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Diary of the DIEP

| May 14, 2016 October 13, 2020 | |

diary of the diepWhen I began my journey of breast reconstruction, I really had no idea how many times I would be asked to retell it. Looking back, I wish I had written a blog about the entire experience from the beginning.  Of course, one would think that such a significant event and physically demanding time in my life would be very easy to recount. While I do remember certain details vividly, the majority of the recovery process is a blur. It was less than two years ago, but it feels much more distant. I guess that is my mind’s way of dealing with the challenges of life. Much like childbirth,  if we remembered how difficult it was, we would never do it more than once. Well, I have four children, so my mind must be pretty good at blocking out the pain. At the moment my minor complications from the DIEP Flap felt huge and overwhelming, but it was so very temporary. However, also like childbirth, I think the bigger reason my mind blocks it out, is the reward.

My new DIEP breasts were very delicate at first and required around the clock monitoring, just like a newborn. They kept me up at night and constantly needed my attention. Then, as they got a little older, it was fun to dress them up and make mental notes of the milestones: swelling is gone, pain ending, scars fading. Now, I don’t remember life without them, they are truly a part of me that I cherish and I  hardly notice the scars it took to get them here.

Even though I didn’t keep an official journal of my experience, I do have messages between myself and a dear friend. It begins with her first message to me on the day after my surgery, all the other posts are my own, and it goes to almost two months out from surgery.


“Well… You probably feel like you got hit by a truck, by tomorrow it will feel like a minivan and eventually a Prius
Hope all went well


12/20, 1:58 pm 
Yes I do

12/21, 10:52 pm 
No shower yet, they haven’t offered. I’m still pretty out of it and hurting

12/22, 8:04am

 Every time I try to eat something solid I get nauseous, I haven’t eaten more than a couple bites since Thursday night. I had horrible gas pains last night, so I’ve walked more and sat in the chair. At least the flaps are doing great, I really haven’t gotten a full look at everything yet

12/23, 8:57am

  I feel so much better this morning. I’m not sure if it was all the meds on an empty stomach etc. or a stomach virus because it felt that violent. I’ve never felt so bad in my life! Thank you for checking in on me, I’m sure I looked like death warmed over! Heading home in a few minutes and the Docs are just the best, Dr. Tiwari talked to me personally on the phone twice

12/23, 3:52 pm 
I emailed Dr. Kocak. It doesn’t hurt and still feels warm, so I’m not sure. Nobody ever took my bra completely off and I was too sick to even think about it. Ugh, I wish I would have looked before I left. They did a Doppler check not too long before I left and it sounded good, but this definitely doesn’t look good

12/23, 4:04 pm

 Talked to Dr. Tiwari, he said it looks like just bruising to him and since it’s not on the flap it is not likely necrosis, thank God! I love those guys, they are so awesome!

12/24, 4:03 pm

 Earlier I went to the bathroom, thank God for the little things! I also brushed my teeth. Going to try for the shower in a bit. Just eating a little here and there, probably have to get some of the protein shakes on Friday. Everything is closing

…Christmas Eve.

12/24, 10:42 pm 
The shower felt so great! Gotta be honest, I’m a little geeked about this “bruising” on the one side. It’s not on the flap at all, but that area was never uncovered at the hospital so I have no idea if that’s how it’s looked all along? Last night, the little blister area on the bottom must have burst because my bra had leakage on it and it’s noticeably smaller, but still very dark looking. I’m just going to try and not think about it until my appt Friday, nothing that can be done between now & then anyway I suppose.

12/24, 11:29 pm 
 Yes, I’ve sent them multiple pictures. Dr. Tiwari says he is quite confident it’s just bruising, may get worse before it gets better. My flaps looks great, they are bigger than I had imagined they would be, so not sure what that’s about exactly. Maybe it’s based on areola size, because mine were large. They also left my c-section scar below my DIEP scar, which I thought would be gone. All of these questions I didn’t know I had because I felt so bad at the hospital, I didn’t care what I had underneath my gown! Thank goodness my appt is as soon as it is!

12/26, 11:04 am

 Already on the way home. He took out 3 drains, said the bruised area looked better than he expected, just leave it covered with gauze and everything else is so far so good. Hopefully get the rest of the drains out next Friday. Going back home to sleep 😊
 in my recliner!
December 27, 2014

12/28, 11:39 pm

 I’m ready for these drains to be gone! Even though I’m showering almost every other day, I feel stinky!

12/29, 1:24 pm

 One of my drain bulbs won’t suction. I left a message with the PA. It wasn’t putting out much, so I’m sure they will say it just needs to come out


12/30, 1:02 pm

I only have one more dose of pain meds. I didn’t know you have to have an actual written script to get more, so I can’t get that until Friday.

12/30, 3:41 pm

My Hubby just left, he has to work his 2nd job the next three nights from 4 to midnight. Just me & the kiddos, I’ll be ready for my meds as soon as I can get them to bed. Thankfully, the 9 year old can lift the baby for me!

12/31, 11:11 am
 The drain that had stopped working, literally fell completely out when I showered today. Dr. Tiwari said no big deal.

