Melting Pot of Surgeries: DIEP, Tummy Tuck, BBL?

I started researching BBL prior to my BC diagnosis. I will be looking at bilateral reconstruction ~ May 2013 and I want DIEP. I understand that this is NOT a full TUCK. If I had any kind of muscle tightening afterwards, can this be considered as part of my reconstruction touch-up? Or is this something that I'm on my own with? If I were to get a subsequent BBL and TT which order may be best ? My PS says I don't need to maintain my current weight for DIEP, what about BBL? I just want a new body!

Doctor Answers 4

Breast reconstruction

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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+

DIEP, Tummy Tuck, BBL

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I would suggest concentrating now only upon the breast reconstruction. Although the DIEP does not exactly duplicate a tummy tuck, the removal of excess skin is accomplished. The incision is usually higher than for a TT. 

After that is done and you have recovered, that is the time to consider your goals in body contouring. 

If you do get a BBL, you should be close to your desired weight. Otherwise as you lose weight you will lose results from the fat injections.

Good luck. Thanks for your question.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

DIEP as a tummy tuck?

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With breast reconstruction, it's important to consider first what surgery you need for removal of the breast cancer. If you have already decided to have bilateral mastectomy, then first choose a general surgeon or surgical oncologist that will do a skin sparing mastectomy, so you have the best breast scar, assuming you are a candidate. Next, find a plastic surgeon who performs DIEPs routinely and look at their results, and find out about the differences in reconstruction between a DIEP and implants. The DIEP flap takes a while to recover from, does have a risk of flap necrosis, but can have a result in many hands as good as a tummy tuck, and it IS a full tuck (and with the benefit of natural breasts!). Many surgeons do small touch ups during the nipple reconstruction like dog ears, fat grafting, etc to optimize the result, you can ask them what their policies are.

Lisa Cassileth, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 16 reviews

Breast reconstruction first, body contouring afterwards

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Thank you for the question.  My recommendation is that you focus solely on your breast reconstruction first with DIEP flaps.  Once you are healed and Doug well you can come back and essentially redo the abdominal component as well as BBL at the same time.

All the best,

Dr Remus Repta 

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 171 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.