DIEP flap breast reconstruction is typically comprised of at least two stages for the best outcomes. The second stage of surgery is commonly referred to as the “revision” stage and is usually 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.
Second stage surgery is outpatient (meaning patients do not need to stay overnight in the hospital), and usually takes about 2-3 hours.
What is involved in the second stage of DIEP flap surgery?
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:
Surgeons often perform fat grafting to correct contour irregularities. Fat grafting can also be used to address size discrepancies. During this procedure, fat is liposuctioned from one part of the patient’s body, purified and then injected into the breast.
Scar Revision:
Scaring on the reconstructed breast as well as the donor site scar (the scar from where the tissue was taken) is revised to minimize its appearance as much as possible and improve the contour of the donor site.
Nipple Reconstruction:
Nipple reconstruction is also performed at this stage whenever possible if the patient did not have a nipple-sparing mastectomy. Although there are many different ways to perform nipple reconstruction, at PRMA we use the “bow-tie” method. The procedure gets it’s name from the bow-tie shaped incision used to create the new nipple. If desired, the reconstructed nipple and areola are later tattooed to add color. Patients can choose between a 2D tattoo that adds color only, or a 3D tattoo which also adds more detail (e.g. Montgomery glands) to make the final result even more realistic.
If the reconstruction was performed as a unilateral (one-sided) procedure, stage two surgery usually also involves symmetry surgery on the native breast to match the reconstructed breast as closely as possible if this was not performed at the first surgery. This may be achieved by means of lifting (mastopexy) and/or reducing the native breast.
Author: Dr. Ramon Garza III and Courtney Floyd
DIEP flap breast reconstruction is typically comprised of at least two stages for the best outcomes. The second stage of surgery is commonly referred to as the “revision” stage and is usually 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.
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