Why DIEP Flap Procedure?

Before the mastectomy, I just wanted the cancer gone.  I was more than willing to sacrifice a breast – a breast that was killing me – to be cancer-free.  No, I don’t want to even think about reconstruction right now. I’m nearly 50 years old, and my life is much more important to me than a breast. Just get rid of it!

And truly, after my surgery, there was a huge sense of relief that the cancer had been removed. Recovery and figuring out how to wear a prosthesis consumed my time, energy and emotions.

But then I began to feel lopsided (literally and figuratively). My prosthesis was large, heavy and uncomfortable. It poked out of my bra and showed often if I wore lower cut shirts – embarrassing!

So I came to the decision to have reconstructive surgery.

It is hard for the general public to understand this when you are a “hidden amputee.” I realize there is no comparison to those who have lost limbs. But we frequently look at the visible loss of a limb of an amputee and think to ourselves that it took surgery and physical therapy to regain balance and getting used to the loss of their body part. Only a mastectomy patient would truly understand what I’m speaking of when I talk about the loss of symmetry and what it does to your sense of physical balance.

After researching all my options, I chose the DIEP flap option (“Deep Inferior Epigastric Perforator”) over implants and other procedures for several reasons:

  • The desire for a natural looking and feeling breast

The new breasts are warm, they are soft and they are truly a part of you. The fact that blood vessels are disconnected from one part of the body and reconnected to the breast area lost to disease again, is a feeling that only the patient can truly appreciate the benefit of. You feel “huggable” again. You don’t have any foreign objects in your body.

  • No need for additional surgery down the road

Implants will typically need to be replaced after about 10 years or so. The possibility of a rupture or leak scared me. And having to deal with this again in my 60s, 70s and beyond had no appeal to me! Natural tissue reconstruction is permanent.

  • Tummy tuck bonus

Take my 49-year-old muffin top and make it into a great breast? SOLD!

I still have enough “fluff” on the rest of my body to make my tummy tuck pretty camouflaged, but my pants DO fit better!

The main criteria for being eligible for DIEP Flap? Plenty of abdominal “tissue” – check!

The procedure was actually much more involved than the mastectomy.  I had an amazing plastic surgeon – Dr. Karly Kaplan at Kaiser – who I give all the credit for an amazing procedure that resulted in a beautiful C/D breast!

I was in surgery for nearly 8 hours while Dr. Kaplan meticulously performed microscopic surgery to remove and reattach the flap to the recipient vessels on my chest wall. An incision was made along my bikini line, then skin, soft tissue, and tiny feeding blood vessels were removed. The blood vessels were matched to supplying vessels at the mastectomy site and reattached under a microscope. Tissue is then transformed into a new breast mound. Oh, and my belly button was moved up by about 3 inches. Pretty incredible!

I spent one night in ICU following the surgery and 4 more days in the hospital before going home. The sunshine and fresh air were divine after being in a hospital bed for five days. Drains at both incision sites, compression girdle, walking around like a comma to protect my abdominal incision, sleeping in a sitting position, and dry shampoo for days…ugh.

I continue to be numb at the abdominal scar site where they take the tummy tissue to form the new breast. This is a very large scar, hip bone to hip bone, and many layers of fascia, both deep and superficial, have been cut through to reach the deep inferior epigastric perforator. You can still see all the scars on my breasts and abdomen, but they have faded dramatically.

Lingering issues?

  • My left (reconstructed) breast is actually larger and perkier than my right side (I had a reduction on my right side to match the reconstructed left, and while it’s pretty close, there’s a definite difference – especially noticeable in a bathing suit).
  • I opted for nipple reconstruction on my fake right breast, but still need to finish the tattooing process so it looks natural.

If any of my readers have also had the DIEP Flap procedure, I’d love to hear from you!