“Too Thin” For A DIEP Flap? You May Still Be A Candidate!
Can you be too thin for DIEP flap breast reconstruction?
Many patients think, or are told by other surgeons, they are “too thin” for DIEP flap breast reconstruction. In many cases, these patients are in fact great DIEP candidates. Dr. Pisano and Dr. Chrysopoulo explain further in the below video and blog.
I’ve spoken to several ladies recently who have had the same misconception about DIEP flap surgery. They were scared they were “too thin” for DIEP flap breast reconstruction, especially if they were considering bilateral reconstruction (both breasts). The truth of the matter is that you don’t need to be overweight to be a candidate for DIEP flap surgery. What matters is the distribution of the fat that you do have and your desired results.
I can say that at PRMA we have successfully performed DIEP flap reconstructions on women with BMI’s of 20 and even less. For reconstruction of one breast, all the available lower abdominal tissue can be used and either folded or “stacked“.
In instances where both breasts need to be reconstructed and the breasts are too small after the initial reconstruction, autologous fat grafting can be used to enhance the results. This involves liposuction of fat from another part of the body, purifying this fat, and then re-injecting it into the reconstructed breast for additional volume and to correct any contour defects from the mastectomy.
Additional options for achieving more volume, especially for bilateral reconstructions include placing a small implant under the DIEP flap or using multiple flaps to reconstruct each breast. If there is an obvious significant discrepancy between the desired results and amount of abdominal tissue available, each DIEP flap can be combined with another type of flap from another part of the body (eg TUG flap) to reconstruct each breast, in other words a total of 4 flaps for 2 breasts.
If you’d like to know for sure whether you’re a candidate for the DIEP flap or any other type of perforator flap breast reconstruction, you are welcome to fill out our free virtual consultation form here.
Author: Dr. Minas Chrysopoulo
I can say that at PRMA we have successfully performed DIEP flap reconstructions on women with BMI’s of 20 and even less. For reconstruction of one breast, all the available lower abdominal tissue can be used and either folded or “stacked“.
Leave Comment
I have had two lots of implants both have capsulated as a result of CANCER, it is obvious my body is rejecting them, I have been told by TWO surgeons here in UK I am too slim for the Diep and the TUG, one surgeon claimed I have enough for the TUG, one surgeon out of UK has said I can have the diep I am worried I could end up with a small bump, as stated my body keeps rejecting implants, any ideas PLEASE
July 17,2020
Thanks for reaching out Tracy! So sorry to hear you are experiencing complications with the implants! First, it is wonderful to know you are seeking more than one opinion. It is ideal to hear all of your options and then choose what is best for you. It is difficult for us to say which direction you should go without consulting with you first. We have had patients come to us who were originally told they were “too thin” for the DIEP flap, but we were able to perform the procedure successfully. It is important to discuss the realistic post-operative expectations with both doctors (or even a third) to get a better understanding of what your breast size may be after surgery. If you desire more breast volume post surgery, additional fat grafting can be performed. Again, it is important to discuss realistic expectations with your surgeon and decide what is right for you.
July 17,2020
I have a question if after the diep flap is done and your not happy with volume how long after can a implant or fat graphing be done
July 17,2020
Great question Marcie! Typically we recommend waiting at least 3 months before adding an implant or performing fat grafting to increase volume. We want to give the new flap plenty of time to heal and settle and swelling to go down before adding more volume. Hope this helps!
