For many women recovering from breast cancer, breast reconstruction is about more than restoring appearance—it’s about regaining a sense of control, confidence, and wholeness. Among the available options, DIEP flap reconstruction—using a patient’s own tissue to rebuild the breast—has become a preferred choice for those seeking a natural look and feel without the long-term concerns associated with implants.
So, how does a patient’s BMI (body mass index) influence their results? This article examines the significance of BMI in patient outcomes and satisfaction after DIEP flap surgery.
The Relationship Between Breast Reconstruction and BMI
It was believed previously that a patient’s BMI during surgery would impact their satisfaction post-procedure. Specifically, those with a BMI score of 30 or higher were thought to have less favorable outcomes than those with lower BMIs. Therefore, this belief also influenced patient counseling and surgical decision-making.
| BMI Category | DIEP Flap Candidacy |
| Underweight (<18.5) | May not have enough abdominal tissue for DIEP |
| Normal (18.5-24.9) | Generally, a good candidate with adequate tissue |
| Overweight (25.0-29.9) | Good candidate with higher abdominal fat for flap surgery |
| Obese Class I (30.0-34.9) | Still a candidate, with increased surgical risk |
| Obese Class II (35.0-39.9) | Carefully evaluated; moderate risk of complications |
| Obese Class III (40.0 or higher) | Requires thorough evaluation; higher risk |
What Is the BREAST-Q and Why Does It Matter?
The BREAST-Q is a scientifically validated, patient-reported tool designed specifically to measure the impact of breast surgery from the patient’s perspective. Unlike traditional clinical assessments, the BREAST-Q focuses on what truly matters to patients—how they feel about their appearance, physical comfort, emotional well-being, and overall satisfaction with their care.
Essentially, by asking patients to reflect on their quality of life before and after DIEP flap surgery, the BREAST-Q helps providers better understand emotional outcomes that can’t be captured through photos or medical charts alone. It’s a powerful way to ensure the patient voice is central to surgical decision-making and ongoing care.
Surgeons who use tools like the BREAST-Q can also continuously evaluate and refine their techniques, leading to better, more personalized outcomes for every patient.
DIEP Flap For Plus-Size Patients? What the Results Say
A study conducted by PRMA and published in Plastic and Reconstructive Surgery involved 73 patients who underwent 130 DIEP flap reconstructions between 2012 and 2016. These patients completed BREAST-Q questionnaires before and after surgery. Afterwards, results showed significant improvements not only in breast satisfaction but also in psychosocial and sexual well-being, particularly among patients with higher BMIs.
And while physical well-being scores returned to baseline, breast satisfaction notably increased post-surgery. The findings suggested that DIEP flap reconstruction can enhance the quality of life for most patients, including those with higher BMIs.
What This Means for You
DIEP flap breast reconstruction offers lasting, natural results—and it’s a safe, effective option for a wide range of patients, including those with higher BMIs. In fact, most patients enjoy these benefits post-DIEP flap breast reconstruction:
- Improved breast satisfaction
- Enhanced body image and confidence
- Permanent, natural results
- Lower long-term maintenance vs. implants
Of course, every woman’s body and cancer journey are different, which is why decisions about reconstruction should never rely on numbers alone. If you’re considering your options, the best next step is a personalized consultation to explore what’s right for you—your goals, your health, and your peace of mind.
Explore DIEP Flap Options With PRMA’s Trusted Surgeons in San Antonio
If you’re considering breast reconstruction—whether soon after diagnosis or further down the road—you deserve answers grounded in expertise and compassion. Our expert surgeons in San Antonio are here to guide you through your options, listen to your goals, and help you make the choice that feels right for you.
Reach out today to start the conversation—we’re ready when you are.
