Is It Possible to Do a Diep Flap After a Mini Tummy Tuck?

The perforator flap option is effectively eliminated after a tummy tuck as the tissues supplied by the perforating vessels has been elevated and detached. Other options for breast reconstruction exist, including implant based options, more exotic free flaps like TUG flaps, and pedicled flap options like the latissimus flap.

In most instances the blood supply is compromised espeically if rectus repair is performed but duplex scan, MRA, or traditional angio will be best way to determine if it is possible.

Although previous tummy tuck or mini-tummy tuck surgery was previously considered a contraindication to DIEP flap surgery, it is no longer always the case. Tummy tuck surgery will disrupts some, but not necessarily all of the blood vessels which can be used for a DIEP flap. With preoperative blood vessel imaging, for example with an MRI, it is possible to figure out precisely whether or not a DIEP flap is possible. I have done DIEP flaps in patient who have previously had mini-abdominoplasty surgery, and have reported such cases in peer-reviewed medical journals. 

The following is an excerpt from the Journal of Reconstructive Microsurgery ("Anatomic Imaging of Abdominal Perforator Flaps without Ionizing Radiation: Seeing Is Believing with Magnetic Resonance Imaging Angiography"), published in 2010:

In select cases, the assurance of the presence of suitable perforator vessels may allow a patient with a history of abdominal surgery, which would have previ- ously been considered a contraindication, to undergo an abdominal perforator flap procedure.20 As a dramatic example, we present a patient imaged preoperatively with CTA. The patient had a history of central abdomi- nal liposuction and a miniabdominoplasty 18 years ago, but desired the abdomen as the donor site for breast reconstruction. Figure 5 demonstrates a single perforator identified at 4.6 cm inferior and 5.2 cm lateral to the umbilicus. A DIEP flap was planned and successfully transferred based upon this vessel. Traditionally, without preoperative imaging, this patient would never have been a candidate for DIEP flap breast reconstruction.