12/31, 5:15 pm

….and here come the tears! 😭

1/2, 2:22pm
  Ugh. In the waiting room feeling like the walking dead, everybody else is all in their makeup clean hair & new duds!

1/2, 4:09pm   I am drain free, that feels so good! My bruise area has some dead skin. Dr. T wants me to come back on the 8th to clean in out and put a little skin graft in the OR as an outpatient. He said it will take about an hour and it will be “twilight” sedation. No big deal he says! 

He said if it was on the flap it would be devastating, but on the side is an easy fix

1/2, 6:15 pm

 so thankful my flaps are rockin’ it!

1/5, 5:17 pm

 I’m wondering if the twilight sedation will make me nauseous as all anesthesia does. It’s so funny, before surgery, this wound thing was my biggest fear. Now that I’m dealing with it, just kind of like whatever. Just one day at a time. Maybe it’s the drugs, Lol!

1/7, 10:26 pm
I am still on for tomorrow. Just for kicks, guess what happened today?!? Abdominal incision leakage, oh yeah, fun times!
I’m glad I’ll be there tomorrow so he can see my abdomen. It doesn’t look too bad, but the drainage is worrisome. Ugh! I know, this too shall pass!

1/7, 10:44 pm

Right now, the drainage looks like diluted blood, just reddish/orange. No odor that I can tell & I don’t have a fever.
There is an odor with the wound on the breast, but they all saw it in person and said no infection. I just really hope it looks a lot better after tomorrow.

1/8, 7:05 pm

 I’m home. They did the debridement, but the skin graft wasn’t needed. They both said, it actually looks great. My abdomen was more screwed up than we thought, so they opened it up and now I have to pack. Ugh! However, I do already feel a lot better than I did and I’m not stinky! I have a follow up next Friday.

1/8, 8:01 pm

 My surgeons are so amazing! Dr.Tiwari is going to call me in the morning to walk me through the packing

1/8, 8:13 pm

 He said hopefully 2-3 weeks of packing. I don’t have to pack the boob, just the tummy. They did the light anesthesia & I didn’t have any nausea, yay!

1/9, 3:52 pm

 Ok, so poking gauze into my body, major heebie Jeebies!

1/10, 11:09 am

 My abdomen, is as it should be, I guess. It’s crazy, it didn’t really bother me to see the breast mess, but this little open wound is freaking my freak for some reason!

1/14, 2:38 pm

 I just want to heal! 
 I feel like my incisions are healing very slowly. Sometimes I look and it seems like they still look like day 1.

1/15, 8:02 pm

 My open wound seems to be holding less gauze, but the skin around it has a bluish appearance. I’m not sure about that. I have small amounts of drainage on each boob, but nothing open. I feel like I’m behind the pack. Monday will be a month and I still have weepy incisions. I feel like he will say I’m doing good or oh, not good. Sigh….

1/15, 8:22 pm

 It’s so frustrating, I feel like the more I move, the more I leak. Then I hear all these people say they had zero issues, and I’m just like what am I doing wrong?!?

1/16, 7:40 pm
They say I look fantastic, the wound is healing. Just keep up the packing. I did have another very small spot open right next to it, so it has to be packed too with skinny gauze, Dr. Tiwari told me to just get back to my normal routine, even lifting the baby! He said pack up the wounds and go. Easier said than done I think, but he wasn’t worried about it in the least.

1/20, 7:05 pm
On a good note, I drove myself to get my haircut wearing jeans! How about them apples!?!

1/20, 7:10 pm
I was surprised my jeans weren’t a bit loser, so I guess I’m more swollen than I realize because I’ve actually lost 18# since surgery, though I’m not sure how.

1/23, 9:11 am

 I have tried a sports bra last night, just to see. I was amazed when I put it on how my boobs filled it out the right way and how normal it made me look!

1/24, 11:23 am

 Yay, don’t have to come back for 6 weeks!

2/5, 9:53 pm

 My wound, is looking pretty good, I kind of don’t know if I should put a band-aid over it and proclaim it healed, or keep up. I’m down to very small strips of the little tiny gauze. I asked Dr. T how to know when I could stop packing and he said when I can’t pack it anymore, Lol. Otherwise, I feel great! So worth it!

2/10, 8:45 pm

Healing is going well. I decided to let my itty bitty wound close, so far it’s behaving. The “big” one is now a smallish hole, still packing it though. I figure if the closed one stays closed, I may follow suit with the other one next week. Gosh, it’s nice to pack it and then just a band-aid to go!

2/12, 8:08 pm I am feeling almost totally back to normal! I am so happy I made the decision to go with DIEP, it is so neat that it is all a part of me still. It truly is amazing, even though there have been some bumps in the road, I feel whole, I don’t feel a sense of loss. I’m happy and relieved!


About the Author

Katrina Smith is the Social Media Coordinator/ Patient Liaison at Midwest Breast and Aesthetic Surgery. She is a devoted wife and mother of four boys.
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*Our blog entries are written in order to further educate our patients and raise awareness towards topics related to plastic surgery. Any solutions offered on this blog are intended to help possible patients develop educated decisions before undergoing a consultation with our doctors.

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