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tram or diep? Help!

25 REPLIES 25
ForumMember
Member

Re: tram or diep? Help!

Hi Marita

Thanks for the information about your recon. It sounds like an option worth considering.

I hope all goes well with your chemo. I had 8 cycles of TAC before my surgery. It wasn't nice but my tumor was quite large and grade 3 and already in my lymph nodes so I felt reassured that any C cells anywhere else in my body were getting a good blasting and if that didn't do it I had 20 rads for good measure. For me it was difficult not being able to drink tea or coffee as it tasted revolting. I was very nauseous and vomitting for the week after chemo so my Oncologist changed my pre chemo steroids. This did nothing to help so after the 4th cycle he gave me different tablets called Emmend. I only had to take 3 tablets. The first was on the day of chemo about half an hour before chemo. I was really worried that it wouldn't work and I would be violently ill whilst having the chemo. Amazingly these new tablets worked and although I did feel a bit off colour it was a lot better.

I hope you don't feel too bad with your chemo. I'll keep my fingers crossed for you.

Cora

Marita
Member

Re: tram or diep? Help!

Hi all

Nikki - I had nothing on my tummy for them to take and only just enough on the thigh (I jog, go to the gym and was very close to getting my brown belt in Karate), I don't know about whether it's similar to using the bottom. I was told I couldn't have an implant cos' of rad therapy and I really didn't fancy waking with no breast!
Cora123 - There is no obvious dent which has amazed most that have looked at it! It's just like a tummy tuck on the thigh. If you look hard enough you can see my right thigh is a little thinner than the left but only my OH gets that close!.
As it's turned out I'm not going to need rads (very relieved!) but I start chemo on Friday and getting a bit nervy now, I realy hate feeling sick!!
My fitness certainly helped my recovery from surgery and I'm hoping will help get me through the next few months.

Take care everyone

Kelley
Member

Re: tram or diep? Help!

Mine still has its radiotherapy tan nearly 3 years after treatment!
Nikki- I was told not to lose any weight but to do abdominal crunches which are thought to improve blood supply to the area.
It's also sensible to be as fit as possible before an op but not to lose weight.

Nikpusscat
Member

Re: tram or diep? Help!

Hi Girls

Still a bit confused...!

From what I can deduce from your responses, I guess as I've been asked to do sit ups - it's because I used to smoke...(gave up 7 or 8 years ago)? (They did ask).

However, as I mentioned before, my thoughts are that if I do as many sit ups as they've suggested I won't have that much tummy left so I still cannot understand why they haven't said that they might have to switch to a tram....which takes some muscle? Also why did the PS say I shouldn't have bothered trying to grow a pot, yet others I know have been told not to lose weight?

I too would love to find out if radiotherapied skin ever goes back to normal colour....?

Cheers

Nikki

ForumMember
Member

Re: tram or diep? Help!

Hi Kelley

Does the radiotherapied skin ever fade to normal colour or is the tan permanent?

Kelley
Member

Re: tram or diep? Help!

They will do it if you stop smoking as long as the blood supply is good. My PS always hopes to do Diep but if the blood supply is not good enough she does Tram.

ForumMember
Member

Re: tram or diep? Help!

Hi Nikki

My PS definitely said that I could have recon after 3 months from finishing rads. I am not optomistic about this though as it has been 1 month already and I am still sore and red in some areas. Where my skin has healed it is mottled brown and patchy and doesn't look very nice. I see my onc in 2 weeks to check how I am recovering after rads and am sure he will say the sams as what you have told me. Still I would rather wait and let everything settle down than rush and not get a good result in the end.

Hi Marita

I suppose that if a surgeon does DIEP then he would also be skilled at doing tug flaps as well ? Do you have much of a dent where the tissue was taken ? Has your PS told you how your recon could be enlarged ? You sound as if you are recovering very well !!

Pancake
Member

Re: tram or diep? Help!

Hi Nikki

Do they not do it if you have ever smoked but given up?

Deb

fantan
Member

Re: tram or diep? Help!

Hi Nikki

I didn't do situps specifically before the op - just what I've always done at the gym. I asked about eating for England beforehand and the surgeon said it wouldn't make a lot of difference. I haven't had kids but I did have a little tummy probably not what you'd call a pot belly though! It's really flat now. My friends and I all joked about me having 2 for the price of 1!! It is a major op though, so don't underestimate the recovery. Are you a smoker? because I don't think they do dieps if you've smoked - something to do with the quality of the blood vessels. With a tram flap it stays attached to it's original blood supply, but with a diep they cut the blood vessels and reattatch them to ones in your chest or armpit.
Hope this helps - maybe speak to the surgeon's secretary and ask her to clear up your queries.
Take care
fantan

julro
Member

Re: tram or diep? Help!

