Is it possible to get a double mastectomy diep reconstruction and lipo at the same time?

Performing liposuction during the DIEP flap procedure is not standard or recommended. Both the DIEP flap procedure and liposuction increase your risk for blood clots, or venous thromboembolism (VTE). Performing them together would increase your risk too much. It is important to note that abdominal liposuction is a common adjunct procedure during a secondary operation in which fat is transferred from the abdomen, flanks, and thighs to the breast. The fat grafting procedure is utilized typically to fix contour abnormalities on the breast.

The most common reasons why liposuction is not combined with mastectomy and DIEP flap breast reconstruction are the following: 1. Time: Combined double mastectomy and immediate DIEP flap reconstruction time consuming and complex, often taking 5-8 hours to complete. Additional elective procedures may not be appropriate from a safety perspective.2. Fat as a resource: Flank liposuction and fat grafting is a common strategy for improving the results of DIEP flap breast reconstruction in the months following surgery. These procedures are generally covered by insurance.3. Cost: Elective liposuction for cosmetic reasons is NOT covered by most insurance plans. So patients typically have to pay out of pocket if and when liposuction is performed (except in the context of fat grafting, see above).

A double mastectomy and DIEP reconstruction is a long day in the operating room...anywhere from 7 to 12 hours, with a few days in the hospital afterwards. These operations go hand-in-hand, and there is a huge psychological benefit to waking up with your breast reconstruction completed.
I am assuming your are asking about liposuction for cosmetic purposes, perhaps to smooth out the transition from the abdominal based donor site to the flanks. I wouldn't advise this at the time of DIEP reconstruction for two reasons. First, there is a straight line relationship between time spent in the OR and risk for complications...and so minimizing your OR time in the setting of a big operation would be ideal. In addition, many women need fat grafting to the reconstructed breasts as a Stage II reconstructive procedure, and there would be no reason to throw that fat away at Stage I when it could be useful in Stage II.
In summary...it is technically possible to add liposuction during a DIEP, but I don't think it is in your best interest for either your reconstructive timeline/pathway, or for patient safety.
Best,Chris Pannucci MD Spokane WA