is smaller compared to the left side. I misunderstood and thought that they would use all of the flap to reconstruct and that the new one would be close in size. They only used part of my flap. I am not thin and had some belly fat. The concern was if I would have enough to reconstruct. I think this is why it is smaller. The surgeons did an amazing job of reconstructing the new breast. This is not a simple surgery. The amount of time, effort and skill to keep the flap alive by the surgeons is amazing. I do like that it is not an implant but have concerns about the adhesions. In hind sight, I should have asked a lot more questions about the possibility of adhesions. Please also keep in mind that my surgeon did tell me that it takes a year to heal and I am only 9 months post surgery. I would ask again why you cannot have an implant. I am not recommending an implant or even the diep, but think it’s important to get as much information as you can for your peace of mind. Sorry this was so rambling and please forgive the errors- trying to type on a tablet.

[Redhill88 in reply to beachlake]

Thank you so much for writing all this down..And taking the time to do so..It sounds like a lot you have gone through.The surgeon said it was the solution for me. As I don't have enough skin skin for an implant. Well I'm going to go ahead and hope for the best..Thanks again.

[beachlake in reply to Redhill88]

I am sorry, I didn’t realize about the skin. Diep sounds like the way to go for you. I think that you will be fine. If you haven’t already, get a wedge type pillow to help keep you comfortable. I will be thinking if you and wish you a speedy recovery. Take care

[Redhill88 in reply to beachlake]

Oh thank you so much..I will get that for sure. And I'll let you know how I get on. Thanks so much for your advice.😊