Essential Preparations for DIEP Flap Surgery

Here I am, nearly two months post-DIEP flap surgery. Previously, I discussed how recovery (from bilateral mastectomy) was a mental marathon. I’ve also likened it to a roller coaster. The downs have been a lot lower for me after reconstruction—far more than after deconstruction (aka bilateral mastectomy). My mental stamina is being tested. Which is also physically draining. And, I’ve been less able to put into words all the points of this part of my journey.

When I am having better moments with less pain and more clarity, I often think of practical ways that I could have been prepped for recovery from DIEP flap surgery.

What is DIEP flap surgery?

Deep Inferior Epigastric Perforator (DIEP) flap procedures. This type of reconstructive surgery utilizes a patient’s own lower abdominal tissue to create a natural breast mound after a mastectomy, preserving the abdominal muscles to maintain long-term core strength. Yes. My mama’s belly is now my breasts.  

Why DIEP flap?

For me, this option made sense. I knew I didn’t want implants. My body is even rejecting the undissolved sutures in me post-reconstruction, so I’m grateful that I intuitively knew my body wouldn’t do well with long-term foreign objects.

Plus, I kept hearing “you’re so young,” and knew that implants came with maintenance and risks that all put me back under the knife.

Truth is. There is no easy answer. It’s a very personal choice. Take a deep breath. Weigh your options. And have confidence in your gut. I did 😉

If you’re like me and your gut was telling you to use it for the greater good, I’m hoping this self-care checklist might help.

Here are the practical ways I prepped (or wish I had prepped) for DIEP flap surgery:

• Stock up on Tylenol &/or Ibuprofen: You’ll take either or both throughout most of your early recovery. So as not to run out, I ran to Costco. I took both during the recovery from my bilateral mastectomy. But, recovery round 2 has shown me that Ibuprofen is off the list: I get immediate heartburn.
• Stock up on unscented lotion: “Dry skin” does not seem to capture the extreme itch I was experiencing post-DIEP flap. Dry skin post-surgery is not uncommon. It can occur due to several factors, including anesthesia, pain medications, or certain antibiotics. The healing process itself can cause temporary tissue swelling and draw moisture away from the skin surface. I suspect my itchy skin may have been a result of all the things. Time seems to be the true healer here, but you’ll want the lotion in the meantime. Well, lotion and a good exfoliator. The 70″ version of this quick-drying body net is what I use—very handy for full-body exfoliation when your range of motion is limited.
• Wedge or support pillows: To keep tension off my incision/abdomen, I was (and still am) really only comfortable in one position. Think lounge chair posture when poolside—torso tilted back and knees bent. I relied heavily on two things: my adjustable bed and wedge pillow set. Both were key in helping me to relax and sleep in a supported position. The latter is obviously more attainable for most (I’ve had my bed for years). And the pillows proved most valuable. The pillow set was a purchase I made in preparation for mastectomy recovery. It has MVP (most valuable purchase) status because of the storage bag, lightweight foam construction, and modular way in which I could arrange them around my house.
• Supportive (non-underwire) bras: A comfortable bra with a front closure was key for me. Why? After a bilateral mastectomy, mobility is limited, and post-reconstruction, posture is hunched. The search started before my mastectomy, but the challenge I hadn’t considered was how much my body would change in a relatively short amount of time. Zipper-front sports bras I bought cheap on Amazon didn’t fit post-mastectomy. Plus, my skin was so sensitive to fabric, I really needed something made of the softest material. A friend recommended Soma. I loved the AnaOno Front-Closure Post-Surgery Bra so much that I bought two sizes. A smaller size to wear immediately and one that would fit future me (full expanders and post-reconstruction).
• Overalls. Surprised? So was I. Overalls are not for everyone—unless you’re a DIEP flap patient. The loose fit around the waist and the ease of getting dressed are quite literally everything. So much so that I have four in rotation. The Free People Hot Shot Onesie was my first purchase. Then I found a similar version plus a couple of different styles for a lot less on Amazon. Also in this comfort category: nightgowns and full coverage panties.

Of course, outside of shopping and stocking up, there were practical considerations that did (or would have) come in handy too.  

I wish I had… Rearranged my daily-use items pre-surgery. My husband and I are both on the tall side. We tend to use a lot of vertical space, particularly in the kitchen. Much like after a mastectomy, however, the Docs don’t want you reaching overhead post-reconstruction. I wish I had moved as many daily-use items in my kitchen to or near countertop level. Luckily, we had help around the house and in the kitchen for the first several weeks. I took note as family and friends navigated new territory and made adjustments as needed (“you can just leave that on the counter”). This same idea rang true throughout the house: the bedroom closet, the bathroom, the laundry room.

In my bedroom… I cleared space on my bedside table so I could easily access medications, my water bottle, and any other necessities while resting: phone, charger, earbuds.

Stamina, spent. I think I’ve covered most of what I can. Details, like how to shower, will have to be in another post. I simply don’t have the energy for that right now. IYKYK.