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This is yet one more reason to discuss phase 2 before having phase 1. These may include a breast reduction, breast lift or breast augmentation. Because DIEP flap surgery involves two sites on your body, the time it will take for your body to fully recover will be longer. The purpose of the second stage of DIEP surgery is to fine-tune the reconstructed breast and improve the overall cosmetic results. Goodenough CJ, Rose J. This results in a full restoration of core muscle function after patients have recovered and a lower risk of developing an incisional hernia. This is because the shape and feel are determined by the implant itself. Understanding the Stages of DIEP Flap Reconstruction | CO. This is called flap failure.
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. Your surgeon removes tissue — including muscle — from your abdomen in a procedure known as a transverse rectus abdominis muscle (TRAM) flap. Second Stage Breast Reconstruction Procedure. Revision of DIEP Flap – Recovery. After all, this is your life. Patients may have many breast implant options, and each technique has a unique set of considerations.
A literature review by Yun et al indicated that although there has been an increase in the use of implant-based breast reconstruction techniques in the setting of postmastectomy radiation therapy (PMRT), quality of life and sensory recovery are better in patients who undergo autologous reconstruction with PMRT. Although uncommon, some women experience muscle weakness in the back, shoulder or arm after this surgery. I did have nipple reconstruction with my implants years ago. The Advantages of DIEP Flap | Texas. This usually doesn't happen until you've completed all your cancer treatments. Breast reconstruction with flap surgery is a complex procedure performed by a plastic surgeon. The timing of your DIEP flap procedure will involve many factors including your goals for reconstructive surgery and the details of your cancer.
When transferring a pedicled TRAM flap, preferably base the flap contralateral to the reconstructed breast and create the subcutaneous tunnel slightly on the opposite side of the sternum in relation to the reconstructed breast. Breast reconstruction with flap surgery involves taking a section of tissue from one area of your body — most often your abdomen — and relocating it to create a new breast mound. Second stage diep flap surgery recovery time off work. This page was reviewed on February 10, 2022. In mild cases, liposuction and/or excision can correct this problem. An abdominal wall flap procedure uses tissues from the tummy.
In addition, with the onset of menopause (ie, decrease in estrogen levels), the relative amount of fatty tissue increases as the glandular tissue diminishes. Not to mention I am very happy with the results. Recovery after revision of a DIEP flap breast reconstruction is much easier than recovery after the initial DIEP flap operation. An incision is made in the lower abdomen, from which the surgeon will remove the portion of skin, fatty tissue, and blood vessels. But, once your breasts heal from the initial DIEP flap procedure, a plastic surgeon can either reconstruct your nipples with more of your natural tissues and a tattoo to create an areola. Second stage diep flap surgery of the hand. 4% had local recurrence in the chest wall, and 0.
In these procedures, fat and skin may be transplanted from various areas of the patient's body to create the reconstructed breast, with the area and method chosen depending on the amount and quality of tissue available. It wasn't pain so much, but rather, it was soreness I experienced, probably due to liposuction. 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. Second stage diep flap surgery cigna. Daniel Liu, MD, Plastic and Reconstructive Surgeon, CTCA Chicago.
Much of the breast reconstruction using your body's own tissue can be accomplished at the time of your mastectomy (immediate reconstruction), though sometimes it can be done as a separate procedure later (delayed reconstruction). Fever, fluid build up, pain, swelling, and redness are all signs of a possible infection. They use a multi-disciplinary approach to breast reconstruction that includes: The DIEP flap procedure differs from other breast reconstruction surgeries because the surgeon leaves your abdomen muscles in place. Fat is a rich source of stem cells, which are critical to healing. Patients undergoing delayed reconstruction deserve special mention. If you've had only one breast reconstructed, you'll need to have screening mammography done regularly on your other breast. 2021;147(2):281-292. It's a never-ending saga. Dr. Sadeghi will provide you with more information during your initial consultation. It may also be the safest option for some, particularly those who: Smoke.
A newer type of procedure, called a lumbar artery perforator (LAP) free flap, might be an option if there is not enough abdominal wall (tummy) tissue to use as a donor site. When you undergo a mastectomy to remove breast cancer, you may receive either a nipple-sparing mastectomy or a non-nipple-sparing mastectomy. It also may be used in combination with an implant for total breast reconstruction, particularly for women who may not be candidates for any of the above-mentioned flaps. I had areola tattooing done with implants, too.
During phase 2, symmetry of your breasts can be addressed. Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing. Final thoughts about things you should know. What about bruising? Outcomes after oncoplastic breast-conserving surgery in breast cancer patients: A systematic literature review. Suture the latissimus-serratus unit back to the chest wall in an attempt to restore the natural slope of the lateral breast.
Tunneling the tissue beneath your skin to your chest area, the surgeon then creates the new breast mound or pocket for the implant. In this procedure, Selber uses the da Vinci robotic surgical system to remove the tissue from the abdomen. 2018 Oct;25(10):3052-3056. What you can expect. Nerve Coaptation Improves the Sensory Recovery of the Breast in DIEP Flap Breast Reconstruction. You will have to avoid heavy lifting, strenuous exercise, and sexual activity during your recovery period. Outer thigh: Another option for women who might have more fatty tissue on the outer part of their thighs and cannot have or choose not to have a DIEP flap is the lateral thigh perforator (LTP) flap. With implant-based reconstruction, it may be recommended that implants be replaced every 10-15 years. 4%, in the nipple-areolar complex. The blood vessels used for the SIEA flap are more superficial (shallow) and not every person has them. Most times the tummy provides enough tissue for breast reconstruction, so no breast implants are needed.