DIEP procedure

As I had mentioned many posts before, my sister, ironically, was diagnosed with DCIS two weeks before I had my mastectomy.  Although LCIS (Lobular Carcinoma In-situ) is a grey area of breast cancer, DCIS is definitely breast cancer.  With LCIS, both breasts are of concern while DCIS (Ductal Carcinoma In-situ) is usually limited to the breast from which it was diagnosed.  My sister is choosing to have a bi-lateral mastectomy with DIEP reconstruction which is completely different from my bi-lateral mastectomy with silicone implant reconstruction.  She does not like the idea of having a silicone implant in her body so she has taken her time to research and has found that DIEP is the procedure that she wants to pursue.  As she researched the procedure, so did I since I was only aware of the Tram-Flap reconstruction.  I have since found out about Lat Flap reconstruction as well.DIEP reconstruction is a rather intriguing procedure in that it takes tissue and fat from your stomach area but not muscle as in the Tram Flap procedure.  According to About.com,  it gets its name from the deep inferior epigastric perforator artery.  It is similar to a tummy tuck so there has to be enough fat and tissue in the abdominal area to be moved although an implant could be placed in position to increase the size of the "breast" created.  I would not be a candidate for this since I do not have enough fat in my tummy area HOWEVER, if it were to come from my ass...different story.The positives of this surgery is that the new "breast" can be formed right away after the mastctomy so these tissue expanders are not necessary; in addition, a tummy tuck will occur by proxy and there is less pain and a faster recovery time than a Tram Flap procedure.  The negatives are that there needs to be fat in that area to use for the reconstruction. Also, compared to the TE/implant reconstruction that I am undergoing, there is a longer time in surgery and a longer recovery time in the hospital and there will be two scars afterwards.  Since  DIEP flap is microsurgery, it requires extensive training and experience in addition to special facilities and surgical tools. The sutures used to reconnect the blood vessels are about the same diameter as a strand of hair. The surgical team will use a high-power microscope to perform the most critical part of this procedure which is reconnecting the blood vessels. 

The Lat Flap reconstruction gets its name from the latissimus dorsi muscle which is located in your back.  Similar to the Tram Flap in that it uses muscle and tissue, the difference is that the Lat Flap takes it from the back rather than the stomach area to create the breast right after the mastectomy.  According to About.com,  an ellipse of skin and the latissimus dorsi muscle will be tunneled from the upper back to the mastectomy area to create the "breast".  A small implant may be needed in addition.  The positives include less complications in the lower abdominal area as compared to the Tram Flap but there could be loss of mobility/strength in the back area which requires physical therapy.  It is also microsurgery and requires a specialized surgical team and facilities for the operation.  The recovery time is similar to the DIEP procedure which is about 4 to 6 days in the hospital and about six weeks of recovery time afterwards.

I watched videos of both procedures and it was fascinating.  If there is interest, Google "Beth Israel DIEP video" but I cannot remember the site for Lat Flap procedure.  Sorry.  If I remember it, I will revise this.  My sister's surgery is February 18th so I will keep you updated.  Meanwhile, I am slowly exercising which has led to a one pound loss.  Whoo Hoo!