Hi Nikki, I had a tram too last year, and was told that they chose that option because it was the best one for me, something about the blood flow in the veins near the op site.
Good luck with your choices.

debbi
Member

Re: tram or diep? Help!

Hi nikki,they never even said anything about diep,just said that tram was the best option for me so just agreed with them and went for it.I had two boobs made from it,but had mastectomys seperate,first on the left side in june 06,just to recap and second at same time as recon,the one on the left is a little hard underneath from scar tissue from first mastectomy but other than that they r soft and feel totally normal,albeit with no nipples. x
just ask if u want to know anything else,I wish we could put photos on here as I think that would be really helpful to,I have just joined a new group bcpals,where u can do this,which is far better,more helpful,they cant read ur private messages or anything,unlike on here,this will prob get deleted now

Nikpusscat
Member

Re: tram or diep? Help!

Thanks girls!

Fantan... Can I ask...did you do sit ups beforehand? Did you have a pot belly? (I too am a size 10/12).

Marita...is this the equivalent of taking it from your bottom? My original surgeon did mention this as an option. Did they say that your tummy was just too flat to do a diep, as I feel if I do all these sit ups mine will be too!?

Cora...I was told that the reconstruction could only be done a minimum of SIX months after rads. I went in after 3 months, thinking that it would take a further 3 months to get on the system, but the surgeon said I was too early and he should really only book me in once the radiated skin had already recovered! I was so disappointed, he felt sorry for me and allowed me the "booking" only on the basis that I might still not be ready in Nov.

Debbi...Did they actually say that your tummy was too flat for a diep and your only option was a tram? Is the new boob quite hard as a result?

Cheers Nikki

fantan
Member

Re: tram or diep? Help!

Hi nikpusscat

I had my diep recon last oct. I am slim - size 10-12, 34C. I didn't fancy the idea of an implant and would have had to have one to get a matching pair. So my recon boob is about a half to a cup size smaller than the other one. I haven't found this a problem and most women have one that's different to the other. I am delighted with the results. I didn't realise how much I missed having 2 breasts! Because the surgeon tried to get as much fat as possible my tummy was extremely tight and parts of it didn't heal properly. I now have 2 small patches which are lumpy, but I'm using dermatix gel twice a day and they are improving. My surgeon was Mr Fortune Iwuagwu. He's a lovely man and works at Chelmsford and Brentwood. I had my op at the Nuffield in Brentwood and was very impressed with the aftercare. Let us know nearer the time and I'm sure there'll be lots of advice on what to do and not to do etc.
fantan xx

Marita
Member

Re: tram or diep? Help!

Hi cora123

I have a scar that runs from the front round the inner thigh to under the bottom. It's very neat and can't be seen when wearing shorts. I believe they take a cresent moon type piece of flesh, wrap it round and insert to make the breast - including a nipple! I'm only 6 weeks post op so still have some discomfort. I still have numbness down the back of the thigh and a little restricted in movement. Sitting on hard chairs is also uncomfortable. I was out of bed and walking within two days and I now take a longish walk every day and have been given the go ahead to go to the gym and use the cycle machine!!

ForumMember
Member

Re: tram or diep? Help!

Hi Marita

I have not heard of this type of recon. What sort of scarring do you have with this and how does your thigh feel when you walk or run ?

Marita
Member

Re: tram or diep? Help!

Hi all
I have seen the book 'Boudicca Within', I cried most of the way through but what an inspiration!!

I didn't have enough on my tummy to use for reconstruction (something i had been proud of before!!) but my surgeon was able to perform a tug flap reconstruction at the same time as the mastectomy. It uses the flesh and some muscle from the inner thigh and is only suitable for a slim/athletic build with 34B bust or smaller. My boob is going to be smaller but there is a possiblilty of enlarging it at a later date. It doesn't seem very common but worth considering.

ForumMember
Member

Re: tram or diep? Help!

