Free Flap, Autologous Reconstruction

[DeborahNC]

I'd like to hear from anyone who has had this type of reconstruction.

I like the thought of having my own fat and tissue making up my new breasts. I considered the implants, but feel uneasy about something foreign being inside me. Even though my port is working well the foreign feeling is such that I can't wait to get it out.

edit: Again, I forgot to sign my name

Deborah in NC

[SusanAnne]

Hi Deborah,

I believe you are referring to a DIEP flap. I had a TRAM but my cousin had the DIEP and I know others who've had it as well. The DIEP is a longer operation due to all the microsurgery but it seems to be easier to recover from. I believe there is a website (sorry, can't remember what it is) to find surgeons who specialize in this operation. I highly suggest you find a group where there are two surgeons working as a team to cut down on the length of time in the OR. I'm not sure if you are doing a bilateral or not but it would make a huge difference spending half the time under anesthesia. Good luck to you.

Susan

[Unregistered]

There are previous posts looking at pro cons options risks views etc with links.

Search using search button above under masectomy if you are interested.

RB

[kristen]

Hi Deborah,
I had the S-Gap, and it was done by Dr. Bernard Chang in Baltimore. He will only do one side at a time. He was one of the first ps to do these and does 3-4/week. He is at Mercy Hospital, was at John Hopkins, but Mercy made him an offer he couldn't refuse. I was from out of state and went in on Monday and left on Friday. A home nurse came out and inspected my drain tubes. My breast surgeon took out the tubes. A lot of places want you to be there for the 2-3 weeks until the tubes come out. One thing to ask. Another person on this board went to New Orleans and had 2 ps work on her she had a bi-lateral and s-gap done. Very sucessful. You can find the site of the doctors who do it at DIEP Sisters.com. or go to Facingourrisk.com. a lot of them go to NO. to have it done you would get a lot of referrals from them. Good luck and if you have any questions about Dr. Chang, go ahead and leave a personal message for me and I will get back to you. I loved my decision and very happy with my results. I was out 6 months past rads before they would do the surgery if that helps. Best to you.

[Ginagce]

I too went to Dr. Chang in Baltimore. He & the Director of their breast center, Dr. Neil Friedman, worked together to reduce OR time.

Using the sites mentioned above will take you to more info.

I too was uncomfortable with implants and wanted to use my own tissue. I also did not want to have my stomach muscle cut as I'm young (51) and active and I didn't want that slowing me down.

I am pleased with the results although I do need to go back for some additional surgery for alignment and sizing purposes. One is bigger than the other. One is also scarred due to healing challenges. I had had radiation previously (7 years earlier) on that breast and then started chemo right after surgery, which was not part of the original game plan.

I had both breasts done at the same time, mastectomies and then immediate reconstruction same day.

I was at the hospital from Tuesday to Friday and the hospital and care were wonderful.

If you'd like to talk about it, I'm happy to. Just send me a message.

Best of Luck to you in your decision. For me that was the hardest part...making the decision. Once made, it was all downhill emotionally.

Ginagce

[DeborahNC]

Thank you great ladies for the replies! I've heard much more positive results from the DIEP and other autologous reconstruction than implants.

I have an appointment with Dr. Michael Zenn at Duke next month. I've heard good things about him. I may also see Dr. Robert Allen near Charleston, SC. Dr. Allen is the PS who was doing all those who were going to NOLA for recon. Since Katrina hit he relocated to the Charleston area.

Did any of you have problems with insurance?

Hugs to all, Deborah in NC

[frank]

my wifes surgeon says that after doing both types of reconstuctions he encourages inplants due to long term problems with the lower abdomin wall. this is from a surgeon that did 6 operations yesterday alone and works on long island the breast cancer capital.

[Unregistered]

I saw this and felt it was worth posting as relevant to the general topic.

I have not followed it up in any way.

There are some useful resources on this link posted earlier.

http://www.her2support.org/vbulletin/showthread.php?t=22740&highlight=masectomy

RB




http://today.reuters.com/News/newsArticle.aspx?type=healthNews&storyID=2006-03-15T172340Z_01_COL562565_RTRUKOC_0_US-BREAST-IMPLANTS.xml

ABSTRACT

NEW YORK (Reuters Health) - Results of a study that followed women up to 30 years adds to evidence that silicone breast implants do not boost cancer risk.

The study, of nearly 2,800 Danish women who received breast implants between 1973 and 1995, found that these women actually had a lower risk of breast cancer than a group of similar but implant-free women. Also, the implants were not tied to other types of cancer, according to findings published in the International Journal of Cancer.

Women with breast implants did have a higher rate of non-melanoma skin cancers, the most common and least threatening forms of the disease. But it's possible that greater sun exposure explains that association, the study authors speculate.

"Our current results support the conclusions of recent expert review committees that silicone breast implants are not associated with an excess risk of breast or other cancers," write the researchers, led by Dr. Soren Friis of the Danish Cancer Society in Copenhagen.

[Ginagce]

First, in reply to Frank's post on the abdomen wall....DIEP surgery does not cut any ab muscles at all. That is why I chose it over a trans flap which does use the abdomen muscles.

As far as insurance, I was shocked. I have an HMO and not only was I going for this specific type of surgery, but I was leaving a city (philadelphia) with 3 major NCI cancer centers for treatment in Baltimore. I had absolutely no problem. Dr. Chang's office took care of getting everything precertified and I never received a bill other than my co-pay for the initial office visit.

Best to you
Ginagce