Possible to Do Full Tummy Tuck While Doing Diep Flap Procedure?

Question

I understand that the diep flap benefit of a real 'tummy tuck' is not covered by insurance. Is it reasonable to ask for the cost of a full tummy tuck (sewing together muscles, etc.) while the surgeon is performing a diep flap procedure? My surgeon seems very reluctant to even discuss outlying procedures such as abdomioplasty and liposuction, which I believe are both necessary to achieve the best final results. If I'm willing to pay for these procedures out of pocket, I don't know why my surgeon won't discuss them. Any insight appreciated.

Adam Bryce Weinfeld, MD · Answer

It is interesting that your surgeon wont discuss this issue with you.  I am sure the information would make you more comfortable.  Did he say he wont do it or he just wont discuss it?  Removing the excess skin an fat in a diep flap will give you a improved abdominal contour.  It will provide many of the changes you would expect from an abdominoplasty.  Some women can get extra muscle tightening at the time of surgery.The surgery is complex.  Perhaps the surgeon did not want to create aesthetic expectations that he could not be sure could be achieved safely during the complex surgery.  Perhaps he wanted to keep the whole process focused on the important issue of reconstructing the breast.

Jeffrey E. Schreiber, MD, FACS · Answer

Hello - I see your point, but as someone who does DIEP flaps the procedure can take a very long time.  Any added surgery may increase the time and stress of the case for the surgeons and staff.  The best thing for your to do would be to get your DIEP flaps, recover, and then get liposuction and tightening of your abdominal muscles at a later date.  This will allow your body to recover and allow your surgeon to fully concentrate on the cosmetic nature of your surgery.  Good luck!

Aldona J. Spiegel, MD · Answer

This is a good question that should be discussed with your surgeon prior to the procedure. As you know the goal of the DIEP procedure is to transfer the lower abdominal tissue, which is usually removed in a tummy tuck procedure, for breast reconstruction. An additional component of a tummy tuck is also tightening of the rectus muscles that may have been stretched apart, particularly in pregnancy (rectus diastasis). While this improves the abdominal controur, the tightening needs to be done judiciously, as it may cause increased pain. Therefore, it needs to be individualized based to the patient and the degree of diastasis. I perform diastasis repair on selected patients in a conservative fashion.

Robert Whitfield, MD · Answer

Three
basic forms of breast reconstruction exist. You can use your own tissue,
implants or a combination of the previous two techniques. Your own tissue can
be used in the form of the DIEP flap, PAP flap, SGAP flap or fat grafting.
Implants can be done in one stage or two stage. Two stage reconstructions are
started by placing expanders at the time of mastectomy. Once they expanders are
placed they are able to be inflated as determined by wound healing. The final
time consists of combining any of the above techniques.

If
you are interested in being seen in Austin please give us a call.  I know
this is a difficult time for you.  The majority of my practice is devoted
to reconstruction for women with breast cancer or who are BRCA+

Paul Gill, MD · Answer

A tummy tuck consists of removal of excess skin and fatty tissue, followed by tightening of the weakend rectus muscles.    

	 

	In my DIEP Flap patients, I frequently plicate the abdominal muscle, but do not recommend liposuction or an extremely tight abdominal closure if the reconstruction is being performed in the immediate setting of the mastectomy.  Why?  With breast cancer, your body is immunosuppressed.  You are at a much higher likelihood of delayed wound healing or infection, compared to your healthy state.   In addition, you may require chemotherapy after surgery and I do not want to risk a wound healing issue that may delay your cancer treatment.

	 

	You can always come back to fight another day, but our main goal is a safe and predictable outcome/recovery.

Possible to Do Full Tummy Tuck While Doing Diep Flap Procedure?

Answers (9)

Answer: Breast reconstruction

Answer: Breast reconstruction

Answer: Full Tummy Tuck with DIEP Flap Breast Reconstruction

Answer: Full Tummy Tuck with DIEP Flap Breast Reconstruction

Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.

Possible to Do Full Tummy Tuck While Doing Diep Flap Procedure?

Answers (9)

Answer: Breast reconstruction

Answer: Breast reconstruction

Answer: Full Tummy Tuck with DIEP Flap Breast Reconstruction

Answer: Full Tummy Tuck with DIEP Flap Breast Reconstruction

Browse related questions

Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.