My Unilateral Skin Sparing DIEP Operation In Pictures
The morning of the op and being marked up - the orange peel segment is to become the 'stuffing' for my new boob, the skin of my right boob will remain but my nipple will go. I can feel the sadness radiating off this picture, I remember it so well. I asked both the surgeon and oncologist, who were both in the room at the time, if I definitely really needed to have this done. It was a resounding YES.
In hospital a few days after the operation, I could shuffle to the loo in a bent over fashion. If you look at the picture above and the section they took out of my stomach it's amazing I could get anywhere near as upright as I did! The skin is very elastic (think how it stretches in pregnancy) and it was only a few weeks until I was completely upright again.
The first few days post op I was bed bound so you have a wee bag (can't remember what they are called) and you are hooked up to everything going, drips, bleeping monitors the lot. My partner told me he was completely freaked out when he saw all the paraphernalia that surrounded me, I guess it made it seem more serious. I was just glad they were looking after me with great care!!
I also had 3 drains, 2 coming out of my stomach (see the dressings above, this was taken just after they were removed) and one coming from my boob. Most people have drains in for quite a while but my surgeon had mine removed after about 3 days. Drains are just tubes that drain fluid into a little bag so moving around with them is probably quite challenging. I didn't have that problem because they were taken out so quickly.
I was on a lot of drugs including self-administering morphine if you please which I actually enjoyed, all the way along I have focussed *hard* on the good bits! I ended up cancelling all my visitors with the exception of my partner as I felt like I didn't want to have to stay awake and chat when I felt so physically weak. This surprised me but I was glad I cancelled everyone, it was definitely the right thing for me, after that all I needed to focus on was recovering. I had been worrying about when to take my pain relief prior to their visits as wanted to be awake but the medication kept knocking me out. Some people were coming from a couple of hours away to see me and I didn't want the pressure of timing my pain relief.
I also got what my oncologist referred to as "the post op high", I felt really really good which was the last thing I was expecting, I felt very confused by it. She said it's all relative with the worry that has been felt in the lead up to the op and and that now it is over and there is no more scary anticipation. It's actually a thing apparently.
I had to sleep in my bra for weeks (I can't remember how long it was now) but it was tough, you are uncomfortable and sore under your arm for some reason. I ended up wearing a silky cami top with this bra over the top, it made a tiny bit of difference. I also wandered around with a cushion under my arm which helped. I moved into the spare room for my recovery and build a 'nest' of pillows. You'll need every pillow you can get your hands on!! I had one under my legs as you have to sleep propped up for a while, loads behind my head and the cushion under my arm. A water with a straw in and podcasts galore! It's a strangely enjoyable time as you really have to go with the recovery full on. If you try and cheat it you get so tired its unbelievable.
A few weeks later, for some reason my surgeon didn't ask me to wear a support binder on my stomach but I think most people do wear this. The stitches on my stomach were dissolvable and I just had what looked like packing tape on my wound, amazing!
A few weeks post op and to start with it looked to be a pretty good match. My 'new' boob felt very hard (which is very normal) I guess the tissue goes into some kind of shock. The skin you can see where my nipple was is part of my old stomach skin. The surgeon cut off my nipple and areola and scooped out all of the breast tissue through that hole until all that was left was an empty bag of skin with a crater at the top (think volcano). The segment from my stomach was then poked through the hole and important blood vessels were reconnected using microsurgery, this is the bit of the operation that takes a LONG time. This is done so the breast area doesn't reject the new stomach tissue and it all remains living. This operation was an immediate skin sparing reconstruction, not every diep will be the same as mine so check with your surgeon. I was very lucky I could have an immediate reconstruction.
Several weeks on and the new breast is softening up and looking more 'boob' like and soft. The tape is on my nipple area as well whilst the stitches dissolve.
The match isn't as good as it appeared as soon as the surgery was over. This is what the second 'symmetrisation' op is for so it's not a big deal, that and making a new nipple.
The wound tape is off and my scar is healing nicely :) I feel like a magicians assistant that accidentally got cut in half when the trick went wrong. The scars do not bother me at all and are quite fun to scare people with. They don't bother me because I know that they will fade to white eventually.
