Delayed DIEP flap vs. Immediate Breast Reconstruction

Delayed DIEP flap vs. Immediate Breast Reconstruction

Having delayed DIEP flap breast reconstruction and waking up with breast after being a breast amputee following a mastectomy is different for those who have immediate breast reconstruction. Having breast reconstruction of any kind due to breast cancer or a gene mutation is a fierce undertaking.  The women I speak to planning and recovering from surgery go through a range of emotions from diagnosis, finding they carry a gene mutation that puts them at high risk for breast cancer and through the decision to move forward with breast reconstruction.

Those Range of Emotions Vary

Here is a list that I often here as I discuss and speak to those planning reconstruction:

  • sadness in losing your original breasts
  • fear of surgery
  • anxiety in the aesthetic outcomes
  • worry about the new feeling of reconstructed breasts
  • concern about their sexuality after breast reconstruction
  • relief knowing the cancer will be removed from their breasts
  • anticipation of a breast that may look perkier than the breasts being replaced
  • uneasiness in taking that “first look” after waking up from surgery

The list is endless. I do believe, in my humble opinion, that there is a difference of emotions for those having immediate vs. delayed reconstruction.  It is those differences of emotion that I have come to respect and put into perspective after supporting and chatting with many different breast reconstruction candidates.

Immediate Breast Reconstruction

It is an odd feeling for those who have immediate breast reconstruction to wake up with new breasts that have replaced your original breasts.  The fact that you have a drain coming from each breast will be something you must deal with for several days. There will be swelling and bruising from the surgery that can be unsettling to look at initially. Patients often wake up with surgical wraps or compression garments.  Some are anxious to look at their new breasts and others aren’t ready to see their newly reconstructed breasts.  They will feel different than the breasts you had before they put you under anesthesia for the surgery.  I have spoken to women who must give themselves time to mourn the loss of their breasts and get accustomed to and embrace their newly reconstructed ones. Others who have had immediate breast reconstruction adjust quickly and easily. No two patients are identical when it comes to their own recovery.

Delayed Breast Reconstruction

When you have waited a few months or a few years to have breast reconstruction, the feelings can be different if you have lived without your breasts.  This was the case for me since I had mastectomy seven months prior to my DIEP flap breast reconstruction. I have shared this story before but I woke up giggling from surgery when I looked down to see my new breasts, even covered with a not so attractive surgical bra, drains coming from each breast, and an abdominal binder around my lower torso.  To see shape and form where there was a flat silhouette for seven months is something that is still difficult to put into words from a personal perspective. As swollen and puffy as I was from surgery, IVs, monitors, and bandages included, I already felt more feminine seeing the shape of breasts on my body again.  Perhaps we have had that mourning period and loss of breasts that those with immediate breast reconstruction must face immediately when waking.  Perhaps awakening to new breasts is a different exuberance for those who have had delayed vs. immediate breast reconstruction. I acknowledge and respect that difference.

Facing Fears both Delayed and Immediate Breast Reconstruction

What I admire most in all breast reconstruction patients is facing these fears head on and the tremendous planning and decision process that it took to reconstruct your breasts. Did you have immediate or delayed breast reconstruction? How did you feel when you woke up from surgery? Each of our stories are unique to our own experience and I welcome your comments.

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References made to my surgical group, surgeon and healthcare team are made because they are aligned with my values and met my criterion after I did research of their practices and success rates. Any other healthcare provider that displays the same skill, compassion education and outreach to patients will be given consideration and recognition on this website.  The information contained on this website is not a substitute for or should be construed as medical advice. Please consult a licensed physician for medical advice.

2 Replies to “Delayed DIEP flap vs. Immediate Breast Reconstruction”

  1. Nancy's Point

    Hi Terri,
    Many women are “forced” to make these very big decisions at a time when they are being bombarded with information. To say a person feels overwhelmed is an understatement. I wish there could be a little more time allowed for women to mull over decisions like what sort of reconstruction they want, when they want it, or if they even want it at all. In all frankness, I may very well have made different choices had I had, or taken, more time. Having said this, I very well might still have chosen the implant route had I been given more time, but I was rushed. The thing is, I know that now, but at the time, I didn’t fully realize this. Patients need time to make these huge decisions. Thanks for this post and all you do day in and day out. This post is important because it addresses the mixed bag of emotions regarding immediate vs delayed reconstruction (or opting out) in a nonjudgmental way.

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