I had an implant after mastectomy which was subsequently removed. I am now thinking about DIEP flap surgery?

PS indicated that failure of incision to heal was due to my being nutritionally deprived. (I had a Gastric bi pass six years ago..)Are there any recommendations for improving chances of successful surgery....particularly with regard to nutrition? Are there any recommended blood tests to determine nutrition deficits?

Doctor Answers 2

Breast reconstruction

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Checking a pre albumin will help determine your nutritional stores. If this is low then there are options to improve this.  Once that has been optimized a surgical plan can be executed.  I don't typically replant patients after implant infections if there are other options.  There are multiple procedures using your own tissue that can provide safe and durable reconstruction options with natural results.

Nutritional studies and failure of implant

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It may be a good idea for you to talk with a registered dietitian and yes, there are several blood tests that can be run to determine how nutritionally sound you may be after gastric bypass surgery. There are several reasons for implant failure and if your surgeon is truly concerned that your nutritional status being the one and only reason for your implant failure, taking on an even BIGGER and more traumatic surgery like a DIEP flap without intervention to boost your nutrition beforehand sounds like an unusual decision to me. Wound breakdown or failure of successful blood vessel implantation could ruin your best or even last chances for reconstruction and in a worst case scenario-  even be life threatening. It seems it would make more sense to optomize your nutrition, insuring adequate protein and vitamin intake to allow for excellent wound healing (this might involve supplements or even IV infusion in extreme cases), and revisit the implant. That is, unless there are other reasons for the failure and additional benefits to proceeding with the tissue transfer over the use of artificial material. 

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