Hi I had a right MX in December 2010. I have mad the decision to reconstructe sooner rather than later as i have found life harder than i expected living with a prosthesis.
My consultant has assessed me and suggested either a TRAM Flap, which she can do or a DIEP which require a referal to another surgeon and hospital.
I have a ‘relationship’ ‘trust’ etc if you know what i mean which my consultant so my first reaction ‘i wanted her to do it’ as i feel she will do her upmost to make the best breast possible.
But i know i must consider both options and make a decision based on many factors. I have read the ‘Reconstruction your choice’ book and i am very torn between both procedures. They both have pro’s and con’s But which are the best pro’s and which are the livable cons? I am 32 in June. Married with a 5 daughter and nearly 4 year old son and have a very suportive family around me.
Does any one have any words of advice for me? or questions i should be asking my BCN/consultant?
Many thanks
Jo
hi,
i am in recovery from a DIEP flap op about 5 weeks ago.
i felt i could not face life without both my boobs and that there had to be an up side, ie a very very very very flat tummy so i had something to be positive about.
i do have a hip to hip scar but its clearly fading fast and obviously invisible under clothes.
the new breast was very very uncomfortable at first, rock hard and rigid, but has started to soften and reduce.i anticipate a pretty good result about 6-12 months from now.
i have a scar under my arm and a circular scar approximately where the edge of my nipple used to be. there is no nipple right now, just a flat
circle of previously tummy skin.i will go for nipple reconstruct at some point. the op was 12 hours. worth every second.
first few days after op… hell.
recovery is reasonably rapid after that.
info probably doesnt help with the choice, but may be a heads up what to expect either way.
Hi Jo & Izzy
If it’s any help to you Jo, I had to make the same choice between the 2 ops and thought long and hard about both.
I came to the conclusion that although there are pros & cons for both, if I’m going to undergo a major op anyway then undergo a longer op and have the added benefit of the flat tummy.
Also I have heard sooo many good reports about the end results and I have yet to meet anyone who has regretted it.
For those who have been through it or about to go through it, I apologise if I sound a bit naive and I don’t want to sound flippant about what is a massive op, but I’m being truthful about the deciding factor in my eventual choice.
Hi again Izzy - I’ve responded to you on my previous thread but if you would like to provide further info on the progress of your recovery on this thread, and how you found your stay at Wythenshawe -just to save you typing all this out again
The sentence that jumps out from your response to Jo is thae fact that 'it was worth every second of the 12 hour op) I’m so pleased for you.
Love to all and take care
Sue xxx
I may be able to help as I had bi lateral reconstruction 4.5 weeks ago and was booked in to have diep flap on both sides but as the right side decided not to play ball when they reconnected the blood vessels my PS had to remove some muscle and put some mesh in (which i am told is the tram flap op) so i have a bit of both I think. The op was a massive 12.5 hours and yes the first 72 hours are very very tough and questionned what the hell i’d done but i had a horrible reaction to the morphine if it hadnt been for that it would have been hard but no where near as bad! as regards to which op the pain i have had has been the tram flap side and was very uncomfortable the first 2 weeks but by then was on paracetomol and ibruporfen only but that has now eased still gets uncomfy in the evenings.
Jo I too have a young family two girls 5 and 3 and have had my mum to stay for 4 weeks so hubby could work still, i couldnt have done without out her, and certainly needed her there for me the first 3 weeks, showering, dressing ect!! Didnt really realise how much help I would need. Im still having help but managing to do everything for myslef but its things like lifting a kettle, opening car doors that hurt, and the nurses have said if it hurts dont do it!! as although healing on outside you dont know whats going on inside!!
On the plus sides the results are FANTASTIC!!! I am still very sore on my tummy but the boobs are great!!! It was amazing yesterday in this heat not to be wearing the plastic prothesis!!
I hope this helps and more than happy for you to ask away.
Cannot reiterate enough though how pleased I am with the results, great to wear normal bras and have a little cleavage again!!!
Thank you all for your responses so far.
Nicky and Izzy it is good to hear such positive although painful at times experiences. Sue which did you decide to have?
I know i want to have the reconstruction, without a doubt. I just don’t know which method/technique to go for.
I have quite a large bust. 34G and i know that i will probably need to under go some sort of surgery to my healthy left breast to get the best match further down the line.
If im honest the risk, although minimal that the DIEP may fail to reconnect to a blood supply does scare me. The thought of that is my main concern with the DIEP.
Where as the TRAM it it is the weakness to the tummy and hernia risk and the ‘fat necrosis’ but my consultant would use mesh to strengthen the abdomin and she talked about a procedure to enhance the blood supply to the tummy area before the operation.
I hope to make the decision with the help of my family, i want it to be right for all of us. I has been such a hard six months. This part we can have some control over.
Take care all
please keep me updated with your progress
Jo. xxx
I had a delayed Tram Flap op in Dec 2010. The results are really good. It is a big op (10 hours), and the first 3 days were tough. Rest is essential for the first 2 - 3 weeks then after that I turned a corner and felt better every day, 4 months down the line I feel good, my new boob looks good and I am on the waiting list for uplift on good side and nipple reconstruction. Ask any questions that are worrying you. It was the best thing for me.
