Can a DIEP result in protrusion on someone with 18 BMI?

Question

Height 5'2''; Weight 101; I am worried I may not end up with a flat abdomen after DIEP since an abdominal protrusion may be more visible when there is very limited fat in the abdomen. can irregularities end up being more pronounced? small breast pocket to fill, around 80ml

Ryan Rebowe, MD · Answer

Issues with the abdominal donor site in the DIEP procedure are typically more likely in higher BMI patients. Although there may be a chance for an abdominal bulge or protrusion in a low BMI individual, it is not likely.

Derek Fletcher, MD · Answer

It would be very helpful to see pictures of your breasts and abdomen. However, I try to prevent abdominal bulging by reconstructing the rectus abdominis muscle fascia with mesh and by performing a rectus plication above the belly button. Ask your surgeon how they plan to manage your abdomen to get clarification.

Christopher Pannucci, MD, MS · Answer

Hi dafnie,
Your surgeon should meet with you in advance to discuss not only the reconstructed breast, but also the (abdominal) donor site.
DIEP surgery makes an incision in the abdominal wall fascia--the strong layer over the 6 pack muscle. In DIEP, the muscle is all left behind, whereas in ms-TRAM, some muscle is removed. In addition, during blood vessel dissection, some of the nerves which come in from lateral (toward the side) may be divided, stretched, or cut. 
On the way out, the abdominal wall fascia is closed, with or without mesh per surgeon discretion. My partners and I generally plicate/tighten the upper abdomen (above the belly button), but not everyone does.
There are lots of important considerations for core strength and contour after DIEP. I'd suggest talking with your surgeon in advance about your post-op abdomen contour.
 Hope this helps.
Best,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

Can a DIEP result in protrusion on someone with 18 BMI?

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