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Save my name, email, and website in this browser for the next time I comment. Follow the procedures in IRM 21.5.11.20.8.1, How to Determine if Claim Should be Disallowed. Taxpayer did not respond to a request for missing information: Treat claim as a no consideration and follow procedures in IRM 21.5.3.4.6.3, No Consideration Procedures. Thank you for the information. I just found out today that I will need to have this surgery and I am scared. Right now we are waiting on insurance to approve this as it is a work comp claim My c-5 is bruising my spinal cord and c-6 and 7 are pushing on a nerve so I have been in pain for the last 5 months.

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• Care Notes

• Precare

WHAT YOU NEED TO KNOW:

Abdominal paracentesis is a procedure to remove abnormal fluid buildup in your abdomen. Fluid builds up because of liver problems, such as swelling and scarring. Heart failure, kidney disease, a mass, or problems with your pancreas may also cause fluid buildup.

HOW TO PREPARE:

Before your procedure:

• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
• Tell your caregiver if you know or think you might be pregnant.
• Tell your healthcare provider if you have a history of blood clotting problems.
• Tell your healthcare provider if you have had surgery on your abdomen before.

The day of your procedure:

• Write down the correct date, time, and location of your procedure.
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

WHAT WILL HAPPEN:

What will happen:

• You will lie down on a table or bed, on your back or on your side. Your healthcare provider will tap on, and feel your abdomen to decide where to insert the needle. Your healthcare provider may also use an ultrasound to help decide where to insert the needle. An ultrasound uses sound waves to show pictures of the inside of your abdomen on a TV-like screen. Your healthcare provider will clean your skin and cover the area around the procedure site with a clean sheet. Your healthcare provider will give you a shot of medicine called local anesthesia. Local anesthesia will numb your skin in the procedure area so you will not feel pain.
• A needle will be inserted into your abdominal cavity. A syringe will be attached to the needle to remove a small amount of ascites fluid. The needle will be removed once your healthcare provider has removed enough fluid for testing. To remove a larger amount of fluid, a needle is inserted into your abdominal cavity. A catheter (small, thin tube) is attached to the needle and the needle is removed. The catheter tubing will be attached to a suction device (gentle vacuum) to help remove the fluid. The fluid will drain into a container attached to the tubing. Removing large amounts of fluid may take up to 6 hours. When your healthcare provider has pulled enough fluid from your abdomen, he will remove the catheter. Your wound (procedure site) will be covered with a bandage. The ascites fluid may be sent to a lab for tests.

After your procedure:

You may need to lie on the side without the wound for up to 2 hours. Lying on your side may prevent fluid leakage from your wound. If the wound leaks and will not stop, your healthcare provider may stitch the area closed. Do not get out of bed until your healthcare provider says it is okay. You may need fluids or volume expanders given through your IV after your procedure. These fluids include albumin or saline. Albumin is a protein found in your blood. The IV fluids help prevent a drop in your blood pressure. When healthcare providers see that you are not having any problems, you may be able to go home. If you are staying in the hospital, you may be taken back to your room.

CONTACT YOUR HEALTHCARE PROVIDER IF:

• You are late or cannot make it to your procedure.
• You are gaining weight for no known reason.
• You have little or no appetite for food.
• Your legs and ankles are swollen.
• Your symptoms, such as pain, shortness of breath, and decreased movement get worse.

Seek Care Immediately if

• You are urinating very little or not at all.
• You feel dizzy or confused. You may also feel more tired than usual.
• You have a high fever (high body temperature).
• You have nausea or vomiting.
• You have sudden or very bad pain in your abdomen.
• You have sudden trouble breathing.

