What’s it like at six months post DIEP flap surgery?
How much time do you have? Just kidding.
I’m now six months, post DIEP flap surgery. On the one hand, it feels like surgery was yesterday. On the other hand, it feels like ages ago.
Even though I’ve been stuck at home (like most people) due to the pandemic, the past six months have gone by quickly. Not exactly sure what’ve I’ve been doing all this time besides hunkering down trying to avoid the virus and trying to maintain some sort of work schedule.
Am I the only one who hasn’t gotten as much done as I’d hoped during the past year of isolating?
(Feel free to humor me.)
So, what’s to report at six months post DIEP flap surgery?
Reminder: This post is not a substitute for medical advice. I’m offering a few tips for other DIEP flap surgery patients, but they are merely that, my tips based on my experience. Follow the advice of YOUR doctor.
I’m still healing. Yeah, I know. Six months and still healing?
Yep. My plastic surgeon continues to remind me that this is normal. Complete healing takes time.
The abdomen
My abdomen certainly feels better than say, three months ago. Things continue to improve. But, it still doesn’t feel normal — which really means it doesn’t feel like it did before. It’s important to make that distinction. Perhaps it never will feel like it did before. (Input on this, anyone?)
What exactly do I mean?
It’s hard to fully explain, but I’ll try. There is an ongoing feeling of abdominal tightness, which makes sense considering the procedure. This tightness, annoying not painful, reminds me to sit using better posture, so that’s a good thing. Or so I tell myself. For example, if I don’t pay attention to posture while working at my computer, I get uncomfortable. This can vary quite a lot from day to day.
Tip: If you sit/work at a computer, try to maintain good posture.
When I first get up in the morning, all is good, abdominally speaking. When I stand and walk around, the same is true. Sitting too long is what can be a problem. Not a huge problem, but rather a reminder.
So in addition to proper posture, I try to avoid sitting for too long. (Maybe this is why I’ve gotten less writing done.)
Tip: Take frequent breaks when sitting for extended periods.
In addition to the above, I’m still wearing mostly sweat-type pants. Comfort. That’s what I want. Of course, this has always been the case. I’ve always been a comfort over style sort of gal. These days, I pretty much only put jeans on when I go to the grocery store. (Should I be admitting this?)
Comfortable underwear is also a must. If going without works for you, that’s a good option. I really need to get busy searching online for good options for both top and bottom.
Tip: Stick to comfortable, non-restrictive clothing for as long as you want. Keep wearing post-surgical bras as long as directed to do so.
Keeping it real, I will admit that I like my now flatter stomach. HOWEVER, DIEP flap surgery is NOT like getting a tummy tuck. Hearing that sort of thing makes me cringe. I’m pretty sure a tummy tuck is quite unlike a DIEP flap procedure.
I would gladly take back that belly pouch if it meant getting back my other original parts. So, do NOT tell me how lucky I am to have had this “tummy tuck perk”. Uh, uh. No. Nope. Do not say that. I would also strongly advise plastic surgeons to avoid this comparison.
Tip: Avoid telling someone she’s lucky to get a “tummy tuck” from a DIEP flap surgery.
Exercise/movement
I resumed my walking routine pretty much right away post surgery. I cannot recommend this enough. Walking (when you get the okay) works wonders. Photo below is one week out. In winter, walks can be more challenging. Walking around Target or the grocery while hanging onto a cart is a suggestion someone shared as a way to get in wintertime walks. Of course, you’d need someone with you early on.
Recently (like a month ago), I started lifting weights again. I started with light ones. Up to three pounders now. Woohoo! The point is, after you get the go ahead, start slow. Light weights are still weights.
In addition, I really wanted to start regaining core strength. I was thinking sit-ups. My doctor isn’t a big fan of sit-ups post DIEP. So, be sure to ask yours. Mine favors yoga and controlled, modified sit-ups and planks.
(I’m glad I asked.)
Upon Googling, I came across a couple helpful YouTube videos addressing rebuilding core strength. The one I’ll tell you about here is via my esteemed fellow blogger and advocate, Terri, founder of DiepCFoundation (a great resource for anything you want to know about DIEP, btw).
