After deip flap, can the pubic area become puffy?

Hello!
Yes. This is very common after DIEP flap, gravity will bring swelling down as well. Swelling can last for up to six months after DIEP flap and will take time to dissipate. Check with your surgeon if they’ll allow you to wear some abdominal compression to help with the swelling.

Hi Rose1976--
Yes, swelling in the pubic region after a DIEP can be very normal. In general, the most swelling happens above the incision, where fluid accumulates because it can't drain through the scar line initially. However, if you had an SIEA flap, or if the superficial vein was dissected, some of the local drainage pathways from the mons/pubic area can be disrupted and swelling can result. At three weeks, swelling can be completely normal--expect that it will resolve on its own over time.
Best,Chris Pannucci MDPlastic Surgery NorthwestSpokane, WA

Yes it can happen after a bilateral DIEP flap.  As the swelling resolved after surgery this will improve.  Lymphatic massage helps improve this more quickly.

Fullness in the pubic area after DIEP flap can occur for two reasons:

The removed tissue has altered the way blood and fluids move in and out of the tissue causing congestion-  a fluid "traffic jam" where the old main roads are now closed. New pathways will form for fluid distribution, but it may take time. If you notice the swelling is worse when you've been standing all day and better when you wake up after lying down all night, this is most likely the case. The tissue above the pubis in the lower abdomen that was probably sticking out somewhat and is gone now contrasts with the fullness in the pubic area. It's possible that this has not changed, but is now more prominent looking when compared to the new flatness of the tummy area.