DIEP flap reconstruction on 6/28. It is still rock hard and painful. Will it get soft? My PS says just massage it?

Question

mastectomy + immediate DIEP flap reconstruction on 6/28. 5 mm Small triple negative breast cancer in diagnosed in 3/2016 In lumpectomy scar bed from microcalcifications diagnosed 13 years earlier that was positive cancer. Had 35 rounds of radiation 13 years ago. After Diep surgery developed eschar.... Have healing problems. Breast is lumpy

John Paul Tutela, MD · Answer

Thanks for reaching out.  Your flap will go through many changes in the first 6 months after surgery.  Sometimes the vascularity sttuggles and may cause fat necrosis. If this doesn't get better these areas of harder fat can be removed.I hope this helps :)

Jeff Angobaldo, MD · Answer

Thank you for your question.  An examination would be needed to answer your question.   Hard lumpy areas may be just normal post op swelling, effects of radiation or fat necrosis.  Your still very early in ypur recovery and ypur the flaps will change over the next few months.  Discuss your concerns with your plastic surgeon.

Robert Whitfield, MD · Answer

There can be sweeping in the mastectomy skin, the flap or both.  I use lymphatic massage to treat this especially in mastectomy skin.Unfortunately if you are having wound healing issues this can limit the ability to have lymphatic massage treatment by a therapist.

Steven Wallach, MD · Answer

You need to be seen in person.  It could be related to the flap itself having some secondary healing or the radiation or both.  Best to follow with your surgeon.

DIEP flap reconstruction on 6/28. It is still rock hard and painful. Will it get soft? My PS says just massage it?

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