STAGES OF DIEP
There are three stages to DIEP reconstruction:
Stage 1 - The main and most major part of the procedure. If you have not already had a mastectomy, the breast surgeon will be part of the surgical team. The breast is removed, hopefully with the skin-sparing procedure. The skin-sparing procedure will create a breast envelope (pocket), where the breast tissue is removed and the breast skin remains. The nipple will be removed at this time, unless you are having a nipple-sparing procedure, whereby the nipple will remain intact. Once the breast tissue has been removed, the plastic surgeons will began to harvest the flap for transferring to the breast. If you have a skin-sparing mastectomy, the flap that is removed from the abdomen will be used to fill the breast envelope, to form the breast. If you are having DIEP reconstruction after having a prior mastectomy, the 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 4-6 drains, a couple of which will generally be removed within a week.
Stage 2 - This is the "tweaking" stage. During stage 1, the surgeons are mainly focused on transferring the flap and creating the mound. You may be uneven. During stage 2, the surgeon will create your nipples, lift and even out your breasts, and do any necessary nips and tucks. Generally, after stage one, we have what are called "Dog Ears". These are pointy ends of skin on the side of each hip, that remain after the abdomen is closed, during stage 1. These "Dog Ears" are removed at stage 2. This is the stage where you will be brought back to as near normal as we can get. Whole again. Stage 2 is a much easier surgery than stage 1. Initially, when you see your nipples, they will appear huge. Don't panic. They will shrink to a normal size, within the next few weeks. Your PS will provide you with some anti-bacterial ointment that is also used to keep them moist. You will also have a plastic guard over them, for protection.
Stage 3 - This is the stage where the finishing touches are done; the tattooing. Some women choose to have ink tattooed onto the areas around the nipple, to create the look of an areola. Some women are fine without the tattooing. Here is a tip: tattooing generally fades, over time, and you have to go back, time and again, to get it redone. You need to choose a good artist and then have the tattoo done in a darker ink than your normal color. This way, when the darker ink fades, it will fade to a lighter, normal color that will stick around for a while. Just make sure that the pigment you choose is one that is right for your skin color. Your artist will be able to help you with your decision. If you are having a nipple sparing reconstruction, stage 3 is not necessary for you. You are done at stage 2.
You are done! Now, move on with your life and enjoy those cleavage showing dresses and bathing suits at the beach or pool! You are not going to believe how normal you are going to look and feel. I could walk down a beach topless (which I would never actually do) and no one would know that my breast are not my original breast...unless I told them.
~~~~~~~~~~~~~~~~~~~~~~~~~~
At this point, I have to say thank you to all of the wonderful angel DIEP docs who have perfected this skill and who allow us to once again be whole. It is an amazing surgery, that allows us to feel and look normal, which was not afforded us in pastimes. Bless all of you for your services.
Stage 1 - The main and most major part of the procedure. If you have not already had a mastectomy, the breast surgeon will be part of the surgical team. The breast is removed, hopefully with the skin-sparing procedure. The skin-sparing procedure will create a breast envelope (pocket), where the breast tissue is removed and the breast skin remains. The nipple will be removed at this time, unless you are having a nipple-sparing procedure, whereby the nipple will remain intact. Once the breast tissue has been removed, the plastic surgeons will began to harvest the flap for transferring to the breast. If you have a skin-sparing mastectomy, the flap that is removed from the abdomen will be used to fill the breast envelope, to form the breast. If you are having DIEP reconstruction after having a prior mastectomy, the 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 4-6 drains, a couple of which will generally be removed within a week.
Stage 2 - This is the "tweaking" stage. During stage 1, the surgeons are mainly focused on transferring the flap and creating the mound. You may be uneven. During stage 2, the surgeon will create your nipples, lift and even out your breasts, and do any necessary nips and tucks. Generally, after stage one, we have what are called "Dog Ears". These are pointy ends of skin on the side of each hip, that remain after the abdomen is closed, during stage 1. These "Dog Ears" are removed at stage 2. This is the stage where you will be brought back to as near normal as we can get. Whole again. Stage 2 is a much easier surgery than stage 1. Initially, when you see your nipples, they will appear huge. Don't panic. They will shrink to a normal size, within the next few weeks. Your PS will provide you with some anti-bacterial ointment that is also used to keep them moist. You will also have a plastic guard over them, for protection.
Stage 3 - This is the stage where the finishing touches are done; the tattooing. Some women choose to have ink tattooed onto the areas around the nipple, to create the look of an areola. Some women are fine without the tattooing. Here is a tip: tattooing generally fades, over time, and you have to go back, time and again, to get it redone. You need to choose a good artist and then have the tattoo done in a darker ink than your normal color. This way, when the darker ink fades, it will fade to a lighter, normal color that will stick around for a while. Just make sure that the pigment you choose is one that is right for your skin color. Your artist will be able to help you with your decision. If you are having a nipple sparing reconstruction, stage 3 is not necessary for you. You are done at stage 2.
You are done! Now, move on with your life and enjoy those cleavage showing dresses and bathing suits at the beach or pool! You are not going to believe how normal you are going to look and feel. I could walk down a beach topless (which I would never actually do) and no one would know that my breast are not my original breast...unless I told them.
~~~~~~~~~~~~~~~~~~~~~~~~~~
At this point, I have to say thank you to all of the wonderful angel DIEP docs who have perfected this skill and who allow us to once again be whole. It is an amazing surgery, that allows us to feel and look normal, which was not afforded us in pastimes. Bless all of you for your services.
