Can I Get a Breast Implant in One Breast and a Diep Flap in the Other Radiated Breast and Acheive Symmetry?

I currently have tissue expanders in and I had radiation on right breast. I am expriencing complications and I am having the expanders removed and having surgery soon. My doctor recommended a breast implant in my left breast and diep flap on right side. Can symmetry be obtained? I would like to be a C cup but their isnt enough belly fat for both breasts. Are there other options?

Doctor Answers 3

DIEP Flap for One Breast and Implant for the Other

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   Autologous tissue to the radiated side is the best option.  Given the lack of autologous tissue on the abdomen, the placement of an implant in the nonradiated breast is the simplest option.  With a skilled surgeon and depending upon current anatomy, a good match in size and shape can be achieved.  Longer term results will tend to diverge.  Kenneth Hughes, MD breast implants Los Angeles, CA

Breast Reconstruction and Symmetry

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Thank you for your question.  I am sorry that you are having complications, but unfortunately complications are higher with radiation therapy.  You have a difficult problem and it will be hard to obtain symmetry by performing two different operations on the two breasts.  I have performed exactly what is being suggested in the past only once, with a nice outcome.  However, I generally recommend performing the same procedure on both sides for optimal symmetry.  There are other free tissue transfer options available if you do not have enough tissue in your abdomen for both breasts.  You could consider flaps from both of your buttocks to both of your breasts, or tissue from your inner thigh.  Ask your board certified plastic surgeon if that is option.  If he/she does not feel comfortable with those flaps, perhaps you can consider looking for another surgeon who performs those types of perforator flaps.  Additionally, implants could be added later if necessary to obtain the volume you desire. Another option would be to use both of your latissimus (back) muscles on each side; again in an attempt to obtain symmetry by performing the same operation on both sides.  Good luck

Diep flap and tissue expander in different breasts?

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Unfortunately, you are in a difficult situation.  You are correct to assume that if you have one breast reconstructed with a DIEP flap and the other with a tissue expander/implant, they will not be symmetrical in shape or feel.  Under ideal circumstances, you would want to have both breasts reconstructed with the same technique to help achieve symmetry.  I would recommend that you discuss your options with your plastic surgeon.  It sounds like you also have a limited amount of tissue available to perform a DIEP flap on both breasts; one compromise may be to perform a bilateral DIEP flap breast reconstruction and accept a smaller breast size or later attempt to place implants underneath the flaps.  Keep in mind, that even under ideal circumstances, it is difficult to achieve perfect symmetry if one breast has had radiation.  Good luck!

Anureet K. Bajaj, MD
Oklahoma City Plastic Surgeon
5.0 out of 5 stars 21 reviews

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