How many revisions are recommended with DIEP flap reconstruction?

Question

Looking to do bilateral prophylactic mastectomy; diep flap recon with Nipple sparing. How many revisions do most people have? I heard that one revision is a given. I may need fat grafting to bring me up to my pre-surgery size. I have heard that most get tired of having surgery and give up with perhaps results that are less than ideal. I want a great outcome but also don't want multiple surgeries every year.

Jonathan Saunders, MD · Answer

i believe the key word in your question is ideal. if you are using the word ideal as a synonym for perfect , then people may give up. the usual patient gets a reasonable result with greater than half wanting a touchup surgery of some type

Mark A. Schusterman, MD, FACS · Answer

Usually for my patients I try to perform the reconstruction so they have no revisions.  But it is common to require one or two revisions including fat transfer to get a perfect result.

Steven Wallach, MD · Answer

Hopefully, after the DIEP flap, all you  might need is a nipple reconstruction if the nipple was removed.  If it is done for prophylaxis, then the nipple is kept on. Some patients need revision to add fat grafts like you mentioned or reposition the flap a bit if it has moved.  Or sometimes need a skin tightening procedure like a mastopexy.

How many revisions are recommended with DIEP flap reconstruction?

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How many revisions are recommended with DIEP flap reconstruction?

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