DIEP Flap Breast Reconstruction

Dr. Sumeet Teotia at UTSW will be my plastic surgeon performing the DIEP Flap reconstruction surgery.  I was very impressed with him.  He came highly recommended by my breast surgeon Dr. David Euhus and my chemotherapy oncologist, Dr. Barbara Haley.  I also spoke with Dee Simmons from Dallas yesterday and she also highly recommended him.  Dee is a friend of my high school friend, Carolyn R. Thanks, Carolyn and Dee!

Here is an article about Dee's work with cancer patients:
Women that Soar

The green area above is tissue that is usually discarded.  Dr. Teotia said he would need to use ALL of my tummy to build a new boobie big enough to match my remaining boob - LOL!  I know - TMI!

 Here is what I have researched online about the procedure:

Excerpts from Breastcancer.org:

DIEP stands for deep inferior epigastric perforator. This is the name of the main blood vessel that runs through the tissue that will be used to reconstruct the breast. In DIEP flap reconstruction, only skin, fat, and blood vessels are removed from the lower belly (the abdomen between the waist and hips). No muscle is removed. 

The DIEP is a called a "free" flap because the tissue is completely detached from the belly and then reattached to the chest area. Hooking up the blood vessels from the belly tissue to chest blood vessels is delicate work. Your doctor has to use a microscope during surgery, which is why DIEP is known as microsurgery. Because of the time required for the blood vessel microsurgery, DIEP flap surgery takes about 5-8 hours to reconstruct one breast.

You end up with a tummy tuck as a fringe benefit of DIEP surgery because fat from your abdomen is removed to reconstruct your breast and loose skin is tightened up.

Breast reconstruction using your own tissue is popular because it’s a long-lasting solution (implants usually have to be replaced after about 10 to 15 years) and the consistency of the belly tissue is very similar to natural breast tissue. But the new breast will have little, if any, sensation.

DIEP has been used since the early 1990s. Because the surgery is more complicated, it's not offered everywhere. It's usually done by plastic surgeons who specialize in free flap breast microsurgery. 

A small incision along the bikini line is made and the necessary skin, fat, and tiny blood vessels are removed. The fat and skin are shaped into a natural looking breast and sewn into place. The tiny blood vessels that feed the tissue of your new breast are matched to supplying vessels in your chest and reattached under a microscope. DIEP is major surgery and you should expect to spend about 4 weeks recovering.

STAGES OF DIEP FLAP RECONSTRUCTION

There are several stages to DIEP reconstruction: 
First surgery  - The tummy flap will be transferred to the chest and stitched in to create the mound. This is why there is an eliptical shaped scar, in those instances. You will end up with 2-3 drains, a couple of which will generally be removed within a week. 

Second surgery (after first surgery has healed) - This is the "tweaking" stage. During stage 1, the surgeons are mainly focused on transferring the flap and creating the mound. During stage 2, the surgeon will create the nipple, lift and even out your breasts, and do any necessary nips and tucks.  The opposite breast is made to match by augmentation, reduction, or lifting.  Stage 2 is a much easier surgery than stage 1.

Final Stage (after second surgery has healed) - This is the stage where the finishing touches are done; the tattooing the ares around the nipple, to create the look of an areola.

I will probably have this surgery at the end of September.  This surgery will put me out of commission for a good while.  Five days in the hospital, come home with drains & one month until I can drive!  I will be going to my daughter Monica's home to recuperate as I did after my mastectomy last August.

Shingles Schmingles

SHINGLES CYCLE (FROM CHICKEN POX AS A CHILD TO SHINGLES AS ADULT):

It has been 3 miserable months since I broke out with the shingles.  My advice if you had the chicken pox as a child is TO GET THE SHINGLES VACCINE!  I got it a couple of years ago & believe it made me have a lighter case.  Even though I had it on my face it didn't spread to my eyeball which could have caused blindness.  Praise God  that didn't happen!

After a coupe of weeks the gross scabs were gone & I was left with red splotches on my forehead, eyelid, temple, & side of nose - which luckily I could cover with makeup.   I still have light red splotches in the affected area &  hope they go away within the next 3 months.

This graphic shows the areas where shingles break out:  (My area was the face - yuk!)

Medications my doctors prescribed for the shingles:

1.  Valacyclovir (Valtrex)(val ay sye' kloe veer) - 1000 mg once daily:

Valacycovir is an antiviral drug used to treat herpes zoster (shingles). It does not cure shinges infections but decreases pain and itching, helps sores to heal, and prevents new ones from forming.  Because of my suppressed immune system due to chemotherapy & radiation, my cancer oncologist has me taking this for 6 months.  So, I figure I can get off this med right before Halloween - wonder if I can get a scary shingles mask to wear?  NOT!  Prescribed by my cancer oncologist.

2.  Gabapentin (Neurontin)(ga' ba pen tin) - 900 mg, 3 times daily:

Gabapentin is used to relieve the pain of postherpetic neuralgia (PHN; the burning, itching, stabbing pain, or aches that may last for months or years after an attack of shingles).  It does work well to tame the PHN or else one could probably go nuts - especially when the affected area is the face!  However, the side effects really slow you down:  tiredness, drowsiness, & dizziness!  I have been feeling those side effects so severely the past month that I am have discontinued this medication. I think I'd rather itch than be useless! Prescribed by my internist.

3.  Lidocaine  (LIE-doh-cane) - spread on skin as needed:

This medication is used to relieve nerve pain after shingles. This type of pain is called post-herpetic neuralgia. Lidocaine helps to reduce sharp/burning/aching/itching pain as well as discomfort caused by skin areas that are overly sensitive to touch. Lidocaine belongs to a class of drugs known as local anesthetics. It works by causing a temporary loss of feeling in the area where you apply the cream.  This cream has worked very well! Prescribed by my dermatologist.

This pic of me was taken after the scabs fell off.  Now, red splotches are much lighter & swelling is about gone.  I feel blessed that my case was not any more involved than this.  Get your shingles vaccine!


This too, shall pass!  I can see the light at the end of the tunnel!