Join Now
Sign In
If a woman is very thin, is she still a candidate for DIEP flap reconstruction?
Diseases:
Answer Summary
Video Answers
(1)
2
Expert Answers
JoshLevineMD (Physician - Surgery - Plastic (Verified) ) - 07 / 14 / 2011
Yes, thin women are often good candidates for DIEP breast reconstruction. Thin women typically have breasts that are proportional to their body size. If a thin woman is having a mastectomy, she should consider what size breast reconstruction she wants. If her preference is to have reconstructed breasts approximately the same size as her current breasts, we can usually get enough from the abdomen (the DIEP) to replace the mastectomies. If there is not enough, or she wishes to be bigger, there are several other autologous (her own body tissue) options. These include using tissue from the lower back (love handles), the buttocks or thighs.
drchrysopoulo (Physician - Surgery - Plastic (Verified) ) - 07 / 14 / 2011
I agree with Dr Levine's comments completely. Many thin women have adequate fat for breast reconstruction using their own tissue, even DIEP flap reconstruction. What matters is the distribution of the fat.
Almost all women undergoing DIEP flap breast reconstruction will undergo a second surgery to "tune up" the reconstruction for the best results possible. At the "revision surgery" we optimize breast symmetry, reconstruct the nipples, improve the tummy contour, and revise the scars.
In instances where the reconstruction ends up too small after the first surgery, most women are candidates for autologous fat grafting at the second surgery. 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.
We used to occasionally place a breast implant under the DIEP flap in women who needed a slightly larger reconstruction to match the other breast. Unfortunately the patient is then exposed to the risks of breast implants like capsular contracture (hardening of the implant and breast) over time. We have therefore moved away from doing this in our practice.
Fat is not free of issues either though - some of it can become reabsorbed or form little pea-sized areas of hardening (fat necrosis), especially if the fat grafting is not performed in a meticulous way. There were fears for a while that the injected fat could cause calcifications on a mammogram that could look like or even mask a new breast cancer. Several studies have since shown that fat grafting is safe though some plastic surgeons are still reluctant to perform the procedure because of these previous fears. Even though fat grafting may not be 100% predictable, it has served our patients very well and we now prefer it to implants in these situations.
Hope that helps.
Dr C
http://www.PRMA-enhance.com
Almost all women undergoing DIEP flap breast reconstruction will undergo a second surgery to "tune up" the reconstruction for the best results possible. At the "revision surgery" we optimize breast symmetry, reconstruct the nipples, improve the tummy contour, and revise the scars.
In instances where the reconstruction ends up too small after the first surgery, most women are candidates for autologous fat grafting at the second surgery. 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.
We used to occasionally place a breast implant under the DIEP flap in women who needed a slightly larger reconstruction to match the other breast. Unfortunately the patient is then exposed to the risks of breast implants like capsular contracture (hardening of the implant and breast) over time. We have therefore moved away from doing this in our practice.
Fat is not free of issues either though - some of it can become reabsorbed or form little pea-sized areas of hardening (fat necrosis), especially if the fat grafting is not performed in a meticulous way. There were fears for a while that the injected fat could cause calcifications on a mammogram that could look like or even mask a new breast cancer. Several studies have since shown that fat grafting is safe though some plastic surgeons are still reluctant to perform the procedure because of these previous fears. Even though fat grafting may not be 100% predictable, it has served our patients very well and we now prefer it to implants in these situations.
Hope that helps.
Dr C
http://www.PRMA-enhance.com
Similar Questions
Note: All content on this site is informational and not a substitute for professional medical advice.
Always seek the advice of your physician or other qualified health provider with questions regarding your health.
Note: Usernames have been made anonymous and profile images are not shown to protect the privacy of our members.
Thank you for flagging this content. We will look into it right away.
Add Answer
1) Question:
2) Background Info (optional): What context or background information is relevant to this request?
Notes:
The more clear and thorough your request, the more likely you will receive support.
Many of our members are learning from this information or english might not be their first language. Please use standard english and spell out all words. For example, use 'you' instead of 'u'.
The more clear and thorough your request, the more likely you will receive support.
Many of our members are learning from this information or english might not be their first language. Please use standard english and spell out all words. For example, use 'you' instead of 'u'.
Newsletters
Share Conversation
To tell people about this conversation, type their email addresses here (separated by commas):
From:
Add a personal note here:
Cancer Updates
Sign up for our
All Cancers
updates for the latest news, best answers and featured experts.
Ads keep TalkAboutHealth freeadvertisement
Similar Questions
Updates
Sign up for email updates of the latest news, best answers, and featured experts.
Benefits
Custom health, wellness, & medical offers from our partners including clinical trials, market research opportunities & new programs.
Upcoming Workshops
-
Breast Cancer Oncology
Mon., May 20th
Expert: Katherine Crew, MD -
Melanoma Oncology
Mon., May 20th
Expert: Steven O'Day, MD -
Gastric (Stomach) Cancer Oncology
Tues., May 21st
Expert: Manish Shah, MD -
T-cell Lymphoma
Tues., May 21st
Expert: Francine Foss, MD -
Breast Cancer Oncology
Wed., May 22nd
Expert: Linnea Chap, MD -
Cancer Support and Psychosocial Education
Thurs., May 23rd
Expert: Jeff Kane, MD -
CLL - Chronic Lymphocytic Leukemia
Fri., May 24th
Expert: Jennifer Brown, MD, PhD
SHARE Support
1) Call SHARE at: 866-891-2392
to speak directly to a trained breast cancer survivor for support and guidance.
2) Direct message the trained peer supporter you select.
3) E-mail us at support@talkabouthealth.com, and we will find the right match for you.
More info
to speak directly to a trained breast cancer survivor for support and guidance.
2) Direct message the trained peer supporter you select.
3) E-mail us at support@talkabouthealth.com, and we will find the right match for you.
More info
3 Quick Ways You Can Help
1) Spread the word! Tell people you think might want some support. Tell medical professionals, health providers, and organizations.
2) Like us on Facebook and follow us on Twitter!
3) Volunteer - email us at volunteer@talkabouthealth.com for more information.
More Ways To Help!
2) Like us on Facebook and follow us on Twitter!
3) Volunteer - email us at volunteer@talkabouthealth.com for more information.
More Ways To Help!
View All Newsletters