It’s important you do not do any of these exercises without your doctor’s approval. Even at six months out, I’m still only doing the first two exercises explained in the video.
I’m also working on forearm planks. Let’s just say, I have a ways to go here. (Why do they look so easy?)
Tip: Walking, light weights and carefully chosen core-strengthening movements — those are the three things I do and recommend.
Healthier Eating vs the scale
I avoid advising others about diet and nutrition. There is far too much finger-pointing and blaming that goes on about how a person should/should not eat. Much of that advice too often feels judgmental. As if before cancer, we were living recklessly eating whatever and whenever. And post diagnosis, if you haven’t adopted whatever fill-in-the-blank diet, you might be made to feel that you are not doing survivorship right.
Yep. A blame-game pile on is what that is.
You might want to read, Stop Blaming Yourself for Getting Cancer.
We all know trying to eat healthy is important. Most of us try to do our best, which means entirely different things to each of us.
Following DIEP flap surgery, your body works extra hard to heal and needs proper nutrition in order to do this. Try to keep that proper nutrition stuff going for the long haul.
Once you reach a certain age, healthier eating is more about exactly that — healthier eating. It’s not about the scale. Okay, not as much about the scale. It’s not about deprivation. It’s not about good food vs bad food. Of course, it never was.
Again, since reaching a certain age, I need to walk a minimum of two miles per day to sorta maintain my weight. I’ve figured out (finally) that this is what works for me. If I wanna eat more, I gotta walk more often and further, so I adjust accordingly. Okay, I try to.
When I first got home post surgery, I was down roughly ten pounds after the initial swelling/bloating phase post surgery. (Yeah, those f****** implants were heavy.)
I’m still maintaining pretty well. But since the holidays, my weight’s been slowly creeping up. (Yeah, weird post holidays, not during the holidays) I can tell I probably shouldn’t allow myself to pack on too many pounds because as I mentioned above, my stomach is just different now.
I mean, where would “belly fat” go now?
Tip: Try to eat as healthy as you can, but do not focus on the scale. This is about your overall, ongoing health.
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My reconstructed breasts
First of all, I will just say (again) the new breasts that I have are reconstructed breasts. They are still nothing like the real deal. It bugs the heck out of me when the illusion is perpetuated that implants and autologous reconstruction methods recreate breasts. They do not.
Some things cannot be recreated. Reconstructed breasts are exactly that. Reconstructed.
You might want to read, Things We Aren’t Supposed to Say About About Mastectomies, Reconstruction & Breasts.
Also, reconstructed breasts do not make women whole again. Women are whole with or without breasts.
I share this quote from my friend Lisa, blogger at Habitual Gratitude, every chance I get:
The sum of my parts makes me whole. I don’t feel less of a woman without breasts, just a woman less her breasts.
Amen.
This a perfect spot to emphasize (again) that no matter what choice a woman makes regarding reconstruction, including opting out, it is her choice and that choice must be respected. Opting for aesthetic flat closure is a completely legit and perfect option that many women choose.
And it goes without saying that saving lives, not breasts, is what matters most in this entire scenario.
For the most part, I am content with the results of my DIEP surgery. My reconstructed breasts feel warm and more natural. Definitely more like me. I also seem to have more sensation now than I did when I had implants. These things are huge. For me.
What about phase 2?
Yes, generally DIEP flap surgery requires a phase two and sometimes a phase three. Implant surgery more often than not, also is not a one time and then you’re done type deal either.
Breast reconstruction is complex and takes time, sometimes quite a lot of time.
You might want to read, 10 Reasons Why Breast Reconstruction Is Not a Boob Job!
At this point, I’m thinking I would probably like a phase 2 when I’ve been vaccinated (still waiting) and when I feel more ready. Maybe this summer I’ll do it. Maybe. Then perhaps nipple tattoos. Again. Or perhaps not. I can only deal with one phase at a time.
