Can tummy tissue be used for breast reconstruction if I had liposuction 13 years ago?

Question

Due to breast cancer I had a lumpectomy and radiation on right breast in 2009. Now I got breast cancer on my left breast. I will be having a bilateral mastectomy next month. Can my tummy tissue be used for reconstruction if I had liposuction in 2005?

Gary M. Horndeski, MD · Answer

At the time of breast
reconstruction, volume is required to reconstruct the breast.  You may have very little volume left because
it has been aspirated at liposuction making it more difficult to obtain the volume
required.  Since you are having bilateral
mastectomies you will need bilateral reconstruction, so each breast will have
to be reconstructed from each half of the abdomen.  Your volume may be compromised and you may
not obtain as big of breasts as you desire. 
Alternative solutions are fat transfer or a different donor site.  It would be good to have photographs of your
breasts and abdomen to provide a more accurate assessment.    Best Wishes,Gary Horndeski, M.D.

Christine Fisher, MD, FACS · Answer

Hello and thank you for your question. Breast reconstruction using abdominal tissue, known as a DIEP flap, is an excellent way to create a natural breast mound without the need for implants. Previous liposuction is not necessarily a contraindication for using tissue in this area, but you should be assessed via a CT scan to ensure this procedure would be safe for you. If there is not sufficient tissue in the abdomen, there are other areas where tissue can be removed and transferred into the breast for reconstruction. For example, you could consider a PAP flap for breast reconstruction instead, where the donor site would be the gluteal fold. Consult with a board-certified plastic surgeon that specializes in breast reconstruction using flap procedures to ensure the best possible outcome for you. Good luck on a safe and successful mastectomy and reconstruction process.

David Light, MD · Answer

A DIEP flap can be performed following liposuction if enough fat is still present under your abdominal skin in order to reconstruct a breast to your satisfaction. It is also very common to order either a CT angiogram or MR angiogram prior to surgery to evaluate the perforators going to the DIEP flap and ensure that they weren't damaged during your liposuction procedure. It would also be helpful to know what type of liposuction was performed. Traditional liposuction causes less scarring under the skin than energy based liposuction, such as ultrasound or laser assisted liposuction.

Rahul Vemula, MD · Answer

Hello. Thank you very much for your question. YES! Tummy tissue can be used for breast reconstruction after liposuction. In my patients that have had liposuction, I ALWAYS get imaging such as a CT Angiogram of the abdomen to look at the vessels to see if they are in tact to perform a DIEP Flap. 
In the worst case scenario, if the perforating vessels have been damaged, one can still get a procedure known as a TRAM Flap. Or tissue can be taken from the thighs to perform a breast reconstruction using a TUG flap or PAP flap.

Please consult with a plastic surgeon board certified by the American Board of Plastic Surgery who is experienced in microsurgical breast reconstruction to learn about all of your options. 
Best wishes! 
Rahul Vemula, MD 
Double Board Certified Plastic and Reconstructive Surgeon

Anh Lee, MD, FACS · Answer

Having liposuction does not exclude you from using your abdominal tissues for breast reconstruction.  I have performed the DIEP flaps on many  patients who have had prior liposuction.  Make sure you see a PS who specializes in this procedure.

Noël Blythe Natoli, MD, FACS · Answer

You absolutely can have your own tissue used.  As a result of having the prior surgery it's safest to have a CT scan prior to surgery that acts as a road map to make sure none of the blood vessels were disrupted.  This had been well studied and is a very safe method of breast recon after liposuction.  We do this very often and very safely.

Robert Whitfield, MD · Answer

Yes you can use your tummy tissue.  I have done over 1000 cases like yours using the tummy tissue.  The fact that you had liposuction should not be an issue.  A Cat Scan of the abdomen to look at the blood vessels will demonstrate this.  I have more information and videos so I will provide a link to help.

Can tummy tissue be used for breast reconstruction if I had liposuction 13 years ago?

Answers (7)

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