I had double mastectomy with immediate DIEP flap procedure on May 20, 2016. (Photo)

I have great results except for the left still feels like a foam pillow (leaving indentions after wearing a bra all day or laying on it a certain way) and seems a bit swollen still. I massage it frequently and it seems to help. So my questions are, do some surgeons do the areola tattoo before the reconstruction and do my results look good after 3 months? Should I be concerned about the swollen one ?

Doctor Answers 4

DIEP flap reconstruction

Your flap reconstruction looks very good.  Everyone varies side to side.  Is the swelling in the chest/mastectomy skin or the flap.  I refer my patients for lymphatic drainage massage to help in these cases.

DIEP 3 months

Your results look excellent for three months and you should be very pleased with your reconstructive surgeon. Believe it or not, you are still in the healing phase and these big reconstructive procedures can take many months to heal fully. Scars and wounds can heal for a year or more after surgery. The swelling is an indication of healing. My question for you is whether you have received radiation on the left side after surgery or perhaps before with a lumpectomy as radiation can prolong the healing process and the swelling takes much longer to resolve in those cases. 

As for the Nipple reconstruction and tattooing, the timing depends on the technique your surgeon uses for the reconstruction. Most will tattoo at the end once the reconstruction has healed and the swelling resolved. 

Jeffrey Michael Feiner, MD
Orlando Plastic Surgeon

Post-op swelling

Hi, Firstly, yes your results look good!3 months is still too early to judge the final results of what your breasts will be like. We usually think it is safe to say after approximately 6 months, you will have the best idea of your results. Swelling can be present after 3 months, but if it is leaving indentations then that sounds like there may be some edema present in that breast, and I would advise that you have a doctor look at it. It could be what is known as a seroma which can occur post operatively. In my experience I have never known a surgeon to do the areola tattoo before the reconstruction because it is not always predictable exactly how the breast will turn out, as there could be unforeseen events during surgery etc, therefore I think that most surgeons will tattoo after reconstruction and wait a few months for things to settle before committing to the tattoo.

Ben Brown, MD
Pensacola Plastic Surgeon
5.0 out of 5 stars 61 reviews


Your results look great for 3 month.  Areola tattooing is usually the last thing to be done.  The swelling will get better with time. You should get a great final result.  Congratulations!

Jules Walters, MD
New Orleans Plastic Surgeon
5.0 out of 5 stars 50 reviews

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