How much better would my breasts look after second DIEP surgery? Right now, they're not as expected.

Question

I was told in the pre opp appointments that a flesh disc is made and the scars will mimic a lollipop incision. When I woke and got a good look, there was a large panel on my Radiated breast(explained as a poss. but larger than expected), AND on my right (good)breast! Can the disc and scars be revised on the second surgery? Also can they be made smaller, if so, how...can a reduction be done on diep breasts? I am grateful for healthy breasts, but I feel like a monster

Christine Fisher, MD, FACS · Answer

Thanks for your question and I am sorry to hear you are not satisfied with the results of your first reconstruction procedure. The good news is there are many options in revision surgery of a DIEP flap that can address these concerns and improve your outcome. It is best to either work with the original surgeon that performed your reconstruction or to get a second opinion from another board-certified plastic surgeon with extensive experience in breast reconstruction, so you can weigh all your surgical choices. Good luck to you as you progress throughin your reconstruction process.

Daniel Barrett, MD · Answer

Dear winslow1,it is hard to tell for sure without an examination. I would suggest you to consult your plastic surgeon or ask for a second opinion. 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

Eric Wright, MD · Answer

From what I understand from the question, you have already had a mastectomy with DIEP flap reconstruction on the left side.  Pictures would be helpful to further give any thoughts on options. But yes, do not worry.  Revision breast reconstruction procedures following all types of flaps are very common. You can reduce DIEP flaps with direct surgical debunking, liposuction or a combination.  We even put implants beneath DIEP flaps to make them larger if needed.  You have lots of options that are best discussed after an office examination with a board certified plastic surgeon who specializes in breast reconstruction.  Good luck with your ongoing reconstruction.

Keith T. Paige, MD · Answer

Dear wingracie,
From your question, I would assume that you had previously had your mastectomies and then had bilateral DIEP flap reconstruction.  With delayed reconstruction having an exposed skin paddle is not uncommon.  It can be very difficult to wake up with a result different that what you were expecting.  Sometimes the exposed skin paddles can be modified and reduced with revisional surgery; however, in my experience to preserve a good overall shape they often cannot be removed.  I would recommend consulting with your plastic surgeon and try to be clear as to what is possible and what is not prior to pursuing revisional surgery.  Preconstruction using tissue expanders before DIEP flaps can sometimes avoid this problem.

How much better would my breasts look after second DIEP surgery? Right now, they're not as expected.

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