Questions to ask your DIEP Flap Surgeon

Blogs
March 11, 2011

If you are considering DIEP flap breast reconstruction finding the right surgical team is key. Before choosing a DIEP flap surgeon be sure to ask the following questions:

  1. Are you certified by the American Board of Plastic Surgery? Your surgeon should be a board certified plastic surgeon.
  2. Do you have extensive experience with this type of surgery – How many have you performed? Preferably your surgeon will have performed over 100 DIEP flap procedures.
  3. What’s your success rate? Top specialist centers boast a success rate of at least 98%.
  4. How long does the surgery take? This will vary between institutions based on experience. The most experienced surgeons typically take between 3-6 hours depending on whether one or both breast are being reconstructed (not including the mastectomies).
  5. How often do you plan to perform a DIEP flap but end up changing the procedure to a free TRAM flap during the surgery? The “conversion rate” to a free TRAM flap should be low.
  6. How many microsurgeons will be performing the surgery? Since the DIEP flap procedure is so technically demanding and long, it is preferable to have two microsurgeons performing the surgery rather than just one. Not only will this ensure you benefit from the expertise of two specially trained surgeons, but it will also significantly cut down the length of the procedure and anesthesia.
  7. Do you have residents or fellows? Will they be performing any of my surgery? Some centers have surgeons-in-training known as “residents” or “fellows” that may be helping with your surgery or even performing part of it. This may or may not be something you are comfortable with considering the complexity of the surgery.
  8. Do you “balance bill”? Centers that are in-network for most insurance plans will ask the patient to pay ONLY what’s laid out by the patient’s insurance plan (ie copay, deductible, etc). Other centers “accept insurance” and will often help the patient get money back from their insurance company – however, the patient is still expected to provide the difference between what the insurance pays and the doctor’s fee. This is known as “balance billing“. While many centers do this, some DO NOT balance bill. Make sure to ask ahead of time to avoid nasty financial surprises down the line.
  9. Do you have Insurance Specialists on staff? Unfortunately, some patients will face difficulties in gaining access to DIEP flap specialists even though insurance companies are federally mandated to pay for the cost of breast reconstruction. Here again it pays to seek out centers that specialize in these procedures as typically an insurance specialist is available to help patients with insurance issues. Again, this can prevent a nasty financial surprise after your surgery.
Learn More About DIEP Flap Breast Reconstruction

9 Comments

(The content of this field is kept private and will not be shown publicly.)


  • Lenka

    Hi, I am researching/ having a prophylactic double mastectomy due to high rate of family breast cancer . Can the DIEP surgery be performed following the mastectomy. ( same day surgery) Thank you , Lenka

    Reply
  • PRMA Plastic Surgery

    Yes Lenka! The DIEP can be performed immediately after a mastectomy. Great question!

    Reply
  • Andrea

    Hello. Is it necessary to have a mesh inserted at stomach for DIEP? I’ve heard of some people getting infections due to mesh. How safe is mesh? If I choose not to have mesh, what are alternatives. I have sensitivities with surgical tape or the glue that is used for EKG electrodes. Thank you

    Reply
  • PRMA Plastic Surgery

    Hey Andrea! Standard practice at PRMA Plastic Surgery does not include the use of mesh to the abdominal site during the DIEP procedure. The only time the physician may use mesh is if the patient has a hernia. If the hernia is small it can usually be repaired without the mesh but the larger hernia repairs generally require mesh. As long as you do not have a hernia you should not have mesh with the DIEP flap procedure. Regarding your skin sensitivities, we can use paper tape which is more gentle on the skin. Please let us know if you have any other questions.

    Reply
  • Andrea

    Thank you so much for your reply.

    Reply
  • Vidula

    Hi, I am a breast cancer survivor and have developed lymphedema in my right arm due to axillary node clearance. I am interested in having a diep flap surgery for breast reconstruction. My question is can the diep flap surgery put a person at risk for lymphedema of the leg. Your reply will be greatly appreciated. kind regards, Vidula

    Reply
  • PRMA Plastic Surgery

    Great question Vidula! During the LNT the PRMA surgeons use lymph nodes that are not responsible for draining the leg. This makes the possibility of lymphedema in the leg very minimal.

    Reply
  • Mariam

    hi What are the risks for delayed DIEP if any? Thanks

    Reply
  • PRMA Plastic Surgery

    Hello Mariam! Thanks so much for asking! There are no significant differences in the risk for complications in delayed vs immediate DIEP flap breast reconstruction.

    Reply
PRMA Plastic Surgery