I need to get a second free flap reconstructive surgery because my first flap failed from thrombosis. What will my doc do next?

I'm 33, active, no other history of clots, no alcohol or drugs but I had a reconstructive free flap fail because of a clot. What will my surgeon likely do the 2nd time around? He wants me to do an angiogram at the new donor site. What else? Put me on a blood thinner before surgery? Just wondering what the general procedure is on a failed flap. He took from my left side 1st and will take from the right side this next time, but if I have another flap failure can he take from my left a 2nd time?

Doctor Answers 2

Breast reconstruction after a failed free flap

There are several options regarding free flap reconstruction for you.  If someone has had a thrombosis they will receive a hypercoaguable work up to evaluate all available possibilities.  There previous medical records will be reviewed.  The operative report will be very important to have at a consultation.  It can also be sent ahead of time for review.  After reviewing all of the information and examining you I can make some recommendations.

Three basic forms of breast reconstruction exist. You can use your own tissue, implants or a combination of the previous two techniques. Your own tissue can be used in the form of the DIEP flap, PAP flap, SGAP flap or fat grafting. Implants can be done in one stage or two stage. Two stage reconstructions are started by placing expanders at the time of mastectomy. Once they expanders are placed they are able to be inflated as determined by wound healing. The final time consists of combining any of the above techniques.

If you are interested in being seen in Austin please give us a call. I know this is a difficult time for you. The majority of my practice is devoted to reconstruction for women with breast cancer or who are BRCA+

Flap failure

There are several options for free flaps as well as myocutaneous flaps and I would discuss them with your surgeon. Generally patients are kept on thinners for a short time after surgery just to limit thrombosis

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 61 reviews

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