Risks

• During abdominal paracentesis, the needle may damage your abdominal organs or blood vessels. After abdominal paracentesis, you may bleed, or remaining ascites fluid may leak out from your wound. You may get an infection in your wound, or in the lining of your abdomen. If a large amount of fluid is removed during your procedure, your blood pressure may become very low. Very low blood pressure may decrease blood flow in your body and make you dizzy or short of breath. You may get a blood clot in your abdomen or lungs. A blood clot in your lungs can cause chest pain and trouble breathing, and can be life-threatening. Even with abdominal paracentesis, your kidney or liver function may not improve. Ascites fluid may build up again, and you may need another abdominal paracentesis.
• If you do not have an abdominal paracentesis, your symptoms may get worse. You may feel short of breath, have abdominal and chest pain, and have trouble moving around. You may not learn why fluid is building up in your abdomen. You may not get proper treatment. You may have bleeding inside your stomach or bowels. Your kidneys may stop working, and your liver problems may get worse. The fluid inside your abdomen may get infected and cause abdominal pain and tiredness. An infection may become life-threatening and you may die. Talk with your healthcare provider if you have questions or concerns about your procedure, condition, or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

DIEP (Deep Inferior Epigastric Perforators blood vessels) flap breast reconstruction is a micro-surgical re-constructive plastic surgery procedure where fat and skin connected to the abdomen (lower) are removed and moved onto the chest area, reconstructing the breast. This operation is usually what may follow after a lumpectomy or mastectomy (breast removal, typically from cancer). There were over 39,000 deaths from breast cancer in the United States in the year 2011 and these numbers are increasing slowly every year. Having breast cancer surgery can be devastating, but there are good chances of survival.

It is very common place for a woman who has had a part of her breast removed (even the whole breast) due to cancer to have a DIEP flap operation. The main reason why women opt to have a DIEP flap is because it involves a tummy tuck and also due to them wanting to have natural looking breasts whether they were born disfigured or whether they had to have a chunk of their breast/s taken out. The DIEP flap procedure surely is not for every woman. This type of breast surgery is suitable for ladies who have a decent amount of tissue in their lower ab area to transfer onto the chest. A DIEP flap is recommended over a TRAM flap as no muscles are removed but it is a little harder finding a surgeon who performs this procedure over the TRAM flap.

Before and after photo

Photo #1

Odessa decides to have a DIEP flap surgery after having a lumpectomy due to breast cancer. The operation was a success and you can see from the photo the surgeon even managed to give her a nipple. The new breast is very similar to her natural except the scar makes you think twice.

How is the operation performed?

Your surgeon will make an incision using a scalpel along your bikini line and any fat, skin and blood vessels are removed that will be moved onto your chest area. Then fat and skin are shaped into breasts given as natural look as possible and sewn in to place. Any blood vessels which feed tissue of your to be breast are matched together to supply vital blood to those areas. The average time taken for a DIEP flap operation is four to five hours.

Before surgery

Weather you were born with a disfigurement, had an accident or had a piece of your breast removed from cancer you are not alone. There are tens of thousands of women in the United States who suffer from some sort of deformity of the breasts. Having deformed breasts can be a very emotional experience that puts great pain on your mental state, you may wish to join some therapy groups on the matter where you may feel more human and accepted among other women who suffer from similar problems.

Having deformed breasts can give you a disastrous self-image which leads to mental anguish and sometimes self-destructive behavior. The good news is you can fix it because surgeons around the world developed the DIEP flap procedure. If you are lucky to afford and have the strength to go through the surgery it is much advised. Below we have list several tips that surgeons advise to future patients to try and follow before going under the knife for a DIEP FLAP.

Preparations and facts

• At least one month before surgery eat a healthy balanced diet. Make sure you get all your vitamins and minerals balanced too, see a doctor if you are feeling tired to check the vitamins in your body it will be ready for surgery and will recover well.
• A week before the DIEP Flap surgery consume plenty of fluids especially water so you’re not dehydrated.
• Try organizing someone like a relative, friend or partner to be home with you for a couple of weeks that will help you with everyday chores and assist you in any way possible.
• Avoid all blood thinners like Aspirin unless instructed by your surgeon or physician as this will make you bleed more than usual and could cause complications during or after surgery. This is very important.
• Consult the doctor performing the operation with the medication you’ve been prescribed to see if you need to stop taking them straight away because of any risks involved.
• Smoking will reduce your body’s ability to heal and should be quit altogether or at least cut down to a few cigarettes a day. This may be impossible but you should still ask your doctor what the risks are associated with your addiction.
• Have a list of important questions you want to ask your doctor before undergoing the operation and if need to be sure to write down the important things he/she informs you.
• Be sure to advise your surgeon/s of ongoing health problems you currently have as this could literally save your life on the day of the surgery.

