DIEP Flap Reconstruction Surgery After Capsular Contracture

The below question is answered by Dr.James Craigie of The Center for Natural Breast Reconstruction.

Does anybody have any idea what the difference is “surgically” when DIEP surgery involves removing an implant that has developed a capsular contracture? That is what my situation is. I’m wondering if the skin that has been stretched over the implant will be removed, or become part of the new flap?

Thirty percent of our patients have previous implant surgery that has failed. During the reconstruction we remove the implant, implant capsule and any Alloderm that may have been used.   We also must return the chest muscle to its natural position because the implant always goes under the muscle. Unfortunately the muscle may be permanently changed from implant surgery. The stretched skin over the implant is allowed to recover and usually not removed.  If the skin initially needed to be stretched by the implant/expander then that indicates breast skin has been removed during the mastectomies. Usually skin from the DIEP will be needed depending on previous radiation and size of the DIEP breast. If the remaining breast skin is thin, tight, too scarred or damaged by radiation we may need to remove more of it at another surgical stage.

-James Craigie

Center for Natural Breast Reconstruction

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