Many women considering DIEP flap breast reconstruction believe that prior abdominal surgeries, such as cesarean sections, hysterectomies, or appendectomies, disqualify them from being candidates for the procedure.
This belief is a common misconception.
In most cases, previous abdominal surgeries do not prevent a patient from being a suitable DIEP flap candidate. In fact, a significant percentage of our patients come to their initial consultation with a history of previous abdominal surgeries. In this article, we’ll explore this misconception further by unveiling precisely who and who is not a candidate for DIEP flap surgery.
Am I a Candidate for DIEP Flap Breast Reconstruction After Prior Abdominal Surgery?
Procedures like C-sections and hysterectomies can sometimes damage essential blood vessels, but this has been a very rare occurrence for most of PRMA’s DIEP flap patients. If there is ever a concern that DIEP vessels have been compromised, an imaging test can be ordered to check for potential damage prior to the surgery.
Common abdominal surgeries PRMA patients have had before undergoing DIEP flap include:
- Appendectomy
- C-section
- Gallbladder removal
- Hernia repair
- Hysterectomy
How Prior Surgeries Can Affect DIEP Flap Candidacy
In some cases, previous abdominal procedures can leave behind scar tissue or affect the small blood vessels (perforators) that supply blood to the tissue used in DIEP flap reconstruction. While that can make surgery more complex, it rarely makes it impossible.
Surgeons use CT angiography imaging before surgery to better understand your individual anatomy. This specialized scan maps your blood vessels in detail, helping identify the best ones to support the flap and ensuring a safe, tailored surgical plan.
Who Is Not a Candidate for DIEP Flap Surgery?
While many women are eligible for DIEP flap reconstruction, there are a few situations where this option may not be possible.
You may not be a candidate for DIEP flap if you’ve had:
- A tummy tuck (abdominoplasty), which removes key blood vessels and tissue needed for the flap
- A prior TRAM flap (pedicled or free), which uses the same donor site and may leave little to no viable tissue
- Extensive abdominal wall reconstruction, often involving mesh or significant structural changes to the abdominal muscles and fascia.
Each case is unique. Even if you’ve had previous abdominal procedures, an evaluation with imaging can help determine what options are still available to you.
DIEP Flap Alternatives: Options for Non-DIEP Flap Candidates
If DIEP flap surgery isn’t right for you, don’t lose hope. There are still highly effective, natural tissue reconstruction options available. Your journey doesn’t end here—it just takes a different path.
Patients who aren’t candidates for abdominal-based flaps can often explore tissue from other areas of the body. These alternatives still use your own tissue and offer natural, long-lasting results:
Thigh-Based Flap Options:
- ALT flap (anterolateral thigh)
- LTP flap (lateral thigh perforator)
- PAP flap (profunda artery perforator)
- TUG flap (transverse upper gracilis)
Buttock-Based Flap Options:
- iGAP flap (inferior gluteal artery perforator)
- sGAP flap (superior gluteal artery perforator)
These advanced procedures require specialized microsurgical expertise. Fortunately, PRMA’s team of reconstruction surgeons has the experience and skill to offer all these options safely and successfully, so you can feel confident moving forward with the best approach for your body and goals.
Any Added Risks for DIEP Flap Surgery and Prior Surgeries?
It is not uncommon to undergo DIEP flap reconstruction if you’ve previously had an abdominal surgery that doesn’t disqualify you. However, it is important to acknowledge the risks of having multiple abdominal surgeries.
Multiple abdominal surgeries can slightly increase the risk of complications like bulging or hernia formation at the donor site. This happens because prior incisions or scar tissue can weaken the abdominal wall.
The good news is that your surgeon will work to minimize these risks with careful surgical planning. Advanced imaging helps map your anatomy beforehand, and meticulous microsurgical techniques help preserve abdominal strength during the procedure.
Learn If You’re a DIEP Flap Candidate at PRMA in San Antonio
Prior abdominal surgery doesn’t mean you’ve missed your chance at natural breast reconstruction. Whether you’ve had a C-section, hysterectomy, gallbladder removal, or even multiple procedures, you may still be a strong candidate for DIEP flap surgery.
Every woman’s body and journey are unique, and so is the care she deserves. If you’re considering your next step, we’re here to help you explore every option with honesty, compassion, and expertise.
Schedule a consultation today to determine if DIEP flap reconstruction is right for you—and take the next step toward reclaiming confidence, comfort, and wholeness.
