I am often inspired to write while reading blogs from other sites, reading research papers, or after speaking to patients who ask questions about my experience having delayed DIEP flap breast reconstruction. This week is a mix of all three. I saw a post on the Facebook page from the plastic surgeon I chose for my surgery. The title of the blog post read:
The blog references an evidence-based study from Plastic and Reconstructive Surgery. It states:
During conversations as a patient advocate, I speak to women who ask me to describe what my delayed DIEP flap experience was like.
My commentary is from the main points in the PRMA blog referencing each paragraph. I describe my own experience at PRMA and my delayed DIEP flap breast reconstruction.
- From paragraph one: The main message; DIEP flap represents the ‘gold standard’ in breast reconstruction and there really is no cut off time for reconstructive surgery. My breast surgeon used those exact terms when she told me about DIEP flap, ‘the gold standard in breast reconstruction’. Our discussion about my options was after a second breast cancer diagnosis. I was anxious to get the cancer in both breasts out of my body. We scheduled my double mastectomy with the full understanding I would research a plastic surgeon to do my DIEP flap breast reconstruction while I was healing from the surgery my breast surgeon performed. I waited seven months in between my mastectomy and delayed DIEP flap. Many women I speak with are dealing with their own individual circumstances making difficult decisions.
- From paragraph two: Timing has the potential to impact overall cosmetic results. I believe this is very dependent on the quality of the mastectomy performed and the plastic surgeon you choose to perform your DIEP flap. The blog speaks about skin-sparing, nipple-sparing mastectomy. I engaged in a shared decision-making conversation with my breast surgeon about saving my nipples and performing a skin-sparing mastectomy. My breast surgeon successfully accomplished both skin-sparing and nipple sparing. The skin envelope remained for my delayed DIEP flap seven months later. She prescribed physical therapy soon after my mastectomy. My physical therapist showed me how to pull the skin envelope away from my chest wall to keep it pliable and ready to receive the flap for my breast reconstruction.
- From paragraph three: The overriding message is, with today’s advancements in plastic surgery, patient reported outcomes for delayed DIEP flap ensure the same high satisfaction scores as immediate DIEP flap. The conversation I had with a patient recently asked me this question, “What do you think a delayed outcome is going to be like aesthetically vs. an immediate DIEP flap?”
- From paragraph four: I was not part of a study nor did I fill out a patient satisfaction score. If I had done either, I can tell you unequivocally I would rate my satisfaction as beyond what my expected outcomes were before I had DIEP flap. I explained to the patient I spoke to, my newly reconstructed DIEP flap breasts look far better than the breasts I had my entire life, adding that my plastic surgeon never saw my “original model”. I told her the key to these results was directly related to finding a board-certified plastic surgeon who routinely performs DIEP flap with a high rate of success and has many satisfied patients. I was one of them. I also emphasized the importance of finding a plastic surgeon who engages in the shared decision-making process to discuss options for your surgery.
- The final paragraph is a quote from Dr. Peter Ledoux of PRMA.
There is no need to rush into a surgery a patient is unsure about. It is important for patients to take time to evaluate all their options and decide what is best for them without the pressure of a deadline.
Why do I appreciate this comment? It precisely reflects my experience. I encourage you to take your time. Do your research to find your “just right” plastic surgeon; a microsurgeon who has performed many successful DIEP flap breast reconstructions. Know this, my delayed DIEP flap resulted in amazing aesthetic outcomes because this is the model I followed.