If you’ve been told you’re “too thin” for a DIEP flap breast reconstruction, you may be feeling frustrated—or even discouraged. At PRMA, we want you to know that being thin doesn’t automatically take natural tissue reconstruction off the table.
Every woman’s body—and journey—is unique. That’s why our team takes a personalized approach, exploring all the options that can help you reclaim your confidence, sensation, and sense of self after breast cancer.
Can Thin Patients Still Get DIEP Flap Breast Reconstruction?
Being thin does not automatically disqualify you from being a DIEP flap candidate. We’ve helped many women with low body fat—some with a BMI under 20—successfully undergo DIEP flap breast reconstruction. And even if DIEP isn’t the best fit for your body, we offer other advanced natural tissue procedures.
What is a DIEP Flap and Why Is It the Gold Standard?
A DIEP flap is a type of breast reconstruction that uses tissue from the abdomen to create new breasts. In this procedure, skin and fat are removed from your belly and moved to the chest to reconstruct one or both breasts after a mastectomy.
The DIEP flap involves transferring healthy tissue from the lower abdomen to the chest to create new breasts. The tissue retains its blood supply through vessels that connect to the chest arteries.
DIEP Flap procedures are considered the gold standard in breast reconstruction because they:
- Uses the patient’s own tissue from the lower abdomen
- Preserve abdominal muscles (unlike the TRAM procedure)
- Result in soft, warm, natural-feeling breasts
- Produce long-term results with no need for future implant replacement
DIEP Flap Alternatives If You Are Deemed Too Thin
If it turns out you truly don’t have enough abdominal tissue for a DIEP flap, there’s still hope—and plenty of options for breast reconstruction for a low BMI. Here are some of the most common thigh and gluteal-based alternatives we offer:
- PAP Flap: Uses tissue from the posterior thigh.
- TUG/VUG Flap: Inner thigh-based option, ideal for small to moderate volume.
- LTP Flap: Lateral thigh-based option with discreet scars.
- GAP Flap: Uses gluteal tissue, often for bilateral cases or when abdominal tissue is unavailable.
- Fat Grafting: Fat is liposuctioned from one part of the patient’s body to enhance general volume or correct contour post-flap.
The Benefit of Fat Grafting After Flap Surgery
Fat grafting may be an excellent option if you hope for a fuller look after flap reconstruction. This technique involves gently liposuctioning fat from another area of your body, such as the thighs, flanks, or abdomen, then purifying it and carefully injecting it into the reconstructed breast to enhance volume and shape. The surgeons at PRMA typically perform fat grafting during your second-stage revision surgery.
How to Choose the Right Breast Reconstruction Option
The best reconstruction choice is the one that fits your body, lifestyle, and goals—not just what’s most commonly done. Every woman’s anatomy is different, and so are her priorities.
As Dr. Steven Pisano encourages, “Set realistic, attainable goals after your surgery. Your body is going to feel different now than it did before surgery. If you are doing it simply to lose weight or get back into a certain dress or pant size, you may be setting yourself up for failure. Reset your compass.”
At PRMA, we take the time to understand your unique needs and guide you through all your options—whether that’s DIEP flap, another natural tissue procedure, or a combination approach.
Ready to Explore Your Flap Options? Connect With PRMA Plastic Surgery Today
Being told you’re “too thin” for DIEP flap surgery can feel disheartening—but it doesn’t have to be the end of your reconstruction journey. Your reconstruction should be as unique as you are.
Whether you’re exploring your options for the first time or seeking a second opinion, our team of reconstructive surgeons are here to support you with expert care and compassionate guidance every step of the way. Contact PRMA today to schedule your personalized consultation—virtually or in person—and take the next step toward reclaiming your confidence and wholeness.