After the operation

Now the worst is over, following a DIEP flap you will hopefully have natural or almost natural looking breasts again (after they’ve healed of course) and feel content and like a woman again. You won’t be shy to take off your shirt to go for a swim at the beach in your bikinis anymore. Below we’ve listed a few post-operative care tips and information most physicians give to their patients after DIEP flap surgery.

DIEP flap post-operative care

• Make sure you have someone drive to your home after the operation as you will be feeling weak from all the medication and hopefully not too sore.
• You may have a nurse visit you every day if you live alone to assist you with drains.
• You will be given prescription medication like pain relievers to assist with the pain.
• Feel free to shower the day following the surgery but try not bending over as much as possible.
• If you house has two stories it is advised you don’t travel up and down more than once per day.
• Avoid falling asleep and napping during the day as you will no doubt have trouble falling asleep in the evening.
• Eat small meals instead of large ones because they will feel uncomfortable.
• See your doctor the week after the DIEP flap and be sure to bring along your drainage sheet so he may determine the treatment you require.
• Wear loose clothing that won’t cause friction and tightness on your breast area and abdomen.
• You will like our getting stronger day by day so be rest assured the worst is now over and you can start enjoying your life with your new breast/s.

Risks, complications and side effects

While there is no such thing as a risk free procedure we have listed a few risks which may arise after or during DIEP flap surgery.

• Excessive bleeding.
• Fluid collection.
• Swelling at surgical sites.
• Excessive scar tissue.
• Infecting.
• Tissue necrosis.

You should follow up with your surgeon/s if any complications arise after DIEP flap surgery

Cost

The average cost of a DIEP flap is $6,000 to $10,000 depending on your location, needs, surgeon you choose and the amount of aftercare you will require.

5c Lost Procedures

Opinions

I’ve personally been involved in someone’s life who lost both her breasts due to cancer. My auntie had a double mastectomy in March last year. Before the operation she was a bright outgoing person who would always liven up the party and make you laugh. After her surgery, she changed a lot. She’s mostly keeps to herself and is reserved. I really feel for her and all the women out there with breast cancer. It’s very unfortunate.

Submitted by Meg on March 21, 2012

YouTube video

More before and after photos

Photo #2

Chandra also needed to have a breast removed due to cancer. She also decided to have the DIEP flap operation to reconstruct her breast. The surgeon did a pretty good job even giving Chandra a nipple to go with the breast. The new breast look surprisingly very symmetrical to her natural one.

Photo #3

Dona had a DIEP flap also. Her operation turned out a success the only problem being the nipple color doesn’t match but it looks much better compared to the before photo.

Photo #4

Allie needed a dual DIEP flap due to her breasts unfortunately being removed from cancer. The result is much better comparing it to the before photo.

Photo #5

Kelly’s DIEP flap operation was also a success. The nipple and breast symmetry looks very similar to her natural breast. The surgeon did a very good job. Bet Kelly can’t wait for the scars to completely heal.

Aviation Lost Procedures 5 C

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DIEP Flap Before and After, 5.0 out of 5 based on 1 rating

Comment from Anka
Time April 26, 2012 at 2:35 pm

Dealing with breast cancer has been a challenge of it’s own, but the thought of losing my breast, or even one of them just absolutely devastates me. The before & after photos I’ve looked at actually look like something i could live with, although I am still considering getting implants to perk them up a little bit. It’s sad what women have to go through.

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