A 501c3 Nonprofit founded by a breast cancer survivor and breast reconstruction patient. The purpose is to educate and inform the public about topics related to all options of breast reconstruction after a mastectomy due to breast cancer or the high risk of getting breast cancer. The opinions of those on this channel are for information and education only! Please consult your physician regarding options for your personal breast reconstruction procedure. There are various options for breast reconstruction available depending on your individual medical situation and personal preferences. Please contact your medical healthcare provider to answer further questions.
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Amazing information! Thank you so much!
Thank you so much for this helpful video. It was clear, detailed, and exactly what I needed!
Great video
@@m.g.1792 Thank you. Dr. C presents well. ☺️
Do you ever do gradual and small amounts of fat grafting as the only means of reconstructing a breast? I know this would take time, but would avoid implants and scars from flap surgery. Thank you!
Hello, great question. The answer is yes, and you are correct, it takes time, sometimes more than one surgery for the fat grafting. There is a video you may want to watch addressing this. Hope this helps. Thanks for watching the channel! kzread.info/dash/bejne/eIOTl859iZTVgMo.html
Thanks so much. Very helpful for decision making process.
You are most welcome.
Thank you for sharing your stories. I am a B-cup sized woman and plan to have a double mastectomy. I am 5'4", 148lbs. Is there a decent chance that I may get a mastectomy without a mastectomy revision surgery? Thank you.
I believe that is possible but there is always a chance revision surgery is possible with any breast surgery. If you are planning on aesthetic flat closure without reconstruction it is hopeful you can have one surgery. Express these wishes to your surgeon.
After radiation I had breast reduction so that I was symetrical again. No one mentioned the amount of shrinking there'd be from radiation. 9 years later I developed RIAS. I had a mastectomy and an expander was placed, not by my choice. Later a 2nd surgery was needed to remove that and put in the implant, while doing another reduction so that both sides were exactly the same. That didn't happen either. There was nothing about them that were symetrical. One year later I had a recurrence. I had done my research and had opted for AFC and found a surgeon on Not Putting on a Shirt. My surgeon was awesome and I'm totally happy with the results. No emotional turmoil as I had with the other surgeries. I am totally happy with my AFC, but will always wear a shirt (too much tummy)!
NPOAS has great resources for AFC surgeons. I am glad you connected with this organization and very pleased to hear your AFC surgery went well and things are moving forward for you!
Thank you Terri. Keep these wonderful videos coming! They’re so important!
You are most welcome and I appreciate your kind words. I am fortunate to collaborate with these skilled microsurgeons across the globe. ❤
I have a bulging after diep flap. What are my options to get rid of it? I go to gym and work out very hard 5 days a week, I don’t see any improvement. I also have some cramps that sometimes they are very strong and sometimes I can control them. Please tell me if I have any options to get rid of the bulge? I’ve been thinking of getting a 2nd option. Thank you ❤
If you believe you have a hernia or bulge this video may help you understand more. The information to locate these two surgeons to schedule a consult can be found in the credits at the end of the video. Here you go and I do wish you all the best: kzread.info/dash/bejne/n4Ohm9iPnrTFp9o.html
Can I have symmetry surgery if I have a pacemaker
Samantha, this is a medical question that needs to be addressed with a microsurgeon who performs surgery for breast reconstruction.
Can a person with a pacemaker have breast symmetry surgery
This is a conversation to have with your medical team.
I have a pacemaker can I get symmetry surgery
Glad to see this. I don't think many patients consider the stress of a 10 hour surgery on their body and brain when making a decision about Diep Flap. Fat grafting is a great alternative for those not wanting to be put under anesthetic for various reasons (like the likelihood of Alzheimers and permanent neurological damage for those with poor DNA detox profiles which may have been a contributing factor to the cancer diagnosis).
Absolutely agree
Thanks!
Thanks so much!
The Foundation always appreciates hearing from you Kathleen. Thank you.
great prensatation! 0:44 0:46
Thank you Jane.
Thank you! Very informative. Info that I didn't find anywhere else.
I’m very pleased to hear this Terry.
Lots of cancer in my family. I had genetic testing done and found out that I have the PALB2 mutation. Four months ago, I had my ovaries removed and last month I had the first of my cancer prevention breast surgeries. I’m having the DIEP flap surgery done July 9.
