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For these patients, implant reconstruction may be the best option. For a delayed DIEP surgery, your plastic surgeon inserts tissue expanders in your chest and then waits for the second stage of the DIEP flap surgery to completely rebuilding your breast. 64% for free TRAM flaps, DIEP flaps, and superficial inferior epigastric artery perforator (SIEA) flaps, respectively. She answers any concerns or questions you may have, so sweet. Surgery itself will go quickly this time compared to phase 1 — nice for the person accompanying you.

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It might sound surprising, but I actually had more discomfort following phase 2. The aesthetic outcome of your DIEP flap procedure can often be improved with additional breast revisions. Plast Reconstr Surg Glob Open. Textured saline expandable implant with built-in port.

For this procedure, the surgeon tunnels muscle, fat, skin, and blood vessels from your upper back, under the skin to the front of the chest. Most of the time, the thighs only provide enough tissue to make a small or medium-sized breast. Future breast cancer screening. However, because they take advantage of the patient's own tissue, these techniques may yield more natural and longer-lasting results. In this flap procedure, the surgeon takes tissue from the latissimus dorsi muscle in your back, tunnels it underneath your skin to its new location and uses it to form a new breast mound. Do you have a question about DIEP flap phase 2 (or phase 1) surgery? Use of the internal mammary vessels for free-tissue transfer can be considered a refinement in flap orientation. How Long is the Recovery Period from DIEP Flap surgery? Bruising resolved on its own, but it took a few weeks. Essentially, during nipple-sparing breast cancer removal, your surgeon will make incisions around the nipple in order to keep the rebuilt breast mound as natural-looking as possible. DIEP flap surgery is not for everyone. To learn more about the DIEP flap procedure and your options for breast reconstruction, please call ( 303) -706-1100 to schedule a consultation with our experienced reconstructive surgeons.

Second Stage Diep Flap Surgery Complications

Breast reconstruction options: What to know about DIEP flaps and tissue flaps. Breast sensibility in bilateral autologous breast reconstruction with unilateral sensory nerve coaptation. You can live a normal life after your cancer, and regaining your figure is a way to help yourself physically and emotionally. Breast Reconstruction Surgery. When Can DIEP Flap Reconstruction Be Performed? 2020;181(3):599-610. In some cases, two flaps, each one from a different thigh, can be used to reconstruct one breast. Phase 2 is not cosmetic surgery, though procedures might be used that are also sometimes used in cosmetic surgery. It is often possible to keep a sensory nerve (a nerve that controls feeling) within the flap. Although refinements can improve small imperfections in a reconstructed breast, these should not be relied upon to correct improper planning of the initial procedure. The DIEP flap technique is a method of autologous breast reconstruction, meaning your own tissue is used to reconstruct one or both of your breasts.

Conversely, a small implant often can solve the problem. Any type of wound to the body is at risk for infection. Tissue from other parts of the body is used to complete the reconstruction. Phase 2 discomfort was completely handled with Tylenol. Patients shouldn't hesitate to ask questions about breast reconstruction, including: Is breast reconstruction a safe option for me? However, the contour of your new breast can usually be restored so that your silhouette looks similar to your silhouette before surgery. Second stage surgery encompasses many reconstructive and cosmetic-based procedures after an initial breast reconstruction. If not, we can offer a variety of alternatives and answer any questions you may have to help find the best solution for your goals and medical needs. Patients like the "tummy tuck" it provides. W. B. Saunders; 2010. Reattaching blood vessels requires expertise in surgery through a microscope (microsurgery). Discover a better experience by booking your consultation at Southwest Breast and Aesthetics today.

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1, 2] In the past decade, breast reconstruction has advanced because of the popularity of skin-sparing mastectomy. This is an ideal time to resect areas of fat necrosis and to trim both abdominal and breast "dog ears. " If you're contemplating undergoing DIEP flap surgery as your breast reconstruction choice, or if you've already completed phase 1 of DIEP flap surgery, you might be mulling over what to do about phase 2, or wondering if it's needed at all. They just likely haven't personally experienced this stuff. From my consolation up to my post ops I was very comfortable. The decision to undergo breast reconstruction after a mastectomy is a personal one. Your surgeon removes tissue — including muscle — from your abdomen in a procedure known as a transverse rectus abdominis muscle (TRAM) flap. In the first stage, the surgeon places a temporary tissue expander after the breast tissue is removed, then gradually fills the expander over time to stretch or shape the skin envelope.
How Is Second Stage Surgery Performed? Help your breasts look natural under clothing or a bathing suit. Breast cancer strikes one in every eight American women. Those who survive are often scarred for life. Again, don't over-do it.

Second Stage Diep Flap Surgery Center

DIEP flap breast reconstruction is typically comprised of at least two stages for the best outcomes. And yes, at every follow up there have been those photo shoots we all love. Surgeons most commonly remove tissue from the following parts of the body to recreate the breast tissue: "The answer to that is up to the patient, " says plastic surgeon Rene Largo, M. D. "The surgeon is able to customize the reconstruction for each patient.

Yours might be different. And realistic, too, of course. Nipple reconstruction: For women who are not candidates for a nipple-preserving mastectomy, traditional nipple reconstruction may be performed using the skin of the reconstructed breast to create small flaps, which are shaped to resemble a nipple that projects from the breast. If it has been violated, reconstruct it with sutures before proceeding. 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.

As was phase 1 in my case. Because no fascia is harvested, it is believed that function returns more quickly, hernias and bulges are less frequent, and postoperative pain is less severe. Essentially, I'm tailoring your skin to improve the overall shape of the reconstructed breast. Suture the latissimus-serratus unit back to the chest wall in an attempt to restore the natural slope of the lateral breast. To obtain symmetry, performing a reduction or a mastopexy on the opposite breast may be necessary.

As in the free TRAM flap surgery, a microscope is needed to connect the tiny blood vessels. And yeah, I was super fortunate to experience no pain after phase 1. Areola pigmentation. Some surgeons prefer placing sutures through the skin at the inframammary fold (IMF), while others simply mark this area with a pen. You will have a community working together for you, rather than one physician working alone or a hospital whose care can often be impersonal. Skin and fat may be taken from both sides of the lower abdomen to create two breasts if necessary or desired. National Comprehensive Cancer Network (NCCN).

Scarring is permanent, but the scars generally fade over time. Although there are many different ways to perform nipple reconstruction, at PRMA we use the "bow-tie" method. No matter what a woman chooses, a mastectomy is a huge deal and represents a huge loss in more ways than one. Your body type, health status and cancer treatment factor into which type of reconstruction will give you the best result. So, if your PS says you must have a phase 2, this is not the case. American Cancer Society (2019, September 18). 7% suffered local recurrence that included the skin/subcutaneous tissue, 0. The refinements and finishing touches for breast reconstruction with expanders and implants may be far different than those for a transverse rectus abdominis myocutaneous (TRAM) flap for immediate reconstruction or a delayed latissimus flap in an irradiated mastectomy defect. An advantage to this type of breast reconstruction is that you'll retain more strength in your abdomen. Fat grafting can also be used to address size discrepancies. They helped me through my whole reduction process from my insurance to outside appointments even to offer transportation to and from my surgery. If a large amount of volume is required, the fat adjacent to the skin paddle can be incorporated onto the flap by bevelling away from the flap during the dissection.
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