Poor cosmetic result of DIEP flap scar revision. How can it be corrected?

Thank you for your question. Unfortunately without a full series of photos, or perhaps even CT scan images to determine what may be taking place, it is difficult to offer treatment recommendations.  I would continue to voice your concerns with your surgeon so that they fully inform you of what is taking place and you can adequately research your treatment options.  If you are not finding the answers you want, certainly seek out second opinions from ASPS board certified plastic surgeons. 

I do a perform DIEP flap cases several times each month.  The closer of the abdomen is very  routine in our practice.    The incision in the fascia is closed a particular way and has a few situations that can develop.  One is a bulge in the abdomen.  I have had this happen in a small percentage of patients and had to repair it with mesh.  This maybe what your Plastic Surgeon is referring too in this instance.  

:) You really will need to post some pictures but I am disheartened that your surgeon is not able to give you a satisfactory explanation. It may be difficult but I would try and get an in person consultation with another plastic surgeon for a second opinion.  Nobody likes to fix another persons results, but they may help explain some things in a different manner so that you can decide if you want your primary surgeon to proceed with revision surgery or not.  Plastic surgery is more artful then any other discipline and you may be picking up on your primary surgeons discomfort with being able to give you the results you want or merely the fact that breast reconstruction is in effect "robbing peter to pay paul" and in this case, peter noticed.  Breast reconstruction is one of the most rewarding plastic surgeries to perform and I hope that you get resolution to your problems.