July 17,2020
Sign Up for Our Monthly Newsletter
Continue Reading
Comparing APEX Flap and DIEP Flap Breast Reconstruction
Comparing APEX Flap and DIEP Flap Breast Reconstruction August 10, 2020 Share on Facebook Twitter Linkedin We have been receiving numerous inquiries about the “APEX flap” recently. Patients want to know what it is and how it differs from the DIEP flap. APEX is an acronym that stands for “Abdominal Perforator Exchange”. Many patients believe […]
Monitoring the Health of Your Flap During & After Surgery
Monitoring the Health of Your Flap During & After Surgery July 21, 2020 Share on Facebook Twitter Linkedin Autologous flap (or tissue) breast reconstruction procedures represent today’s most advanced options for rebuilding a breast(s) following mastectomy. The most commonly performed method of flap-based reconstruction at PRMA is the DIEP flap. During this procedure, surgeons transplant skin […]
COVID-19 and the Impact on Cancer Patient’s Mortality
COVID-19 and the Impact on Cancer Patient’s Mortality July 21, 2020 Share on Facebook Twitter Linkedin There is still so much we do not know about COVID-19. Likewise, there is little known about how this disease impacts mortality for cancer patients. A study published in The Lancet evaluated and characterized the outcomes of patients with cancer […]
Autologous VS Alloplastic Breast Reconstruction: Patient Reported Satisfaction
Autologous VS Alloplastic Breast Reconstruction: Patient Reported Satisfaction July 21, 2020 Share on Facebook Twitter Linkedin Women who choose to undergo breast reconstruction following a mastectomy have several reconstructive options. Those options can be broken down into two categories – autologous (using your own tissue) and alloplastic (using an implant). Both types of procedures have […]
Dr. Ledoux, BRAVE and Patient Advocate Discuss Breast Reconstruction
Dr. Ledoux, BRAVE and Patient Advocate Discuss Breast Reconstruction July 21, 2020 Share on Facebook Twitter Linkedin Good morning everyone, I am Christine with BRAVE, and I am really excited to introduce our guests today. About a week ago we had Jen Reynolds on as a patient survivor and also the founder of the Pink […]
PRMA Support Spotlight: Pink Warrior Advocates
PRMA Support Spotlight: Pink Warrior Advocates July 21, 2020 Share on Facebook Twitter Linkedin Continuing our weekly support spotlight, we are joined with Jen Reynolds from Pink Warrior Advocates (previously known as Pink Warrior Angels-Hill Country). You can catch the replay of our interview here: Can you please tell us more about your organization? Pink […]
PRMA Support Spotlight: Overcomers
PRMA Support Spotlight: Overcomers July 21, 2020 Share on Facebook Twitter Linkedin We are continuing our weekly support spotlight by featuring the local breast cancer support organization – Overcomers. In this spotlight video we are joined with Genny, a co-founder of Overcomers. What is Overcomers? Overcomers started back in 2015. It was formed for the […]
PRMA Support Spotlight: Susan G. Komen – San Antonio
PRMA Support Spotlight: Susan G. Komen – San Antonio July 21, 2020 Share on Facebook Twitter Linkedin For our Support Spotlight this week we are joined by the local Susan G. Komen organization in San Antonio. How did the local chapter of Susan G. Komen get started? Yes, absolutely, I am so happy to be […]
PRMA Support Spotlight: BRAVE Coalition
PRMA Support Spotlight: BRAVE Coalition July 21, 2020 Share on Facebook Twitter Linkedin In continuation on our weekly Support Spotlight, we are honored to spotlight the BRAVE Coalition! In our interview, we were joined with Christine from BRAVE. Catch the replay here! What is the BRAVE Coalition? BRAVE is a 501 (c)(3) it has been […]
PRMA Support Spotlight: DIEP C Foundation
PRMA Support Spotlight: DIEP C Foundation July 21, 2020 Share on Facebook Twitter Linkedin Today we are honored to spotlight DIEP C Foundation, an amazing organization providing education and resources to empower women and men with information to make an informed decision about options for breast reconstruction after a mastectomy. Can you just kick us of by […]
How Much Does Breast Reconstruction Cost?
TRAM Flap vs DIEP Flap: What's the Difference?
Tracy Hewit
I have had two lots of implants both have capsulated as a result of CANCER, it is obvious my body is rejecting them, I have been told by TWO surgeons here in UK I am too slim for the Diep and the TUG, one surgeon claimed I have enough for the TUG, one surgeon out of UK has said I can have the diep I am worried I could end up with a small bump, as stated my body keeps rejecting implants, any ideas PLEASE
PRMA Plastic Surgery
Thanks for reaching out Tracy! So sorry to hear you are experiencing complications with the implants! First, it is wonderful to know you are seeking more than one opinion. It is ideal to hear all of your options and then choose what is best for you. It is difficult for us to say which direction you should go without consulting with you first. We have had patients come to us who were originally told they were “too thin” for the DIEP flap, but we were able to perform the procedure successfully. It is important to discuss the realistic post-operative expectations with both doctors (or even a third) to get a better understanding of what your breast size may be after surgery. If you desire more breast volume post surgery, additional fat grafting can be performed. Again, it is important to discuss realistic expectations with your surgeon and decide what is right for you.
Marcia
I have a question if after the diep flap is done and your not happy with volume how long after can a implant or fat graphing be done
PRMA Plastic Surgery
Great question Marcie! Typically we recommend waiting at least 3 months before adding an implant or performing fat grafting to increase volume. We want to give the new flap plenty of time to heal and settle and swelling to go down before adding more volume. Hope this helps!