Reconstructive Surgery after Masectomy

Yes we are going to talk about the breast again!!!! I agreed to journal my experience through reconstructive surgery since my mastectomy..... but only to give my true experience for anyone that may have any questions or concerns from a breast cancer patients point of view.

My surgery was exactly 4 weeks ago today and I have been told by the surgeon that I should be able to resume some "normal" activities by week 6 and a full recovery by week 12......so I attempted some light gardening this weekend and as much as I love my garden, my body just was not ready.

So what kind of reconstructive surgery did I have? I had the Diep Flap surgery, performed at Toronto General Hospital and they are currently performing 1 of these surgeries a week. My surgery was a total of 11hours and performed by multiple surgeons. So what is Diep Flap?

A DIEP flap is a type of breast reconstruction in which blood vessels called deep inferior epigastric perforators (DIEP), and the skin and fat connected to them are removed from the lower abdomen and transferred to the chest to reconstruct a breast after mastectomy without the sacrifice of any abdominal muscles.

The DIEP flap is similar to the muscle- sparing free TRAM flap but only requires the removal of skin and fat. Unlike with the TRAM procedure no muscle is sacrificed. The blood vessels, or perforators, required to keep the tissue alive lay just beneath or within the abdominal muscle. Therefore, a small incision is made in the abdominal muscle in order to access the vessels.

After the skin, tissues and perforators (collectively known as the "flap") have been dissected, the flap is transplanted and connected to the patients microsurgery. The plastic surgeon then shapes the flap to create a new breast. As no abdominal is removed or transferred to the breast patients experience less pain post-operatively and a faster recovery compared to the TRAM flap patients. Abdominal strength is also maintained long-term following the DIEP flap procedure.

Many women who undergo this form of reconstruction enjoy the added benefit of a flatter abdomen, with the results that mimic a "tummy tuck" procedure. The risk of abdominal complications such as a bulging and hernia is also very small, much smaller than with the TRAM flap method of reconstruction. As with all other types of breast reconstruction however, 2 or 3 stages performed a few months apart are often required to complete the reconstruction process and to obtain the best cosmetic result.

Unfortunately, due to the complexity of the surgery few breast cancer centers offer DIEP flap breast reconstruction despite the many advantages the procedure offers the TRAM flap.

Stay tuned for more stories about my journey through this surgery.