Hi Kelley and Debbi

Thanks for your comments which I found really helpful. I have private healthcare through my husband's work so in theory I could go anywhere for my surgery which is why I asked where you had yours. My consultant only does the pedicled tram flap but says he is happy to refer me to another surgeon if I wanted to have DIEP. I only had my surgery in April and finished rads 4 weeks ago. My consultant tells me that I can consider recon 3 months after finishing rads. I would probably wait until after Chritmas for the recon so at the moment I am trying to gather as much information as I can. I haven't seen the book you mentioned but am now going to buy a copy as it would be good to see the tummy scars for myself as this is the only drawback to having this operation for me. Despite having 3 big babies I have no stretch marks and my tummy is flatter than my 14 year old daughter's. Don't know how that happened as I am not into exercise although I have vowed to make lifestyle changes to try to make sure this doesn't come back. I am feeling too drained from the rads at the moment but I am going to start regular exercise-honestly.

debbi
Member

Re: tram or diep? Help!

I had tram,and I was only a size 12,with 34b boobs,its been a long recovery,nearly a year now and still slight discomfort,and I am now a d cup,and I was by no ways fat.its mainly the tummy thats uncomfortable,cant wear jeans etc,well not my usual jeans anyway,but the 'having 2 boobs'makes up for the pain,I hated having one boob,it was awful,for me anyway,I am sooooo happy with my recon and would not change my decision for anything.I had mine done at selly oaks,birmingham.But I live in suffolk,which is a pain cos still go to birmingham for my after care and I am having nipples done soon,so going back there,let the same surgeon finish the job.......

Kelley
Member

Re: tram or diep? Help!

I'm lucky enough to live in Norwich so my operation was done by Elaine Sassoon and another consultant Richard Hayward did the tummy.They are both excellent and so nice. Having two consultants working at the same time cuts the operating time in half. Have your seen the book Boudicca Within? This has a photo of me in it and the tummy scar can be seen a year after the op but it has faded a lot since then.

ForumMember
Member

Re: tram or diep? Help!

Hi Kelley

It's good to hear that you are pleased with your results. I realise that having a delayed recon there would be some scarring to the breast but it is the scarring to the tummy that bothers me. If your scar is now a thin line that is good news and just what I wanted to hear. Where did you have your recon if you don't mind me asking ? Thanks for the reply. It is really helpful.

Kelley
Member

Re: tram or diep? Help!

Cora,
My diep was 2 years ago and the scar is now, mainly a thin white line. I have one slightlt raised but pale bit at one end of the scar but it is not noticeable. My PS advised me to put steristrips over the scars and this has worked wonders. The scarring on my breast is only noticeable because my radiotherapied skin is a different colour from the white flesh from my tummy. I am very pleased with my reconstruction.

ForumMember
Member

Re: tram or diep? Help!

Hi All

My only option for recon is an abdominal flap (or an I gap). I am very concerned about the scarring to the tummy afterwards. If I could have a nice flat wafer thin scar I would probably go ahead and have the op. In all the photos I have seen the scar looks lumpy and raised. Does the scar settle to a fine line eventually ? I really don't know what to do.

Cora

Nikpusscat
Member

Re: tram or diep? Help!

Thanks girls..

I'm quite slim, so if I do get up to 180 sit ups a day as the PS suggested, I reckon I'd easily lose the pot I've got. He already told me he would only be able to create a small boob and I would have to have the other reduced/ lifted.

Now I'm worried it won't work for me! I certainly wasn't told not to lose weight?

gillc
Member

Re: tram or diep? Help!

Hi
I had a DIEP flap done 4 weeks ago and am thrilled with the results. Like Kelley was told not to lose weight and had to do tummy exercises. I now have 2 pert boobs (left one lifted) and a very flat tum. Not all surgeons will carry out DIEP flaps. You do need some tummy fat in order to have this done-depends on what size boobs you have/want.
Good luck!
Love Gill x

Kelley
Member

Re: tram or diep? Help!

I was told to make sure i didn't lose any weight, despite being heavier than I should as i needed the fat on my belly. I was told to do tummy crunches because these are thought to increase the blood supply in the area. The diep is considered to be the better option as no muscle is sacrificed and the recovery is quicker and less painful. But it does need more flesh than the Tram. My PS will only perform Tram if there is an insufficient blood supply for a Diep. If a Diep is not possible because you don't have enough flesh, enquire about having an igap when the flesh is taken from the buttock.

Nikpusscat
Member

tram or diep? Help!

I lost my reconstructed with LD flap breast after a recurrence in the skin, so I have just had a consultation with plastic surgeon ref diep flap.

I am quite slim and had been eating loads of carbs to gain a pot belly, but he told me this was wrong and has told me I now have to do 3 months of sit ups!

Does that mean he's not going to do a diep and intends to use muscle ie. tram?

Would love to here if anyone has heard of this as the girls on US sites haven't?!