Bulge over Pubic Area Above Incision for DIEP Flap?

Question

I had a bilateral mastectomy and diep flap reconstruction 2 months ago. My ps says the fist sized bulge is not a hernia, that it is due to weak or lax muscle. He said I could leave it like it is or have more surgery where he would repair it with mesh. It bothers me at night after a busy day. Sometimes it seems bigger then. What are the chances of it getting worse in the future if I do nothing now? Also, how likely is surgery to repair the buldge?

Remus Repta, MD · Answer

Hello,

	Thank you for the question.  The abdominal component of a DIEP flap reconstruction is of secondary importance compared to the breast reconstruction.  It is not uncommon to place the resection of the abdominal soft tissue higher on the abdomen for breast reconstruction compared with a tummy tuck.  With this and several other reasons the "tummy tuck " obtained from a DIEP flap breast reconstruction is rarely as good as a primary tummy tuck.  Regardless of the source additional surgery will be needed.  Options include liposuction or a full tummy tuck revision.

	All the best,

	Dr Remus Repta

Robert Whitfield, MD · Answer

I place all of my patients in physical therapy after surgery to improve core strengthening.  Adjustments in diet to avoid bloating and wearing supportive garments like spanks can be helpful.

Bulge over Pubic Area Above Incision for DIEP Flap?

Answers (2)