Hi Jeanette. Please let us know if the Foundation can be of any support. We do have a private Facebook group if you are interested in joining. DiepCJourney: Breast Reconstruction after Mastectomy. You are making strides in your future given your genetic mutation. I know it's not easy and we applaud you. ♥
So very much informative . Excellent education. Thank you very very much!
I'm am happy to hear this. Thank you for your kind words.
My upper forearm hurts on the side I had breast augmentation revision surgery a day ago. Shall I be concerned.
With the cryo surgery, is just the tumor frozen or is there a standard area surrounding it also frozen as well? Additionally, when tumors are excised, they go to pathology for further and in some cases find more advanced findings than biopsy revealed. Is there a standard adjuvant therapy applied or based on biopsy pathology report? Thank you.
Adjuvant therapy will be based on pathology reports and should be discussed with your medial team.
Thank you so much for the very helpful presentation. I am at the time thinking which option I need to pick up for my breast construction. I finished radiation one month ago. This information answered my most of questions and concerns. My plastic surgeon told me to wait 6 months before construction. I kind of like to do the transplant surgery, but still want to keep breast skin, guess have to let surgeon evaluate if my breast skin can be used by then. Thank you both of you for your time and this gtreat education, I have learned a lot!
I very much appreciate your feedback and watching the channel. ❤
Thanks for sharing!
Always great to hear from you Kathleen. Thank you.
What a great presentation, thank you so much! <3
My absolute pleasure!
After mastectomy do you need to a capsule in order to fat graft intp? So fat cells domt just go anywhere? So they stay in a capsule? My Dr is saying i need to keep tissue expander in me before fat grafting to stretch skin and allow body to build a capsule. Is that true??... fyi i am opting for no implant. Im just trying to have a sm A cup to match other healthy boob. I also had explant surgery, so i could not just go flat; i wouldve been concaved.
Hi Terri and Dr. C! I have a few questions. Thank you so much for this very informative video! It’s exactly what I was looking for and I appreciate the questions to ask my surgeon as well as the super specific ones! I appreciate this information immensely. Small background: I am going on 2 years post double skin sparing mastectomy. I had 32 rounds of radiation to my left side. I have been smoking. Vape pen. I’m stopping after seeing this! My appointment is in either August or September with MDA In Houston. 1. I had an emergency appendectomy in 1997. I still get spasms from time to time when I engage the muscle. Is that something to worry about? I forgot to mention this in my consult. I had the CT angiogram so they can see my blood flow. I’m assuming if they saw a complication I would have been made aware? Is there anything I can do to help with this? 2. Also, with the smoking - I quit right now, will this still affect me negatively and cause a higher risk of complications? I know stopping immediately will reduce that risk, but, should I be worried? Is there anything I can do to reduce those complications besides stopping? Should I tell my plastic surgeon? 3. Finally, I am having a lymph node transfer done at the same time to address the MDA stage 4 (level 2) lymphedema in my left arm & hand. This will be done by another plastic/micro surgeon who specializes in this. This doc says both teams will work on me in tandem and this should reduce the amount of time I am under. His team will help the other. It sounds great in theory, but I worry about the thought of possible mistakes due to a “too many cooks in the kitchen” sort of thing. I hope I’m just overthinking. These teams work together often from what I have been told. Are there any certain questions I should ask, scenarios I should ask them to avoid or perform? Specifics for recovery I should be prepped for or ask about? Any pointers or insight would be so helpful. I don’t want to insinuate that I don’t trust them and possibly ruffle anyone’s ego feathers. (Not that this has been shown. I’m just trying to be cautious). I appreciate you reading this and hopefully replying. I’m so nervous and don’t know what to expect. It would alleviate a lot of pressure and worry if I heard more from an outside expert and source. Thank you so much for sharing everything with those of us in the dark and being a great source of knowledge and light. ❤🙏🏼 Amber
I will be getting DIEP on both sides!
My surgery will be May 14th. for this surgery. Im nervous. I was supposed to get the surgery back i March but the Dr rescheduled the surgery.
I hope you are doing well.
1. Why don't they use fat transfer to the lower abdomen to fix the aesthetics if the belly button and natural belly pooch? 2. As far as revisions, so you ever remove the transplanted skin from the breast to increase the amount of breast volume with active nerves/feelings?
