DIEP, is There Anything else in the Pipeline?

I am 47 and have had breast cancer twice. A lumpectomy with radiation at 31 and bilateral masectomy at 43 without reconstruction. In my opinion, the current options for reconstruction are barbaric. I am tired of wearing I'll fitting clothes and want to do something that does not require more rehab than cancer surgery and without drains. Is my wish ever going to materialize? Stage 1 both times.

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6 Doctor Answers | Asked by pipercub

Doctor Answers (6)
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Breast Cancer Reconstruction

Given your history of radiation, it seems that the best option for you could be to use your own tissue (autologous) to reconstruct both breasts. Implants and fat grafting techniques do not do as well in radiated tissues. While there have been many advances in tissue transfer surgery to reconstruct mastectomy defects, none of them are non-surgical. They all require the use of drains, and recovery time after a typically major surgery. The results however can be quite... more

Options for delayed reconstruction with a history of radiation include the DIEP flap, latissimus dorsi flap, SGAP, SIEA, IGAP, a

Thank you for your question. Options for delayed reconstruction with a history of radiation include the DIEP flap, latissimus dorsi flap, SGAP, SIEA, IGAP, and TUG flaps. All of these surgeries are involved. If you do not wish to have surgery and do not wish to have drains, you may wear prostheses. Fat transfer has preliminary promise but is not widely accepted yet. Also, radiation makes it extremely difficult to get the transferred fat to live. I'm sorry I... more

Breast cancer reconstruction

All of the breast surgeries post mastectomy require invasive procedures whether you use tissue expanders and implants, or autologous tissue like a TRAM or DIEP. Sorry. Nothing specifically in the pipeline that will replace this jsut yet.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Current options for tissue reconstruction

I can understand your concern and hesitation with proceeding with a breast reconstruction procedure. After going through breast cancer twice, more surgery is probably the last of your desires. Unfortunately, the best reconstruction for you longtime will most likely involve use of your own tissue. It is difficult to give exact recommendations without an exam or photos to judge. My concern is your radiation history may not mix well with implant... more

Breast reconstruction using DIEP flap, implants, fat grafting, latissimus flap

I would recommend a consult performed with someone who is comfortable with all options. I don't know which technique it is that bothers you the most and why. There are several options but due to radiation treatments your response to many forms of reconstruction will be limited by your tissues and not so much the technique.

Breast Cancer Reconstruction Options

There are many options for breast cancer reconstruction. The best results are obtained when the reconstructions are performed simultaneously and when the oncological surgeon and plastic surgeon work together. For an immediate implant + alloderm reconstruction, there is minimal down time. You will have to have the opposite breast lifted to mach the the reconstructed breast. Unfortunately, this is not an option for you. For delayed breast reconstruction, there are currently no new... more