You might want to read, Nipple Tattooing, the Final Step in the Long & Winding Road of Breast Reconstruction. (“Final” step. Gosh, I had a lot to learn yet when I wrote that one.)
So, am I happy I chose DIEP?
If you ask me first thing in the morning, yes. Or when I’m walking around, yes. When things are bothering me, mehh.
I tell myself to make the final judgment at one year post surgery. At this point, most of the time, I’m content with my decision. Ecstatic, no.
But again, patience is required for a bit longer.
Dear Hubby hasn’t said much. He’s super glad that major surgery is behind us. I know that much. He’s also super glad I no longer talk about my dissatisfaction with implants. How does he really feel about the state of my chest?
I’m not sure. I haven’t asked him. Why this is I’m not entirely sure.
Oh yeah, the scar!
We can’t forget about the lovely (not) scar. It’s definitely there in plain sight, along with all the others. Anyone who’s had DIEP flap surgery has a pretty darn substantial hip-to-hip scar. So, forgetting what this body’s been through isn’t even a realistic expectation. I’m reminded every day.
My abdominal scar has been a bit wonky. The left side started healing perfectly from day one. The right side was a bit more unruly. Apparently, this is not an uncommon thing. (I’ll spare you the details about the wonky right side of my scar.)
As far as scar care goes, I have not been using scar cream that was given to me at one of my follow-ups. (Using it was optional.) It’s a gel, and I hate how messy it is. Your favorite lotions work nicely too. I prefer Lubriderm, sensitive skin, unscented. I use another brand, too, with cocoa butter. Cocoa butter is what my plastic surgeon recommended as a helpful healing ingredient to look for. Plus, it smells like you’re at the beach!
I’m only addressing the abdominal scar here. My breast scars are pretty much the same as your run-of-the-mill bilateral mastectomy scars. I’ll just leave it at that for now. After all, you don’t have all day to read this.
Lightly massaging your abdominal scar area is important and can really help but ONLY if, when and after you get permission from you doctor.
Regarding scar care, be sure to follow YOUR doctor’s advice.
Tip: Use scar cream, lotion and massage techniques approved by YOUR doctor.
I’m not gonna lie, there are still days (over the past ten years, actually) when I look in the mirror and say, WTF happened?
I’m pretty sure this is normal though. No, I know it is.
Sure, we adapt, we adjust. We carry on.
But forget?
Not gonna happen.
Tip: Allow yourself to grieve for the old you. It’s okay. Breast cancer is a string of losses. There is much to grieve for.
If you were looking for photos of my scar or chest, that’s not gonna happen either. I’ll leave that sort of thing for others to share. You’re stuck with a very unrevealing selfie — apparently one with Ninja looking on.
Writing and publishing this post was hard enough!
So, that’s what it’s like for me at six months post DIEP flap surgery.
Now, ask me anything!
To learn more about DIEP flap surgery, visit PRMA Plastic Surgery.
For help making breast reconstruction decisions, including opting out, check out the free Breast Advocate App.
Read my review of the Breast Advocate App.
Have you had any sort of breast reconstruction, and if so, are you satisfied with the results?
Did you opt for aesthetic flat closure, and if so, how do you feel about your decision?
Do you have a tip to share or question to ask?
Thank you for sharing this post!
A NOTE FROM NANCY: I write about the peculiar twinship between my DIEP flap surgeries and the pandemic in my new book EMERGING: Stories from the Other Side of a Cancer Diagnosis, Loss, and a Pandemic. Order it in print or for Kindle at Amazon. EMERGING is also available at most online booksellers such as: BAM, Bookshop.org, Barnes & Noble, and more. Reviews are greatly appreciated!
Jennifer Dunwoody
Monday 5th of August 2024
Hi Nancy I found your posts really helpful. I am under 4 months post surgery. Single mastectomy and diep done at the same time. I too, struggle with the tightness. I feel at times like I have a stitch you would get from running. I still grimace a lot especially when putting on socks and shoes. My belly button scar is aggravated and taking longer to heal. I suppose because of clothes rubbing against it and the waistband of trousers. The tops of my thighs are numb too. I hope to goodness this all isn’t the new normal. Still unsure whether to get nipple surgery and tattoo. I’ve no other treatment which is good but have no appointments with surgeons to advise me on exercise or things I should and shouldn’t be doing. I know I’m doing too much on some days.
