Diep flap done 4 months ago. Rib cartilage removed on left side and I look like a mess. Can this be fixed? (photos)

Question

I have a huge concave area on left side where rib was removed. It looks like I was born with a chest wall deformity. Can this be fixed? Not finding info online about this. Can the area where they monitored my flaps be fixed so the incision is a straight line? I feel like they botched me up. My sister had same surgery with different docs and her results are far better. We both did this prophylactically. I am so depressed as I could have used my sister's doctor.

Manish C. Champaneria, MD · Answer

Thank you for your question.The area where the rib was resected was necessary to perform the microvascular anastomosis, so that the flaps could live. Sometimes, there is a contour deformity that results, like in your case. This can easily be camouflaged with a fat graft. In this procedure, fat is harvested via liposuction, processed, and then injected into the chest to plump up the area. With regard to the skin paddle used for monitoring, this can easily be revised and the skin can be removed and a straight incision made. Both of these surgeries can be performed once you have healed from the initial DIEP surgery--typically 3-6 months. You have an excellent result thus far, and remember that the initial surgery was to get the flaps to survive in their new location, and then to shape them at a later date. Continue routine follow-up with your surgeon and follow their guidelines.Regards,Manish Champaneria, MD

Susan MacLennan, MD · Answer

HelloI think you're well on your way to a nice result. You could have a revision to address the upper pole indentation (where rib was removed to put the blood vessels together) and the monitor skin paddle at the same time.The usual solution for the indentation is fat grafting. This usually works well, but may need to be repeated for best results.Both skin paddles that were used to monitor your flaps could be removed and repaired as a straight line. Your surgeon may also be able to reshape your breasts a bit at the same time.It's very common to do a second stage like this after breast reconstruction, and the shape of the reconstructed breasts can usually be improved quite a bit.Best wishes-

Ali Sadeghi, MD, FACS · Answer

This is a problem that is often seen when ribs are removed and pectoralis muscle is separated from the sternum.  The best way to deal with this problem is fat graft the area.  This may have to be done more than once to achieve the desired result.  Thank you for your question and good luck.

Steven Wallach, MD · Answer

Yes, some patients have a depression  where the rib was removed so that the microvascular anastomosis can be performed This area can sometime be fat grafted to camouflage.

Diep flap done 4 months ago. Rib cartilage removed on left side and I look like a mess. Can this be fixed? (photos)

Answers (4)

Answer: Diep flap issue

Answer: Diep flap issue

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Diep flap done 4 months ago. Rib cartilage removed on left side and I look like a mess. Can this be fixed? (photos)

Answers (4)

Answer: Diep flap issue

Answer: Diep flap issue

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Recommended reading

Everything you need to know about Breast Reconstruction

Our mission is to create a world where every investment in modern beauty is Worth It.