Antonia Moss | DIEP Flap Surgery
“I had the dream team for my DIEP surgery”
Antonia Moss, 51, was immediately concerned when she discovered a thickening in the skin on her right breast whilst showering. She contacted her GP and obtained an urgent referral for further investigation. After a mammogram and three biopsies, she received a diagnosis of Grade 2 Invasive Lobular Carcinoma.
She explains: “After receiving my diagnosis from my Breast Consultant, Mr Michal Uhercik, I learned that Lobular breast cancer sometimes spreads out like a spider's web. At this point it was measuring 2cm on the MRI scan, but it required more investigation. Thankfully I was covered by medical insurance - this resulted in a faster scan, which unfortunately uncovered another cancerous area.”
Discussing treatment options
Antonia adds: “We immediately discussed surgery options, including the use of a silicone implant versus the DIEP procedure. When we talked through the DIEP process, I immediately saw the positives; although major surgery, it felt like more of a permanent solution that wouldn’t require further surgery in future (as opposed to the silicone implant which would need to be replaced). It also doesn't put any foreign material into the body and naturally fluctuates with weight loss and gain, to match the remaining breast.
She explains: “After receiving my diagnosis from my Breast Consultant, Mr Michal Uhercik, I learned that Lobular breast cancer sometimes spreads out like a spider's web. At this point it was measuring 2cm on the MRI scan, but it required more investigation. Thankfully I was covered by medical insurance - this resulted in a faster scan, which unfortunately uncovered another cancerous area.”
Discussing treatment options
Antonia adds: “We immediately discussed surgery options, including the use of a silicone implant versus the DIEP procedure. When we talked through the DIEP process, I immediately saw the positives; although major surgery, it felt like more of a permanent solution that wouldn’t require further surgery in future (as opposed to the silicone implant which would need to be replaced). It also doesn't put any foreign material into the body and naturally fluctuates with weight loss and gain, to match the remaining breast.
“I was then told the cancer was larger than first thought, and actually measured around 5cm. This was a dark day, as the reality of the potential treatment options really hit home. After considering all options, I decided to proceed with the DIEP procedure and I was referred straight away to Alexandra Molina, a Consultant Plastic Surgeon at The McIndoe Centre.
“Ms Molina initially assessed me to find out if I was a suitable candidate, checking whether I had enough fat tissue on my stomach to create a new breast. She also did another scan to check whether I had appropriate blood vessels in the abdomen for DIEP reconstruction. She showed me photos of previous patients and the results, as thinking about such an invasive procedure at the time was very difficult for me. Ms Molina was so reassuring; she completely changed my initial preconception and I came out of that appointment thinking positively - it would be OK.
“I was put in touch with the Restore Group, where women can talk through their own breast reconstruction. My main fear was pain, rather than losing the breast itself, so it was reassuring to speak to women who had been through this and discuss first hand experiences."
“I’m delighted that Antonia has shared her journey. Deciding on what type of breast reconstruction to undergo requires careful thought and consideration. It was a pleasure to support Antonia every step of the way."
Miss Alexandra Molina
Undergoing surgery
“When the time came for the surgery, I walked into the operating theatre and once I was asleep I had two consultants operating on me at the same time” Antonia said. “Mr Uhercik performed the mastectomy and the sentinel lymph node biopsy. At the same time Ms Molina was dissecting tummy tissue to make the new breast. The whole procedure lasted 7.5 hours, and due to the length of the operation I also received physiotherapy halfway through. I can honestly say I had the dream team; they were absolutely phenomenal.
“My anaesthetist told me the key to recovery is to ‘Get up, get up, get up.’ This became my mantra when I woke from surgery.
“I know some women feel grief after the procedure at losing a breast; I think because I had immediate reconstruction, I didn’t experience this.”
Recovery
“When I came around the first pain I felt was abdominal, down the sides of my stomach and also shooting pains in my new breast. But I had my procedure on Tuesday, was able to have a bed bath on Wednesday, and then by Thursday I was able to have a shower and was pottering about with a little help.
“The care at The McIndoe Centre was wonderful. My nurses, Eva and Jessie were particularly special, and ensured I was well looked after. When the time came to leave on Friday, I felt happy and prepared to go home and I felt so supported that I could contact the team at any time. A few days later I became concerned about a red tender mark on my breast but I was quickly reassured by Ms Molina who confirmed it was just a skin issue. After three weeks I was able to lose the DVT stockings, and six weeks post-surgery I was able to lose the Bridget Jones style pants and surgical bra.”
First impressions
“The breast scar is all in the nipple area, forming a neat round shape and I was amazed to discover that my new breast was warm and soft. There is a loss of sensation in my abdomen from where they took tissue from underneath my breast; I think this is fairly permanent, which is a strange feeling but I am sure this will become normal to me in time. My stomach also felt pretty tight like a drum initially - it felt like there was no ‘give’. The tightness has since eased but I still feel full quite quickly after eating.
“Every woman and diagnosis are different; I understand that for some women their priority is to remove the cancer and are not concerned too much about the reconstruction. For me personally and where I am in my life, it was very important to me to still feel and look like myself, and I feel very happy with what was achieved with the DIEP surgery.”
Following a genomic test to calculate the likelihood of the cancer returning, Antonia had to undergo three weeks of radiotherapy to kill any remaining cancer cells. She is now on Letrozole, a hormone therapy that lowers oestrogen levels to help prevent the cancer from returning.
Antonia’s advice when preparing for DIEP surgery
Pre-Surgery
- I found the best retailer for post-surgery underwear was Jojo Maman Bebe, and bras came from John Lewis, Marks and Spencer and Macom. It is helpful to get measured properly before buying these if you have not been measured recently. I would recommend hand washing these rather than putting in the machine, so ensuring you have some non-bio detergent that won’t irritate is useful.
- Have enough pillows to lie down comfortably post-surgery.
- Stock the freezer with easy meals for family and friends to help you and also paracetamol and ibuprofen so you have plenty for when you come home.
Post-Surgery
- Get up, get moving as soon as possible!
- Take exercise gently, build it up gradually.
- Write down medication to keep track and don’t keep pills by your bed, as you can take them in your sleep and not register you have taken them. Keep them somewhere you have to walk to.
- Stock up on unscented moisturiser such as E45, for massaging scar tissue post-surgery.
- Sit on a chair or get an anti-slip map to give you confidence when showering.
- Wear loose, comfortable clothing and button up tops to avoid trying to lift your arms.
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