Hi Carolyn
Thanks for your message.
Do you feel other than then the scar site across your tummy that you now have noticable weakness in your abdomin? as i have said this is my main worry with this type of recon, i do feel drawn to this techinque because my consultant is able to complete this method. Better the devil you know and all that. I am very happy with the care i have recieved by her and her team so far. I trust her, if that makes sense?
Thank you again
jo
xxx
Hi Ladies
Jo - the one I have opted for is the DIEP - my ps reckons it should be late Summer for the actual op.
I have to have a scan to locate the blood supply they will use from my tummy - this should be in the next couple of weeks.
Also like you Jo, I have a fair size bust (cup size DD) and my ps said that once things settle down with the big op, I will then have the reduction to the ‘good’ side to match them up and at the same time any ‘tidying up’ that needs doing.
Nicki - had you not had morphine previously ? Just wondered what caused your bad reaction to it - sounds a bit scary that but so pleased for you that you’re obviously very happy with the results and also great to hear that the first tough 72 hours are worth it for the end result.
I do love this site and hearing about everyone else’s experiences at each stage of this long long journey we’re all on.
Good night ladies and take care
Sue xxx
I have had morphine before but only orally and not through a drip, the problem was they ended up getting the pain team involved as i was in so much pain in my tummy, and i kept telling them it was like bladder pain and wasnt coming from the scar so they gave me two boosters of morphine as well as the self administered drip, and then about an hour later all of a sudden my catherter bag started filling very quickly, and the pain went. I think there was a problem with the catherter not the tummy scar, but by this time i was so pumped up with morphine, i was itching, couldnt eat, couldnt drink and was sooo sick!! All beacuse i needed a wee!!! Funny to read back on now but if i hadnt had to have so much morphine and the catheter had been okay the first 72 hours wouldnt have been half as bad!
Hi Jo,
I had to have a differnet consultant and hospital for my recon, I too completely trusted my BC surgeon and didnt feel happy going to someone else, but he said you are best off with a complete specialist who does this all the time as techniques change. I am now happy with my PS and the team at the hopspital were a specialist plastics team of nurses and they were totally amazing and so know there stuff especially for your recovery.
I dont feel much weakness, I sometimes feel a bit of pulling but I think that because I am still healing, I am back to dog walking, all household chores and have been swimming. I have been holiday and walked a lot there. Sometimes forget the op was less than 5 monyhs ago. I am glad I had the op.
I just don’t know which way to go, TRAM or DIEP. All the reading ive done and speaking to you lovely ladies encourages me that both procedures have been positive for thoose that have already undergone them.
It feels like this is the biggest decision i may make in my life. It would be great if i went along to my next meeting with my consultant and she said ‘If i were you I would…’ but i know thats not going to happen.
I do hope you all enjoy the royal wedding and have a lovely weekend.
Jo xxx
I had my mastectomy in March last year and had an implant but that had to be removed as I kept getting seroma. I was placed on waiting list for DIEP in November and have just been informed that I may have to wait 9 - 12 months for this operation I am not very happy with that as I feel I cannot move on I may go see my GP again. Prior to this I never went to GP now I feel I am never away.
Hi Jo,
Just wanted to share my experience with you whilst you try to make a decision.
My surgeon tells me that I am a rarity in that I had a left TRAM and right DIEP done in the same surgery in July 2009.
It had been planned that I have bilateral DIEP following biateral mx in 2002 and a failed bilateral LD reconstruction (long story!)but when I was in surgery, the blood supply on my left abdomen was found to be slightly compromised and as a result, the surgeon had to do TRAM to the left.
I can honestly say that there is no difference to either my abdomen or my “breasts” on either side - none whatsoever.
I was told however that with TRAM, a possible complication is develoment of a hernia but as a “mesh” is inserted at the time of surgery, the risk is minimised.
The surgery is immense and my recovery was slow but the result is so worth it for me and I have no regrets whatsoever and am so pleased with the results, having lived breast free for so long.
Good luck with your decision making - please feel free to ask me anything at all if you wish, eeither here or by pm - I’m more than happy to help x
Great post and really interesting. I have to travel 3 hours for my surgery and my surgeon has just changed, originally he said diep or tram and now my new surgeon sent me for ct scan on tummy to check if okay for tram if not diep or might decide on day so I suppose decision out of my hand. I am terrifed, have had 1 masectomy and then about 6 months ago they decidced to put temporary expander in to strecth skin and it is pumped to over expansion and then will do 2nd masectomy along with double recon using tummy put im a challenge apparently as already gg size on current side and then expander on otherl I was hoping for the two small circles of skin but she’s now talking about a saddle of skin so means bigger skin moved for more chance of failing - all this sounds immense to me as I was actually in for 5 days with expander as drains just wouldnt drain and I am always sick after wake up so not sure how cope with catherter, lying flat and hot room - argghhhh wimp or what.
Well i’m no further on making my decision, too busy enjoying the royal wedding. I thought the whole day was wonderful, they all looked lovely and you never know with the tummy tuck both procedures have as an add on i too may have a ‘Kate Figure’ Haha, who im i kidding. It’s just been nice to watch some happiness, joy, and sun shine.
