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Why am I choosing to have reconstruction surgery? There are different types of abdominal wall (tummy) flaps: A free muscle-sparing TRAM (MS-TRAM) flap is like a free TRAM flap except only part of the muscle from the same part of the lower abdomen, is completely removed and moved up to the chest. Of the available options, DIEP flap breast reconstruction utilizes the skin and fat of the lower abdomen. Less than 5% of surgeons in the United States perform this intricate procedure, and the board-certified reconstructive surgeons at The Breast Center Park Meadows Cosmetic Surgery are proud to be among them. Prolonged time in surgery and under anesthesia. Second stage diep flap surgery and lymphedema. Additionally, your doctor will advise you to start stretching exercises after you have reached a certain point in your recovery period. Second Stage DIEP Flap Surgery.
This can either be left as a small ellipse which will be totally removed, or it will be left as a circle in the middle of the breast reconstruction to represent the new areola. Womens Health (2015) 11(3), 325–342. Sadeghi does his best to ensure these incisions (and inevitable scars) are easy to conceal under bras and bathing suits. The timing of your DIEP flap procedure will involve many factors including your goals for reconstructive surgery and the details of your cancer. In addition to improving breast shape and volume, transferring fat may help stimulate the formation of new blood vessels and improve skin texture. The first stage is to place an implant expander and the second stage is to complete the tissue 'll likely need another operation to perform nipple reconstruction. The techniques used will depend on which surgery is performed. 2008;75 Suppl 1:S17-23. DIEP Flap Surgery: Tissue Based Breast Reconstruction | Nashville. This liposuctioned fat is then processed and injected as a graft into the patient's reconstructed breasts to improve volume or contour or symmetry. Partially erase the physical reminders of your disease. In these cases, or for any woman who has already had a mastectomy without reconstruction, delayed breast reconstruction is often a viable option. This connection helps stimulate the tissue flap to regain feeling. This is an ideal time to resect areas of fat necrosis and to trim both abdominal and breast "dog ears. "
Because DIEP flap surgery takes tissue away from your abdomen, there is a small risk for developing an abdominal hernia. Most second stage breast procedures are performed on an outpatient basis; however, the procedure length will vary on the techniques being performed. There were similar follow-ups periodically over a period of months. This condition occurs when the transferred tissues do not receive a sufficient blood supply to oxygenate the cells. An incision is made in the lower abdomen, from which the surgeon will remove the portion of skin, fatty tissue, and blood vessels. The procedure is also designed to decrease recovery time compared to other techniques that may cause more damage to the donor site. If uncertainty remains, several options are available, including delaying reconstruction, resecting the questionable skin with immediate reconstruction, and closing the questionable skin over a non–de-epithelialized skin paddle, which allows full demarcation of the questionable skin and definitive surgical repair 2-3 days later. Help you avoid the need for using a form (external prosthesis) inside your bra. After your mastectomy, several factors determine the best time for your DIEP flap breast reconstruction. "Not only is this easier on the surgeon, but it almost always results in a speedier recovery for patients because the surgeon doesn't have to cut through as much of the abdominal musculature like we do in a traditional DIEP flap. Second stage diep flap surgery results photos. So, if we sucked out fat from your flanks and love handles and your abdomen, I want you to wear Spanx that will compress that area. American Society of Plastic Surgeons. Wearing an elastic bandage or support bra can help keep swelling down and support your breast while it heals. Other tidbits of advice.
I started taking daily walks right away, though shorter ones. Final thoughts about things you should know. You may be tired and sore for a few weeks after your surgery. The advantages of implant reconstruction include a shorter time for surgery and recovery. The surgeon disconnects the tissue completely from its blood supply and reattaches the tissue to new blood vessels near your chest.
Will you have immediate or delayed reconstruction? There's much less risk of a bulge because no muscle is taken. Ischemic complications in pedicle, free, and muscle sparing transverse rectus abdominis myocutaneous flaps for breast reconstruction. However, once the flap is removed, it will have to be replaced. People who smoke are often advised to delay breast reconstruction until they have abstained from smoking for at least two months. This muscle-sparing technique offers women natural, long-lasting results without the use of breast implants. Having immediate reconstruction may be preferable because it allows for two surgeries to be completed at once. Every interaction, including each phone call and email, will be with one of our staff members trained to help you through this difficult time. I've been having an issue getting a portion of mine covered, so just a heads up. After your breast has healed from reconstruction or mastectomy, a plastic surgeon can reconstruct a new nipple and areola. Second stage diep flap surgery cuts. Both the breast surgeon and reconstructive surgeon will evaluate and discuss each patient's breast reconstruction options. After about two or three days, you will need to start doing some arm exercises to help your muscles function and heal properly. I mention this because like you perhaps, I went into both surgeries expecting the worst and the worst didn't happen. DIEP flap surgery is not for everyone.
Placement of the skin paddle depends on the amount of excess skin on the patient's back and the location on the breast where the skin paddle is needed. Fat grafting is usually used for breast revisions or "touch up" surgeries. Both direct excision of excess fat and liposuction can achieve the desired result. Immediately after your surgery, you will feel sore around your breast and around your abdomen. Second Stage Breast Reconstruction Procedure. TUG flap surgery, which isn't available everywhere, may be an option for women whose thighs touch and who have small to medium-sized breasts. Close cooperation with the oncologic surgeon can alleviate problems, since technically no breast tissue lies inferior to this plane. Because fat from the abdomen is soft and pliable, similar to breast tissue, many patients find their results to be more comfortable and natural. Autologous tissue breast reconstruction uses one of two surgical methods: - Pedicled flap surgery The surgeon cuts some of the blood vessels to the tissue to be transferred but keeps other blood vessels intact. Products & Services.
There does need to be adequate time post-phase 1 for healing. Just be aware, that normal sensation won't completely return, but as your breast continues to heal, some feeling will usually return. DIEP flap surgery is a technique for rebuilding your breast without an implant.