In 2000, I had a lumpectomy, chemo and radiatioon for cancer in my left breast. In 2002, I underwent another lumpectomy to remove suspicious tissue, which was determined to be fat necrosis. After that surgery, I have experienced even more problems with some breast deformity, hard painful tissue, and most importantly, interference with diagnostic tests. Although getting clear answers was very difficult at times, all of these problems were attributed to fat necrosis.In February 2009, I had this hard area in my breast removed and had DIEP reconstruction. Although I have been concerned about the cosmetic result, the graft was successful for the most part and my doctor assures me that some revision will create the desired appearance. However, I have been developing a new, painful, hard lump near the armpit. My surgeon has scheduled surgery to remove this as well as to complete the breast reconstruction/cosmetic revisions. I am concerned that the prior radiation has created a problem with healing that will continue; that the new incision will also develop problems.Is there anything I can do to maximize the success of the sugery?
Answers (4)
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A DIEP flap stands for Deep Inferior Epigastric Perforator flap. It is an evolution in technique from a traditional free TRAM flap. The main difference is the goal of sparing the muscle from the abdomen to decrease the likelihood of bulging or hernia in the abdomen after the procedure.
DIEP...
The good thing about DIEP flap is the preservation of all the abdominal muscles and fascia when compared to a TRAM flap, which makes abdominal hernias less likely. Usually we do not need a fascial tightening during a regular DIEP surgery. But if you had had a rectus diastasis and it was repaired...
Issues with the abdominal donor site in the DIEP procedure are typically more likely in higher BMI patients. Although there may be a chance for an abdominal bulge or protrusion in a low BMI individual, it is not likely.
