Is DIEP flap breast reconstruction safe for obese patients?
As more women choose the DIEP flap for breast reconstruction after mastectomy, some patients are unnecessarily turned away because they are overweight.
Surgeons at PRMA Plastic Surgery say that a lot of times these patients are more than likely good candidates even if they do have a higher than normal body weight.
Dr. Oscar Ochoa said that although previous studies suggest the TRAM flap is contraindicated in high risk populations, such as obese patients, DIEP flap reconstruction is much safer in the same high risk groups.
“Previous studies identified obesity as an important factor increasing flap and abdominal site complications following free and pedicled TRAM flap surgery, “ said Ochoa. “However, after studying 639 DIEP flaps in 418 consecutive PRMA patients, we found that overall flap and abdominal complications remain similar across all body mass index groups. In other words, being overweight did not increase the risk of losing a flap or developing abdominal bulging or a hernia after DIEP flap reconstruction in our patient population.”
Despite these findings, many surgeons continue to turn away patients with obesity.
PRMA patient Lisa Scheuplein said that she was turned away by two different surgeons who told her that she was too overweight for the DIEP flap.
“My first surgeon told me how much easier getting implants would be, but I didn’t want implants. The second one told me that I wasn’t a candidate for the DIEP flap and that he would not touch me unless I was a BMI of 25,” Scheuplein said.
It was around this time that Scheuplein says she found PRMA.
“I came in for a consult with Dr. Nastala who said I was a good candidate,” Scheuplein said. “So here I am, post-surgery and all is looking good. I am thankful to PRMA because they gave me a choice.”
PRMA surgeons say that DIEP flaps are safe in obese populations and may in fact be the recommended method of breast reconstruction in patients with a BMI less than 40.
Scheuplein says she is grateful that she finally had a choice and was able to have the surgery she wanted despite a BMI of 37.
“PRMA has the training and expertise to give women the choice of having the type of reconstruction they want,” says Scheuplein. “I think that is important when all of us facing these options did not have a choice when it came down to getting cancer.”
Read the full article in Plastic and Reconstructive Surgery
Author: Dr. Oscar Ochoa and Brandy (Korman) Haslam
PRMA surgeons say that DIEP flaps are safe in obese populations and may in fact be the recommended method of breast reconstruction in patients with a BMI less than 40.
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