DIEP Flap Reconstruction

Reconstruction, oh what a word.  Well the next step in my journey, path, process, <insert your favorite term>, is a big step.  On April 21st I will be having my final reconstruction surgery.  I will be having DIEP Flap surgery at the Hospital of the University of Pennsylvania in Philadelphia, also known as Penn Medicine.  Penn performs this surgery more than any other facility in the US and has a success rate over 99%.

DIEP (Deep Inferior Epigastric Perforator) Flap is an intense surgery that involves taking tissue, veins, and arteries from my abdomen and essentially transplanting them to my chest.  That is the simplest explanation, I’ll give a little more detail down below so those that are somewhat squeamish can bail out before then.  You may recall that I fainted during my first biopsy so I completely understand, as fate would have it I am not as squeamish as I was two years ago. 🙂

I mentioned that this is an intense surgery, I typically understate things and am probably doing that here. The surgery itself will likely be about six hours long, my surgery will be a bit shorter than some experience, since I already had my bilateral (double) mastectomy, my surgeons will not have to remove any breast tissue.  I will be in the hospital for five days including the day of surgery, the nurses and doctors will follow me closely during the hospital stay to ensure that the blood supply to the “Flap” or transplanted tissue takes and stays working.  Because Penn has such a large focus on this surgery I’m not too worried, I know that I’ll be in good hands, the best, actually.  I will come out of surgery and from the hospital with four drains (an all time high for me), these drains are basically tubes that go into  little grenade-like things, I like to call them blood grenades.  They’re annoying, somewhat uncomfortable, but they perform an important job of preventing fluid build-up in the area of surgery.  I’ll have two drains on my chest and two on my stomach, they’ll remain in for 10-14 days, perhaps a bit longer.  I will be staying in Philadelphia for about two weeks following surgery, I may be able to go home sooner but we’re planning on two weeks.

All of this does leave me a bit nervous. Being four hours away from home, relying on the kindness of family and friends in CT and PA, having another significant surgery, going back into recovery mode, etc.  I don’t doubt that this is the right choice for me, but I know the road ahead will have pain and work to get back into full health.  Before my mastectomy I had no fear but also no firsthand knowledge of the extent of what I was facing.  Now I have a much better picture of recovery.  I’m not fearful, but I’m aware, much more aware, and that’s OK.  Please pray for me, for us, during this time.  God has been beyond faithful to us, meeting our needs and giving us strength when we had none.  We will be praying for a smooth surgery with great veins and arteries to use, good pain management, smooth healing with no complications, and a good transition for all of us.  Please hold our girls in prayer too, they will be cared for by my parents (pray for them too) and some friends.  I expect they will thrive, but it’s been a long road for them as well.  Matt or I will keep you posted as we continue!! 😀

—— Bail Out Warning ——

DIEP Flap has been around for several years now.  It involves cutting a hip-to-hip ellipse shape (or eye shape) on my abdomen.  Then the primary veins and arteries circulating blood are found, these are followed further into the abdomen by cutting through the fascia and muscle and tails to both vessels are cut.  These arteries and veins will be attached to the mammary vein and artery near the sternum.  The tissue (aka fat) will then be used to form a breast or foob (fake boob).  The fascia and muscles in my stomach will then be sewn back together and my skin pulled together.  For the curious, here are a couple links: a basic description of DIEP Flap and a really interesting abridged video of a DIEP Flap surgery.  I actually watched the video and I did not pass out (!!!) it’s really interesting and further confirmed my conclusion that these surgeons (really all of my Docs) are rockstars.