Nancy Stordahl
Tuesday 20th of August 2024
@Jennifer Dunwoody, I'm so glad you found my posts helpful! Complete healing takes a long time. Some of the sensations - like that tightness - don't subside completely. At least not for me. You do get more used to things though, and as I said, healing takes time. You're still not that far out. I still have not gone forward with nipple reconstruction or tattooing. I did nipples (and tattooing) with implants and they didn't last. This time, I am thinking about 3-D type nipple tattoos. But, I've yet to do it. At this point, I'm not sure I will. Sometimes, I just don't want any more stuff to deal with. I might try some stick on nipples to test color etc. But I haven't yet done that either.
Thank you for sharing. I wish you all the best. Keep healing.
KazzieP
Friday 28th of June 2024
Hi Nancy
I’m 5 weeks out of my mastectomy with immediate diep flap reconstruction, reading your blog and all of the ladies comments are really reassuring that everything that I’m feeling and going through right now is pretty standard. I work in M&S in the UK (which do great post surgery bras!) although they aren’t putting pressure on me to return to work until I’m ready, I recognise their obvious hints! Having read all the comments on here though I no longer feel guilty about wanting to wait and listen to my body and I’m definitely not going to be rushed back, I’ll return when I’m ready! Thank you for sharing.
Nancy
Wednesday 17th of July 2024
Kazzie, I hope you're continuing to heal well. It's a lengthy recovery, for sure. I'm glad you found the post and all the comments reassuring. Do take your time about getting back to work. My best to you. Thank you for sharing.
Marisa Ciancimino
Wednesday 8th of November 2023
Thank you for sharing Nancy I can relate to this, as I too got rid of those nasty implants!!! Went to diep flap and I’m 8 months post. They still feel somewhat weird and kind of heavy considering they’re half the size of those toxic implants they took out! I’m guessing this will ease up with time as I find having to wear a bra 24/7 is a must at this time..I also have far necrosis on both breast ugh!
Nancy
Thursday 16th of November 2023
Marisa, It took longer than eight months for things to settle down for me. With time, things feel more normal. I think it's probably more that I've gotten used to things. But I know without a doubt that things feel much better for me now than with implants. I never adjusted to them. Like I wrote about it in Emerging, reconstructed breasts will never be like the ones Mother Nature gifted you with, and that's important to keep in mind. Even with autologous procedures. Thank you for sharing.
MC
Wednesday 6th of September 2023
I’m six months post diep flap surgery. I had phase two 3 months ago. I still feel tightness in breast is this going to be a permanent thing? I also had removed implants because of problems! Ugh I can’t win…
Nancy
Monday 11th of September 2023
MC, I can't really answer your question about that tightness being a permanent thing. I would say that six months post DIEP isn't really that long. Plus, you had phase two only three months ago. Healing takes a long time. In my case, it took more time than that. Quite a bit more. Some things will never feel the same. This is just reality, at least it is for me. Be patient. This was a major surgery, and healing is a long process. Please discuss any concerns with your doctor - including that tightness. Good luck and thank you for sharing.
Alice Mcmille
Monday 14th of August 2023
This insightful post provides a candid and informative account of the author's experience six months after undergoing DIEP flap surgery. The author reflects on the ongoing healing process, highlighting the unique sensations and tightness in the abdomen that persists, along with the importance of maintaining good posture and taking breaks when sitting for extended periods. The practical tips shared, such as the recommendation to continue wearing comfortable clothing and post-surgical bras, and the emphasis on the significance of walking and gradually incorporating exercise into the routine, provide valuable insights for those who have undergone similar procedures. The author's honesty and relatability in discussing body image and the differences between DIEP flap surgery and a tummy tuck add depth to the narrative.