Hi Everyone, This is my first ever post on this website! I decided to join up because I have been encouraged by your posts and would love some advice about future reconstruction options. I am 37 and was diagnosed with early breast cancer on 5th August 2011. Left mastectomy followed, then four rounds of chemo, and I am scheduled to start radio on 16th January 2012. I currently have a tissue expander in which looks great, but sometime next year I was thinking I would like to have the TRAM, but during my reading about it the DIEP kept coming up, and I think I prefer that to the TRAM now. I don't speak to a plastic surgeon until the end of Jan. A few questions: Has anyone had Dr Megan Hassall as their plastic surgeon? What is the recovery time like for the DIEP. What is the abdominal scar like from the DIEP? I look forward to hearing from you all soon! hjoyy

Hi, Just writing something about this elsewhere.... my radiation oncologist recommended Dr Harvey Stern, plastic surgeon- this is in Sydney. Today my surgeon also suggested Dr Stern. He does the DIEP flap which my surgeon says he thinks would be the go for me. If you are not in Sydney, ask around your other health professionals that are treating you as I think they often see the work of all the surgeons. Good Luck, Julia

Thanks Julia for the name, I'll have a look. I am in Sydney. Are you about to have this reconstruction too? Regards, Heather

Hi hjoyy Both the TRAM and the DIEP are major operations and both require you to have enough abdominal fat to transfer. I have not had a reconstruction but have been on a research focus group for it. The major difference is that the TRAM has muscle, skin and fat transferred while the DIEP only has fat and skin. There is a much reduced risk for future problems in the abdomen with the DIEP as no muscles are cut/removed. Both operations leave a scar across the abdomen but there is a sticky support strip that you can place over the incision line (once it is healed) to prevent keloid scarring, ask your PS about this. With love Joy K

Hi Hjoyy, Dr Meagan Hassell is very good and comes highly recommended. I have seen her work on one of my friends, and her new breast so good. She had it done about 6 years ago. I have also seen another bilateral job on someone else, at a cancer meeting, and again, the results were excellent. Meagan is very hard to get in to see. I had an appointment to see her, and had to wait over 5 months. I ended up cancelling this appointment when I disvovered that she only does the TRAM, and not the DIEP. Neither of these 2 ladies had any muscle problems though. The surgeon who I saw who seems really good is Professor David Pennington at RPA and Strathfield. He has an excellent web site, so google him. He seemed so nice and very confident about this type of surgery, and again, I have seen his work first hand, and it is excellent. I ended up having tissue expanders as I haven't had radiotherapy, and ended up having both breasts removed, so much easier to match up. Good luck with your search. Love Chris xx

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12 Replies

stephaniek
Member
11 years ago
Yes I too was referred to Dr Hassall and she only does the Tram Flap, and did not even advise me that there was another procedure called Diep.

Have since heard not good things about this surgeon and was going to see Dr Pennington but he has now retired.

Have an appointment with Dr Stern in July, 2015.
Joy_K
Member
14 years ago
Hi hjoyy

From discussions with women on other cancer chat rooms and also follow up stats, there appears to be a hernia problem following TRAM flap for very active women, not just 6 months out but years later. Interesting to note that you say your PS does not do the DIEP, so naturally she would be talking up the one she does! Perhaps find a PS who does do both and get their advice. In this decision you have to be your own advocate!!

With love

Joy K
hjoyy
Member
14 years ago
HI Chris,

Thanks, I hope the surgery goes really well. I had two of my kids at the SAN and its a great hospital. I'm sure they'll look after you well.

I think I have about 400 ml in my left tissue expander, and I don't want any more. I am happy to be smaller than I was, although I can't really enjoy it yet as my R side is still bigger so I have to add a prosthesis to the L to match the R. Looks passable with nothing extra in swimmers though. I agree with you that the expander is a bit uncomfortable, I'll be glad to get rid of it.

