ask: Having bilateral mastectomy with immediate reconstruction DIEP flap... questions!
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Anonymous
July 24, 2009 - 9:01pm
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Hi:
I have wanted to lose weight for a number of years and have recently lost 25 lbs only to find out that now I need it for my DIEP flap to reconstruct my breasts. I am currently a C cup and would love to be the same or even a little larger if possible. Anyone know how much tissue is needed to do the reconstruction? Anyone else gone through this? Thanks so much for any info or thoughts you might be able to share.
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Dear Anon
Thanks so much for your question. I'm sorry you are facing these challenges now but it sounds like you are keeping a great, proactive attitude - good for you!
We have submitted your question to one of our experts so please check back in the next 72 hours for a response. We look forward to talking to you more!
July 27, 2009 - 8:04amThis Comment
Hey anon, welcome to EmpowHer. We asked one of the country's best breast experts for her thoughts and here's what she had to say ...
"The amount of tissue that is "moved up" is dependent on how much tummy fat you have. Tummy fat though usually is the hardest fat to lose when weight reduction happens. It is a slower metabolic rate, like breast fat actually. Sit in a chair and grab your fingers around the tummy fat you feel. Keep in mind that the tummy fat removed and used goes all the way over to both of your hips too. Someone with 40Cs needs more than someone who is 34C, due to width needed. So, if you want, eat a little extra high fat foods to put a few pounds back on. Tell your friends, "I'm eating for three- myself and my two new breasts!"
That answer comes courtesy of Lillie D Shockney, RN., BS., MAS
Administrative Director
Distinguished Service Assistant Professor of Breast Cancer
Assistant Professor, JHU School of Medicine, Depts of Surgery and Gynecology
Assistant Professor, JH School of Nursing
Johns Hopkins Avon Foundation Breast Center
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July 28, 2009 - 1:01pmI am 51 years old and I'm having a double mastectomy and immediate reconstruction by diep procedure. I have the brca1 mutated gene. I am menopausal and in october i will get a hysterectomy to get me to the post menopausal stage i guess. i am currently approx. 15 lbs overweight with a small belly. It is for the most part evenly distributed throughout. My plastic surgeon says i should have enough but i may be a little smaller. I would hate to be smaller but refuse to get implants. So if i gain 10 lbs or so before the surgery, will i lose it in my breasts when i try to reduce my weight and all will be for naught???
Confused
July 22, 2010 - 10:32amHi,
According to the expert answer above, if you gain 10 lbs before surgery in your "tummy area", this can be used to "move up" to your breasts. Then, as also stated above, when you lose weight (after surgery), your breast fat is the hardest to lose, so you most likely will not see this part of your body reduced when you lose weight.
If you are only 15 pounds overweight at the moment, and after surgery, exercise and eat in a healthy manner, most women lose weight evenly throughout their body. Building muscle through weight-bearing exercise will also help burn more calories, and will help you lose extra weight. If you lose some weight in your breasts (since we are only talking about 15 pounds "extra" you have throughout your entire body), it will be insignificant and unnoticeable.
We wish you the best through your procedure, and please let us know if you have any additional questions!
July 22, 2010 - 12:10pmI had the DIEP flap done in 2007. When I went to have it done i only had mastectomy on my right breast. They did a skin sparing 0n my second breast during my DIEP surgery. If you don't have enough tissue in your belly , they can take from your glute (behind) You can look at the site where i had mine done. www.breastcenter.com they have a photo gallery also. Love the doctors there. I traveled from Indy to New Orleans for the DIEP flap. Have many, many friends here that went there. Best of luck to you!
October 15, 2009 - 11:19amAnon,
Thank you so very much for writing about your experience. There's nothing like hearing from other women when it comes to dealing with our own conditions or undergoing our own procedures. It's also so interesting that you and many of your friends traveled to have this surgery.
For others who are reading, the page she refers to is the home page of the Center for Restorative Breast Surgery in New Orleans, Louisiana. It introduces you to their doctors and procedures with detailed information and photographs. The procedures they do include:
--Nipple sparing
--DIEP flap
--"Stacked" DIEP flap
--SIEA flap
--SGAP flap
--IGAP flap
--Bilateral Simultaneous Immediate GAP flap
--Hip flap
--One Step Alloderm Implant Reconstruction
--Lymphedema treatment
--Poland's syndrome treatment
--BRCA 1 and BRCA 2 gene screening and genetic counseling
Thanks again for writing, Anon. Best of luck to you.
October 16, 2009 - 9:13amThanks for the info! I did have my bilateral mastectomy with immediate DIEP reconstruction in San Antonio. They were able to use enough from my tummy to reconstruct my breasts (which are fuller now than before!) and give me a nice flat tummy. I am so very happy with the outcome and the cancer is out of me! That is even better! I appreciate the information here. I can't say enough great things about Dr. Chrysopoulo at PRMA in San Antonio www.prma-enhance.com Many blessings, Tammy
January 3, 2010 - 5:35pmThank you for sharing this resource, and I am so happy to hear that you are not only happy with the outcome of your appearance, but that your cancer has been successfully treated!
January 3, 2010 - 8:57pmVery Happy for you Congratulations =] There are so many wonderful DIEP reconstructive doctors out there and I am so thankful for that. I met alot of women that had the DIEP flap at a conference I went to in Jacksonville Florida. They were from many different areas in the US and all had wonderful doctors. Its great that we have this choice after going through so much.
January 4, 2010 - 5:14amI'm not sure how much tissue is needed exactly, but I do know that if you don't have enough they can do the Gap Flap (I think that is what it is called) they remove tissue from your backside. Check out the website where I had my Diep Flap done www.breastcenter.com They now have their own hospital where they only do breast reconstruction. Wonderful Doctors, they also have a photo gallery of before and after pictures. When I went I stayed at the Hope Lodge , ran by the American Cancer Society. It is a fabulous place. Best of luck to you. Oh, I had a mastectomy on my right breast, when I went to do the DIEP flap, I had a skin sparing mastectomy on my left breast. They only removed the tissue. I also chose to have a mastectomy on my other breast , just like you, I wanted less of a chance of it coming back.
January 4, 2010 - 5:02am