Liposuction prior/post DIEP flap reconstruction - options?

Question

I had a unilateral mastectomy and am looking at DIEP flap surgery in about a year. Unfortunately, I have also put on weight and am now 13 stone. I was wondering the feasibility of having liposuction to my lower back and sides prior to this surgery and wondered: a) How long before hand would it need to be? b) If it could have any adverse effect on the DIEP flap? c) If further removal was required, how long would I need to wait after the reconstructive surgery? Many thanks

Alan Gonzalez, MD, FACS · Answer

Hello @Katelucca, thank you for your question. Ideally, the area from which the flap is to be taken, which needs to have good connections and vascularization, should not be touched for at least a year or 2 years. Preferably it should not have been touched because sometimes the vascularization is affected. If you want to remove fat from your back and the flap is going to be removed from your abdomen, it is recommended that you do it not less than 6 months to a year in advance. It will all depend on what the treating physician wants for the procedure and which method will be used to remove the fat. The less trauma the easier it is to have a good flap for breast reconstruction. It is important that you have a consultation with a board certified specialist to determine a surgical plan according to your needs. Best wishes! Alan Gonzalez MD, FACS.

Daniel Barrett, MD · Answer

Dear Katelucca,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

You can have liposuction to your back and flank areas, but do avoid treating the abdomen to save it for your breasts.  If it is done after your reconstruction, then wait at least 6-8 weeks.

Mats Hagstrom, MD (license on probation) · Answer

I would say any patient with the need for breast reconstruction should be conservative regarding getting any cosmetic surgical procedure of the torso in any area that may be needed for reconstruction. Plastic surgeons are taught to always have a back up plan and the back up plan if your DEAIP fails will most likely be a Litismus flap. If that’s the case you’ll want as much fat as possible over the muscle.
I suggest putting reconstruction first followed by cosmetic touchup as needed after the major operation.
If you have a plastic surgeon already for your reconstructive procedure then discuss your thoughts regarding cosmetic surgery with him or her first.
Personally I generally don’t spot treat the torso with Liposuction. I view the torso as a single anatomic unit and either treat the entire torso or don’t treated at all. there are of course exceptions like patients who had previous other surgical procedures but in general it’s better to leave the entire torso with a consistent even thin a fat distribution. this is definitely not something you should consider before the DEIP flap
Best,
Mats Hagstrom MD

Liposuction prior/post DIEP flap reconstruction - options?

Answers (4)

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