Fat transfer is often utilized in a second phase of breast reconstruction. You can find more videos on this channel on phase 2. I'm not sure exactly what you are asking in question #2.
@@DiepCFoundation Yep, I understand that Fat Transfer is used for the breast and face, but wonder why it is not used to give a more natural shape to the abdomen. A slight amount of fat around the belly button would solve the funnel issues... Maybe it is just me, but I can spot the tummy tucks a mile away because the contour is not natural. For #2, I wonder why they don't use a two step method to remove as much of the belly skin as possible from the breast area, inorder to accomplish two things 1. Improved skin sensitivity, since the remaining skin would be that of the chest and upper abdomen, vs the belly skin. So many women complain that their breasts have no sensitivity at the transplant site, and the existing skin/nerves would provide that, and 2. Removing scar tissue, or at least yielding a scar that looks more like a breast reduction. (I've seen too many photos where the women's skin color/aging/texture is very different at the transplant line.)
14 yrs ago with the 1st infiltrating cancer stage 1, grade 1, I was not given an option for any reconstruction had I chosen mastectomy. I was told it is best to save the breast by doing lumpectomy- radiation. 13 yrs later new DCIS stage 0 cancer popped up in the same breast & after doing biopsy on my left breast there was doubt for pre cancerous cell. They suggested surgical biopsy. So decision was made to go only skin sparing bilateral mastectomy & look for delayed reconstruction. My cancer surgeon didn’t help out much with getting me more options for reconstruction but one of doing latissimus flap on radiated right breast, tissue expanders & later switch them with implants. After fighting, doing my own research & hard work got a consultation with micro vascular plastic surgeon who recommended Diep flap reconstruction. 3 wks ago surgery was done @ USC. So recovering. I’m 69.5 yrs young 😊not sure what phase 2 may be FOR ME. But watching you & the other Dr. Talk about layered reconstruction sounds great answer to get little projection & symmetry 👍 One Q is the implant above the muscle or under the muscle? If you can answer this Q would help. thx for sharing your experience. Really appreciate it. GOD BLESS & stay cancer free 🙏
To my understanding, the implant in a combined DIEP Flap/implant reconstruction is that the implant is placed under the DIEP tissue so that the outer layer is the soft tummy tissue. I would definitely ask your plastic surgeon about placement if you are thinking of this "hybrid" breast reconstruction.
@@DiepCFoundationthank you
Thank you for this and many other videos I watched that got me through this journey. I had diep flap surgery last October 2023. Now I've developed a sort of ridge and extended looking tummy on the opposite side of the reconstructed breast (which is the left breast). I'm pretty active with walking/hiking, a little bike riding, some yoga, tai chi zoom sessions thanks to my hospital support group and such. Can I actually help this bulge go away? It feels like I'm over stretching it, if there is such a thing.
A very good question but you'll have to ask your surgeon or physical therapist specialist. Thank you for watching the channel.
Dr. Bassam is always so informative.
I am scheduled for DMX next month. I am wondering if I choose implants and get this PMPS can they go in after the fact and fix the nerve like what he discussed? Or do they do that only in Diep flaps?
Great question Tammy. To my knowledge, they may be able to go in after implant reconstruction but it is a fair question to ask your surgeon. It would require more surgery. The hope is you do not experience PMPS. You may experience some "zingers" after surgery as the nerves wake up but hopefully, like in my case, it will be short-lived and not a persistent issue. Best wishes to you!
I have what I can only describe as a Charlie horse rolling under and along the lower part of my breast. Is this caused from intercostal nerve damage? Also, I use a tens unit on my back shoulder after a failed LD Flap reconstruction surgery. Does the tens unit help or harm the nerves? It seems to give me some relief in that area. Nothing helps the Charlie horses though.
Hi Shirley. I cannot tell you what is causing the pain. An evaluation by a physical therapist or your surgical team may give you some answers. Have you seen the video on the Relivvr Rose on this channel? You used the tens unit. Viewers on this channel can use the discount code in the description of the video if you are inclined to try the Relivvr Rose. It was developed by a microsurgeon who frequently deals with post mastectomy pain for patients. Here is the link to the video: kzread.info/dash/bejne/lZyn26mniLPYlNI.html
Ok so this is exactly what I wished for as an option. Will it soon be available everywhere and listed as an option after mastectomy?
