Diep Flap vs. Expansions with Nipple Sparing

 

WEDNESDAY, OCTOBER 20, 2010

Diep Flap vs. Expansions with Nipple Sparing

A little over a year ago, Dr. Peter Kreymerman met with me in his office to discuss my options for reconstructing my breasts. I remember him taking a marker and drawing a design of each choice on the tissue paper that patients usually sit on in a surgeon's office,s. I was amazed then, and I still am at the knowledge and talent of Dr. Kreymerman.
At that time, my mind was so full of un-uncertainties and lack of knowledge I really did not care what he did. I just wanted the VILLAIN out of my body....who cares what boobs look like, right? Some have asked me what the difference in the options I was given are; I will try to explain it to you, but remember, I chose the expander, so to really compare the recovery would not be fair to me.

DIEP flap is a procedure that is actually very popular among surgeons and their patients. A DIEP Flap procedure uses fat and skin from the lower abdomen but does not require removal of any muscle. When Dr. PK drew that picture on the tissue, my mind was checking out. Are you kidding me? Now I was looking at another scar as a constant reminder on my abdomen?

Then he explained the expanders; a tissue expander is a temporary device placed on the chest wall deep into the pictorial's major muscle. This may be done immediately following the mastectomy or as a delayed procedure. The expander's purpose is to create a soft pocket to contain the permanent implant. Dr. Kreymerman put my expanders in at the same time as my mastectomy. Then over several months, I visited him every other week, and he stuck a needle into the port of the expander and filled it with usually around 50cc of saline per breast; this part was painful for me, I think, because I was also going through chemo at the same time, so I had expansions one week then chemo the next, I remember feeling really sick one week then really sore the next. Dr. Kreymerman is also among a few surgeons who can do nipple-sparing for mastectomy patients. I'm not sure of the qualifications, but I know I qualified, and this is how Dr. Kreymerman became my "nipple repairman."

The 2nd part of the expansion surgery is what I just had on Thursday, expansions out and implants in. Again as I have stated before, be careful what you say "you would never do" I used to say I would never get implants...mostly because I already had big boobs, and I hate big boobs... I am amazed at how soft my boobs are now, they were as hard as a rock a week ago, and now they feel normal. I am still in some pain from the incisions, but the pain I am feeling now is temporary and is nothing like the pain I have been feeling for over a year now.

From what I have experienced and from what I have read, expanders with nipple-sparing will give you a totally normal-looking breast. The pain you will have to endure will be worth it if you look for an average-looking breast. With the diep flap, I am not sure they can do nipple-sparing (you will need to get a tattoo) and no long-term pain in your breast, but you do get a tummy tuck out of it all. Either way, if you decide to go, there will be a pain, and there will be scaring.