Okay so now I’m researching what sort of reconstruction I want. I am totally confused as to why they would move some of your tummy muscles? Why do they need that on a free tram? DIEP seems to be the best option, so why would people put themselves through the muscle removal bit? This is all pretty new to me so please forgive my ignorance. I have had mastectomy with aux clearance, chemo and rads. Do many hospitals have a microsurgeon to perform the DIEP flap?
Can someone explain a little more for me.
Thanks
Vanessa
Hi mummyv
Whilst you wait for the other forum users to reply with their experiences you might find it helpful to have a look at our booklet on reconstruction, it can be found by using the following link:-
breastcancercare.org.uk/docs/breast_reconstruction_dec06_web_0.pdf
I hope you find this helps.
Kind regards
Sam
Bcc Facilitator
Hi Venessa
So far as I know muscle is removed if the veins in the tummy are found to be not good enough or if the surgeon is not confident enough to do everything without it. They need to be a very experienced plastic surgeon to do a DIEP. I would research all the plastic surgeons who can do one www.optionsforbreastreconstruction.com will give you all the hospitals and what ops they can do. Not everyone is suitable for all the recons so you will need to see a good plastic surgeon to get the full answer to what you can have.
Hope this helps
I just looked up Portsmouth (should be Gosport really as that is where Haslar hospital is). Guess what… they dont do DIEP! Great does this mean I cant have it done or can I get referred outside my NHS trust? Odstock being the nearest.
I suspose I should be asking this of my BCN but dont like to bother her with mini stuff.
Winchester has a good surgeon Mr Rainsbury, I got referred to him from East London. I’m not sure if he does DIEPs but you should be able to look up on Dr Foster website which has details of each breast clinic with which reconstructions they do
mole
Hi Mole
Thanks I had a looksie and he doesnt do DIEP. It is a fairly new procedure? Southampton do though so that’s an option if it comes to it.
I think you can be referred to any plastic surgeon. Be warned if using BUPA, they aren’t paying the whole cost of my immediate DIEP because a) they consider DIEP unnecessarily expensive, and extensive, for the cover they are providing - my ex challenged them, pointing out that most American insurers pay for it because it is so good, and b) they could have found a cheaper plastic surgeon! Sorry, but I wanted the best reputation - of course another surgeon may have done as good a job or better, but their reputation is all you have to go on, isn’t it? Re muscle, I stressed that I did not want to sacrifice a muscle I need (I have horses, lots of heavy things to lift), to gain a breast I could actually live without. He agreed to do a muscle-sparing TRAM or DIEP, and I got the DIEP, decision not made until in theatre, when they can see the quality of the blood supply they are transplanting with the donor flap. If it isn’t great they take a small piece of muscle to help it graft better and reduce the risk of the tissue dying, which can happen if the blood supply is too weak. Lyn xx
I went to another Trust for DIEP. I saw the PS at my usual hospital as she did an outlying clinic there. I had a CT scan before surgery to check the quality of blood supply in the abdomen, which was then marked on my skin pre op. This tells the surgeon the exact places of the best blood vessels for reconnecting for the breast. Don’t be fobbed off, the skill of the PS makes all the difference to your post op recovery and eventual outcome. Hope this helps. Polly20
Thanks Polly. I now know I will have to fight my corner
xx
I had a free tram flap recon after my mast and the muscle is removed from the tummy to provide support to the new boob. It sort of goes underneath the boob like a hammock to support the tissue and fat from your tummy that is placed there. My recon boob looks great even without a bra as it doesn’t sag like my ok boob. So I’ve now got an appointment to see my PS about having this boob lifted sometime in the future.
The tram op went well with me and my stomach is fine now.
Which ever op you choose will be the right one for you, good luck.