Have you viewed a more recent video on fat grafting only for breast reconstruction? It can be viewed here: kzread.info/dash/bejne/eIOTl859iZTVgMo.html
The woman I'm dating is facing this issue, and I'm learning about it so I can support her. She was very concerned about how I would react seeing the damage to her breasts. Honestly, I was a little worried myself. When she showed them to me, along with the long scars on her sides, I was able to accept it and normalize it as who she is. She is still wildly attractive to me. I'm sharing this to let cancer survivors know that if your partner is telling you that they are still attracted to you, please believe them. They aren't just trying to be nice or just faking their attraction; they really are still attracted to you. It's amazing how love works. To anyone reading this, I hope it might encourage you a bit. Best of luck to all of you.
What a heartwarming comment from a partner of one who has faced breast cancer. I truly appreciate you sharing this and yes, I hope others see this as well. Thank you.
I this video is a few years ago, I had a diep flap, and the pain I get is as if I'm getting a heart attack. My left breast cramps up all day everyday and I can't breathe.
Have you done any physical therapy or massage to this area causing you pain and cramping?
Hi, All, You both touched on many special, if not stunning parts of the Cancer saga in your lived experiences. It is so evident, no 2 paths are exactly alike. We are the stronger for the experence, refined by fire, at times, so it seems. We gain more courage from overcomers like yourselves. I am reminded, "The Lord's mercies are new every morning. Great is Your faithfulness, Lord to me." Lam 3:22-23 Wonderful that you three, all have recovered even stronger w the curve balls you each were thrown. Every story has at least one curve ball before its said and done. So satisfying to hear yourr stories.Thanks😅
Thank you so much Donna for these beautiful words. Very well stated with great heart!
I wanted to go flat, but I also wanted to keep my nipple and areola. I opted for a nipple sparing mastectomy and flap reconstruction because I was informed that it was the only way I could keep my nipple and areola. It seemed to me at the time that what I was asking for was the equivalent of top surgery. Was my assumption wrong? I've often wondered why nipple and areola sparing isn't available as an option for women who want to go flat. It would also be a better aesthetic outcome because the incision line would then be moved to the bottom of the breast which would make the scar less visible.
Thank you for your inquiry and comments. For clarification, did you mean "I opted for NSM and "flat" (not flap) reconstruction? Also, I'm not certain what you mean by "top surgery". To have an aesthetic flat closure with the scar line to "the bottom of the breast along the fold" in a NSM is something the surgeon would have to discuss with the patient. A lot depends on skin laxity, tumor location, size of the nipple/areola complex. You ask great questions. It is certainly a conversation to have with your surgeon for those who are reading these comments.
I am having this surgery on May 14th. 2024. I am very nervous about having it done. They call it L D flap- Breast reconstruction here in the US.
I hope all went well for you.
I wish I had known about this when the tumour was tiny....
What if your tumour is a large hard mass? Is there any hope?
Ann thank you for watching and the inquiry. Treatment plans for your tumor will be discussed by your medical team. The size, location, tumor biology, your age, family history are some of the factors that will be considered for breast cancer treatment whether surgical or adjunctive therapy. Wishing you all the best.
I had my double mastectomy in 2019 and they removed 31 nodes total under both arms. I also had DIEP reconstruction a year later. The only place I don't have lymphedema was my head. I've done the massage, wraps, compression, and pump. I was told by surgeons from before I ever had my first surgery that I shouldn't worry as I could get lymph node bypass surgery. Well, that made me feel better until I got to the point where I was done with surgeries and was trying to maintain the lymphedema with everything my certified therapist recommended, but my insurance would not cover any surgery for lymphedema. They said it was experimental and refused to allow me to go out of network to the Clevland Clinic where they do this surgery all the time. Cancer is so hard to process mentally all on its own and then to know I have to deal with this the rest of my life and knowing it will progress, makes this issue hard to deal with mentally. I learned much during this video and thank you for discussing this. I hope there is more work on getting insurance companies to help us more. It took me almost a year just to get a pump from my insurance and was denied the corrective surgeries available for people like me.
Jeanne, thank you for your honest feedback. I am sorry you have encountered so many obstacles with insurance coverage. I do hope some of your symptoms are being managed and we hope in the future as more studies prove the efficacy of this intricate and important surgery, insurance coverage will not be an issue.