At the moment I'm still thinking I might try the TRAM. I have an appointment with Megan at end of Jan, which was less than two months wait. Considering I am away over Christmas I thought that was quite good. I have called and am waiting for an appointment with David Pennington too. May as well get a couple of opinions.

All the best with your surgery, let me know how it goes,

Merry Christmas,

Heather
Chris
Member
14 years ago
Hi Heather, my tissue expanders are now full with 500mls of normal saline, and i'm just waiting till they are fully stretched before having silicone implants put in. I'm booked in at the SAN on January 11th to have this operation, which is about 3 months after my second mastectomy and insertion of bilateral tissue expanders. He pumped me up quickly with 100 ml lots, so I was at this size on the last week of November. My recent side is still very tight, probably due to the extra surgery I had to remove the massive haematoma, but the physio laser is helping it soften. I will be happy to get the new implants as the expanders aren't that comfortable. I chickened out of the DiEP, mainly due to the length of the operation, approx 12 hours for both breasts done together. It would have been nice to get the flat tummy though. The DIEP does give a very nice natural looking breast, but there are a lot more scars. I guess you have to decide what is important to you and go with that. The cost of the DIEP with Dr Pennington, is about $19 K. My plastic surgeon charges $28 K for the double TRAM. I know Dr Hassell has a public list, but not sure about Pennington, but he probably does, as he is mostly at RPA. Good luck with your appointments. How long do you need to wait to see each surgeon? Love Chris xx
hjoyy
Member
14 years ago
Hi Chris,

Thanks for your advice. I now have a referral to Megan and to David Pennington (so that I can discuss the option of the DIEP). It sounds like we are in the same boat as I have also had left Mastectomy and tissue expander and am planning a mast. for the right next year. Trying to decide if I just do implants in both or if I want to do the TRAM or DIEP. What do you think you will do after the tissue expanders?

Thanks, Heather
hjoyy
Member
14 years ago
Thanks Joy K for your advice. I don't think my plastic surgeon does DIEP and she is confident that the TRAM does not show reduced abdominal strength once 6 mths is reached (not what all the other websites say!). What did your research focus group discover? Regards, Hjoyy
Chris
Member
14 years ago
Hi Hjoyy, Dr Meagan Hassell is very good and comes highly recommended. I have seen her work on one of my friends, and her new breast so good. She had it done about 6 years ago. I have also seen another bilateral job on someone else, at a cancer meeting, and again, the results were excellent. Meagan is very hard to get in to see. I had an appointment to see her, and had to wait over 5 months. I ended up cancelling this appointment when I disvovered that she only does the TRAM, and not the DIEP. Neither of these 2 ladies had any muscle problems though. The surgeon who I saw who seems really good is Professor David Pennington at RPA and Strathfield. He has an excellent web site, so google him. He seemed so nice and very confident about this type of surgery, and again, I have seen his work first hand, and it is excellent. I ended up having tissue expanders as I haven't had radiotherapy, and ended up having both breasts removed, so much easier to match up. Good luck with your search. Love Chris xx
Chris
Member
14 years ago
Hi Hjoyy, Dr Meagan Hassell is very good and comes highly recommended. I have seen her work on one of my friends, and her new breast so good. She had it done about 6 years ago. I have also seen another bilateral job on someone else, at a cancer meeting, and again, the results were excellent. Meagan is very hard to get in to see. I had an appointment to see her, and had to wait over 5 months. I ended up cancelling this appointment when I disvovered that she only does the TRAM, and not the DIEP. Neither of these 2 ladies had any muscle problems though. The surgeon who I saw who seems really good is Professor David Pennington at RPA and Strathfield. He has an excellent web site, so google him. He seemed so nice and very confident about this type of surgery, and again, I have seen his work first hand, and it is excellent. I ended up having tissue expanders as I haven't had radiotherapy, and ended up having both breasts removed, so much easier to match up. Good luck with your search. Love Chris xx