I Am 6 Weeks Post Single Diep-flap Surgery and Have Been Having Lower Back Pain. Is This Unusual?

In order to harvest tissue from the abdomen for use in breast reconstruction, the rectus abdominus ("6-pack") muscles must often be dissected. This allows the surgeon to follow the perforating blood vessels from the deep blood vessels (in this case, the Deep Inferior Epigastric artery) to the surface of the abdominal soft tissue. The rectus muscles, in conjunction with the erector spinae (lower back muscles), are crucial for providing stabilization of the torso. Based on the degree of perforator dissection, part of the rectus muscle can become paralyzed or devitalized (without blood flow). This can result in imbalanced forces on the torso, and soreness of the lower back can result. Once cleared by the surgeon for postoperative exercise, a physical therapy regimen can help to relieve muscle tension and strengthen the abdominal musculature.

I put all of my patients into physical therapy starting between 1-2 weeks after their surgery to hopefully avoid these issues.  There are excellent physical therapy protocols for DIEP patients.Three
basic forms of breast reconstruction exist. You can use your own tissue,
implants or a combination of the previous two techniques. Your own tissue can
be used in the form of the DIEP flap, PAP flap, SGAP flap or fat grafting.
Implants can be done in one stage or two stage. Two stage reconstructions are
started by placing expanders at the time of mastectomy. Once they expanders are
placed they are able to be inflated as determined by wound healing. The final
time consists of combining any of the above techniques.



If
you are interested in being seen in Austin please give us a call. I know
this is a difficult time for you. The majority of my practice is devoted
to reconstruction for women with breast cancer or who are BRCA+

This is something that is not uncommon after a tummy tuck or diep flap.   The abdomen is closed under some tension, which makes it difficult to stand upright.  This causes strain on the lower back muscles.    

This will generally resolve with time, but it is unusual to last 6 weeks, unless you had a previous back condition.  I wish you a safe recovery and please consult with your plastic surgeon.

Dr. Gill