Something to be aware of, I lost all feeling in my new boob and part of my tummy below the belly button. This can come back over time but I feel this is unlikely for me although that is just a gut instinct. Apparently, some surgeons reattach nerve endings in the operation but my surgeon didn't, when I quizzed him he said it was unlikely to make a difference. I'm not sure whether that is based on fact or not but aside from that he was a pretty stellar surgeon in my opinion so I think he probably had based that on experience, I know he has literally done hundreds of these operations and I chose him for his experience. I felt pretty bad about the numbness for a while but gradually your brain adjusts and it doesn't feel anywhere near as weird as it starts off feeling, I promise. Plus I don't think everyone experiences it. It's good to be aware though.
You get a 'new' belly button hole put in which is inevitable given the skin is pulled down. The belly button is effectively on a stalk so this needs to be rethreaded through the new hole. Mine is pretty small now and a bit higher up, but I can live with that.
Several months on just prior to operation 2. I have bigger hips than I used to have, sometimes fat from the tummy tuck can spread slightly I guess. Mine is subtle but this is commonly referred to as 'dog ears' which is usually to overhanging bumps at either end of the tummy scar. This will be corrected by my surgeon using liposuction, I asked him if he could take slightly more whilst he was doing it as my new flat tummy means trousers fall low at the front and generally don't fit properly, he was quite happy to do that.
This will involve lipo to my hips, and lipo to my new boob to get it shaped more like the other one. I have big nipples (nipple) and am a candidate for 'nipple sharing'. This means they literally cut my good one in half by slicing off the top and stitching it on to the other side. The benefit of this means the new nipple will not flatten which quite often it will if it is made with a skin graft. I questioned my surgeon a gazillion times to check I would not lose feeling and he assured me I would not.
A couple of days after operation 2. My hips are zinging here and there with what feels like electrical currents where the liposuction was and I am bruised - I'm not even bothering with the painkillers now so all TOTALLY bearable. I also now have 2 nipples, not seen them yet though. I seem very symmetrical and am delighted.
Bruising on my hips from liposuction. It looks worse than it is, I bruise very easily. You can see from the dressing on the right that the surgeon reopened a small section of my abdominal scar to get the lipo implement in.
Update: It's now 10 months after my first op and things have settled down a lot. The initial symmetry I had after operation 2 disappeared within a week, I'm not sure why, I was slightly disappointed after the initial perfect symmetry because it was way better than I'd dared hope for. On the whole though I feel I have had a really good result. My new boob is bigger and most people would have had balancing lift surgery on the other breast during operation 2 but my existing breast is perkier than my new one so there wasn't much to work with. I'm an unusual candidate I think as this isn't what normally happens.
The nipple sharing was a big success. I didn't lose any feeling in my original nipple which was a massive relief. I still have to get my nipple tattoo done and I will update again once it is done.
My scar is healing nicely and doesn't give me any concerns whatsoever. I quite like it weirdly :) You can just about see in this picture a tiny round scar above the big one, that used to be where I had my belly button pierced many moons ago which gives you a sense of how far my stomach was pulled down.
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I spent such a long time trying to decide whether to go for an implant or a DIEP and did loads and loads of research, it was agonising, knowing that whatever I decided would be with me for life. The bottom line was I wanted a DIEP but I was scared, very very scared. Everyone kept telling me I was brave but I wasn't I just didn't have an alternative as I saw it. As it turned out it wasn't anywhere near as bad as I thought.
It was basically a crappy choice as there wasn't a 'this mastectomy doesn't have to happen' option which was the option I so desperately wanted.
For me personally, I wanted a reconstruction, not everyone does but that was the only thing I WAS sure of.
This is another post I wrote about the surgery options available to me that I could find from the internet: https://unilateralmastectomy.blogspot.co.uk/2017/11/hi-all-whilst-researching-my-mastectomy.html, I hope they are helpful. When you are dealing with a cancer diagnosis the last thing you want to work out on top of that is what surgery to have.
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