“Too Thin” For A DIEP Flap?
By: Dr. Minas Chrysopoulo
I've spoken to several ladies recently who have had the same misconception about DIEP flap surgery. They were scared they were "too skinny", 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, please visit with an experienced microsurgeon. It's the only way to really be sure.