Nerve Problems

Great question!

In fact, I've posted on my blog about this very topic:
http://breast-cancer-reconstruction.blogspot.com/2008/11/avoiding-denervation-of-abdominal.html

The DIEP flap procedure preserves all the abdominal muscle. However, preserving all the muscle won't matter if all the motor nerves supplying it have been cut during the surgery. A muscle without a healthy nerve supply will lose it's tone, strength and function.

If the DIEP surgeon does not take great care to identify and preserve motor nerves supplying the abdominal muscle then the benefits of the DIEP can be lost: the abdominal muscle can become weak, lose its tone, and the risk of abdominal bulging or even hernia increases. Occasionally a nerve has to be cut because it interferes with the blood supply of the flap (eg travels between 2 necessary perforators). In these instances the nerve should be repaired at the end of the procedure. Typically, damage to 1 motor nerve will not cause any issues long term; it's damage to multiple nerves that leads to muscle problems.

I hope that helps.

Dr C
http://www.PRMA-enhance.com Great question!

In fact, I've posted on my blog about this very topic:
http://breast-cancer-reconstruction.blogspot.com/2008/11/avoiding-denervation-of-abdominal.html

The DIEP flap procedure preserves all the abdominal muscle. However, preserving all the muscle won't matter if all the motor nerves supplying it have been cut during the surgery. A muscle without a healthy nerve supply will lose it's tone, strength and function.

If the DIEP surgeon does not take great care to identify and preserve motor nerves supplying the abdominal muscle then the benefits of the DIEP can be lost: the abdominal muscle can become weak, lose its tone, and the risk of abdominal bulging or even hernia increases. Occasionally a nerve has to be cut because it interferes with the blood supply of the flap (eg travels between 2 necessary perforators). In these instances the nerve should be repaired at the end of the procedure. Typically, damage to 1 motor nerve will not cause any issues long term; it's damage to multiple nerves that leads to muscle problems.

I hope that helps.

Dr C
http://www.PRMA-enhance.com