DIEP stands for the deep inferior epigastric perforator artery, which runs through the abdomen.  In a DIEP flap, fat, skin and blood vessels are cut from the wall of the lower belly and moved up to your chest to rebuild your breast.

 

This is an amazing advancement in breast reconstruction.  A surgeon will perform the mastectomy by cutting around your nipple and removing all of the insides.  They will then hand over to a plastic surgeon who will cut a big slice out of your tummy, make it boob shaped, take all the skin off apart from a circle the same size as the one that has been cut out of your breast, and then fit the piece of tummy into your empty boob and sew the old tummy skin to your breast skin. 

 

What this means is that you can have a new breast that is all you.  And while they are at it, you will get a complimentary tummy tuck.  New boob and flat tummy.  Every cloud!

 

It has to be remembered though that this is major surgery.  Prior to the procedure you will have to have a CT scan, so that the plastic surgeon has a map of where all of your veins and arteries are, as some of these will be transplanted from your tummy to give a blood supply to your reconstructed breast.

 

The surgery itself can take between 5 and 7 hours, and when you wake up you will be forgiven for thinking that you have been run over by a train.  The cut to your tummy is hip to hip. You will have drains in either side of your abdomen, one in your breast, and if you have also had lymph nodes removed you will have a drain in your armpit too.  You will very likely be wired up to IV fluids and be catheterized.  You will have so many wires and tubes hanging out of your body, you will feel like a scene from The Matrix.

 

When you wake up you will have a corset around your middle, but usually your breast will not have any kind of dressing or bra, and so the first thing you will do, as soon as you get the chance, is have a sneaky peek down your hospital gown.  Don’t be alarmed by what you see.  It may look a little like a potato that has seen better days.  

But remember, it’s been through a lot, and so must be forgiven for looking like Frankinboob.

 

For the first couple of days after surgery you will be in a high dependency unit, where the nurses will do your obs every hour.  One of the things they’ll need to do is to listen for a heartbeat in your breast to make sure the new blood supply is working.   This is great but they always seem to do it just as you have nodded off, and you’ll spend the next 55 minutes trying to go back to sleep, just to drift off 5 minutes before they wake you up again.

 

The day of the op and the next day go in a bit of a blur, but as you become more coherent and awake and you will start to mobilize (drains, IV lines, catheter and all!).  The other thing is that the drugs given to you during surgery start to wear off, and you really start to know about the 180 stitches in your belly, and the couple of dozen in your breast and armpit. You feel like a ‘saw the lady in half’ trick that went wrong.  It was on day 3 that I really began to regret opting for the DIEP flap and wished I had just let them cut my breast off and be done with it.  However, that was the worst day, and every day after that saw a slight improvement. 

 

After a couple of days you will be moved to a normal ward or room, and the drains will start to come out one by one.  The breast one isn’t a particularly pleasant experience, but the abdomen ones really are a little stomach churning.  I definitely recommend a sympathetic hand to squeeze while those bad boys are removed.

 

When the plastic surgeon is happy with you, you are managing the pain and you are mobilizing, you will be allowed to go home.  This could be anything from 4 to 6 days after your surgery, and you may go home with some drains still in situ.

 

The recovery period is around 7 weeks.  And you really will need this time.  For the first few days at home you will get a sore arse from laying and sitting on it the whole time.  You should wear the corset and sports bra for at least 6 weeks after surgery and, to be honest, for the first week or so, whenever you take the corset off you feel like you might fall in half.

 

After 3 or 4 days at home you’ll have the blissful realization that if you lay or sit in a certain position, you actually won’t feel any pain.  It is such a lovely moment! 

 

Obviously the second you realize the telly remote control is just out of reach, and you have to haul your broken body forwards in the chair to get it before Cash in the Attic comes on, this blissful moment is gone, but it is progress.

 

I actually found this period of incapacitation harder to deal with than the fuggy 24 weeks of chemo.  It think that during chemo, as your head is all over the place, you don’t really have the desire to get out and about, or clear you kitchen cupboards out. 

 

But once chemo is over, and haze in your head starts to lift, you realize how shit you felt before!  After surgery, it is your body that is broken rather than your head, so the forced inactivity feels like it is imprisoning you.

 

But as each day goes by the pain gets less and less, and mobilizing becomes easier and easier.  A couple of weeks after the op you will get up out of bed one day without having to shuffle yourself to the edge and tentatively roll off the side.  You’ll be able to brush your teeth without having to do some kind of weird limbo legs, that gets you to sink height without you having to lean forwards.

 

By week 6 or 7 the pain of that horrible 3rd day post-surgery will be a memory, and you won’t be regretting your decision to go for a DIEP flap any more.  Your new body will be very changed.  You will have a lovely flat tummy, but you will also have that big Joker Mouth scar and your breast will still look a little bit like a jacket potato.  I remember thinking that I looked like one of Sid’s broken toys from the first Toy Story movie.  Your new body will take a long time to settle down.  It might take up to a year for your new breast to soften up, and all the fluid to be drained away.  But, it is all you and The Cancer will be on its way to the history books.