Great video Terri. I wish I would have seen this and then done more research before my most recent Fat Grafting. After watching this I found a fascinating article on liposuction from the abdominal area on Pub Med and it provided all kinds of great information about what to watch out for and what can go wrong. I think a lot of people that follow you don't have fat grafting from the abdominal area because they are getting DIEP flaps which also come from the abdominal area. Because I got a PAP flap, and the last area that had fat to take from was the abdomen, that's where I had my last fat grafting from. It's been the most challenging recovery. What I learned from the Pub Med article was that in Fat Grafting or Liposuction it is important to find a surgeon that is a true artist and has done this procedure a lot because a lot can go wrong and your appearance can be very much affected by the way they do the liposuction. I think this has to be brought to light a lot more. Woman often go into these operations knowing nothing and thinking they "just have to trust their surgeons". Thanks for doing the work to educate all of us Terri. I would like to see Dr. Maratov, or the next plastic surgeon, talk more about the actual procedure and how it's done and what to watch out for to get good results, which ever part of the body you're taking the fat from. I'm experiencing some kind of muscle spasms on my left side and I'm wondering if it was because when they were doing the fat grafting they disturbed the fascia around the muscle, or maybe it was just a consequence of how my body was reacting to the procedure. This would be good to know from a qualified PS. 🙏🧐
I appreciate all your feedback Karen. I hope you find an answer to your question soon but I will certainly do what I can to find out more.
Im so grateful to have the reconstruction with my own tissue - admittedly the first surgery by taking adipose tissue from the abdomen was brutal - not the incision, but under the abdominal skin and 3 drain sites. However the results compared to conventional mastectomies is wonderful, and I don't regret it in the slightest despite the pain. The second surgery to fill in the concave area above my breast was a breeze.
Hi - I can totally relate. I just had a DM with DIep flap reconstruction and yes, it was a very tough recovery. Not so much with my abdomen, even though that hurt very much too, but in the hospital I was sat in a manual recliner on day two and I had to keep using the bathroom and instead of calling the nurses to get me out, I used the manual lever and ended up with a hematoma and a very swollen right breast. Also, on the left my nipple did not survive because the general surgeon cut too deep I was told. Thankfully my plastic surgeon saw that and left some skin so he could fix that three weeks later along with removing the hematoma and liposuctioning out some of the tissue. But going in for surgery three weeks later set me back. I now have rippling on my right breast in the upper inner area so wearing anything low cut will not work right now. Not that I do much anyway, but things such as a bathing suit top I can wear but it won't look that great in that area. I go for stage 2 May 15th. Whether you call it stage 2 or 3. I am afraid of the lipo part of things, but this video did help. I also have a concave area above my left breast and it is nice to know that this can be filled in. I hope the rippling can be fixed too in May or sometime after.
I wish the doctors gave me options
I had a DIEP Flap surgery a few months ago. Even though the surgery was a success, and my recovery has been painless and so easy, I wish I watched this video before the surgery so that I could ask my surgeon about this procedure.
Thank you for your comment and for watching the channel.
I had this surgery did and my belly button was NEVER even mentioned! 😡 I didn't know i had a choice.
How do we find a list of trained surgeons doing this procedure? I live in the Seattle area. Also, if you are not a candidate for robot assisted surgery due to anatomy, what then? Avoid DIEP? Minimize abdominal damage through other means?
Robotic assisted DIEP flap is not available at every facility nor are all surgeons trained to use it. To my knowledge it is not being done in the Seattle area... yet. If you are not a candidate for robotic assisted DIEP, there is no need to rule out the possibility. There are many who have had successful DIEP flap surgery without the assistance of robotic surgery. Go to this channel and watch this video on Reducing Abdominal Wall Complications. The link is here: kzread.info/dash/bejne/i4ZtsM-Po86YhtI.html
Very informative. I didn’t know about this option of using from the back. I had a diep flap with fat from my stomach about a month ago. Even though I am happy with the result, it’s droopy.
Amazing work Dr Selber. Thanks for inspiring a generation of Plastic Surgeons to question the status quo. Thanks Terri for sharing this. I am proud to offer Robotic Assisted DIEP in Australia thanks to the assistance of Dr Selber and Dr Moreira in the USA.
Great hearing from you Dr. Joe!