Breast reconstruction doesn’t end after your initial DIEP flap surgery—and that’s by design.
For most women, reconstruction is a thoughtful, staged process. The second stage, often called the “revision stage,” typically takes place about three months after the initial procedure.
At this stage, it isn’t about rebuilding. It’s about enhancing—bringing balance, softness, and symmetry to help you feel more like yourself again.
Healing is a dynamic process. As your body recovers, subtle changes in shape, volume, and contour naturally occur.
Waiting allows your surgical team to see the “settled” result—so refinements can be made with intention, not guesswork.
The goal of this stage is simple but meaningful:
It’s the final step that transforms a successful reconstruction into a truly personalized outcome.
During this procedure, the surgeon takes care to shape and modify the breast(s) to make them as symmetrical as possible. The surgeon’s approach to these revisions can include a variety of surgical procedures.
Fat grafting is one of the most common techniques used during this stage.
Using your body’s own fat, your surgeon can:
Fat is gently removed from another area of your body (like the abdomen or thighs), purified, and carefully injected into the breast. The result is a soft, natural enhancement that integrates seamlessly with your existing tissue.
Scars are a normal part of healing and will continue to improve, but that doesn’t mean you have to accept them as they are. During this stage, your surgeon can further improve visible scarring by refining:
These adjustments help scars appear more subtle while improving the overall shape and smoothness of both the breast and abdomen.
If you did not have a nipple-sparing mastectomy, nipple reconstruction is often performed during this stage.
At PRMA Plastic Surgery, surgeons commonly use the “bow-tie” technique—a specialized approach that helps create natural projection while maintaining long-term shape and symmetry.
After healing, patients can choose areola tattooing to complete the look. Options include:
This step is optional, but for many women, it represents an important sense of closure in their reconstruction journey. At PRMA Plastic Surgery, 3D nipple tattooing is performed at our Stone Oak office by the talented Terry Lively, who specializes in creating highly realistic results.
When reconstruction is performed on one breast, achieving balance with the natural breast is an important part of the final result.
If symmetry procedures weren’t done during the first stage, they may be performed about three months after the initial reconstruction. The purpose of the second stage of DIEP surgery is to fine-tune the reconstructed breast and improve the overall cosmetic results.
Options can include:
These procedures are carefully planned to create harmony—so both breasts look and feel proportionate.
Because this is a refinement procedure—not a major reconstruction—recovery is generally easier and quicker than your first surgery. Second-stage DIEP flap surgery is usually an outpatient procedure lasting only 2–3 hours.
Most patients can expect:
Your care team will guide you through every step, ensuring you feel confident and supported as you heal.
This stage of reconstruction is about more than aesthetics—it’s about helping you feel whole again.
Whether it’s refining shape, restoring balance, or completing your reconstruction with nipple creation and tattooing, every detail is guided by your vision and comfort.
At PRMA, we’re here to support you through every phase of your journey. If you’re ready to take that next step, we invite you to schedule an appointment with one of our expert breast reconstruction surgeons today.