Ask the Doctor: Phase 2 & 3 DIEP Procedure

diep flapQuestion: Hello! I’m currently seeking a surgeon for phase 2 DIEP. My plastic surgeon
here did a great job for phase 1, but doesn’t seem interested in correcting what I think is
a problem for phase 2. My breast size is currently a DD and I do not like the size. They
are heavy and my back hurts by the end of the day. I’m seeking a C cup. Also, my
abdomen is hard and bloated from underneath the breasts to just below my bellybutton.
This hardness makes it difficult to breathe. Is this something you have seen, and
something you could fix?

Answer: For one reason or another, we routinely work with patients who have had
phase 1 DIEP elsewhere, but end up coming to us for the “finishing” work. Of course,
we are delighted to help, no matter who has operated on you, and no matter what
condition you are in. Breast size certainly can be reduced; symmetry often can be
improved; and the donor site usually can be optimized. It is important to remember that
to obtain the optimal result, several procedures are commonly necessary. Typically,
each subsequent procedure decreases in length and complexity as the process
progresses. An average stage 2 scenario would include open revisions of the breast
mounds and donor site, and stage 3 would involve free-fat grafting to further refine the
shape of the breast mounds and lower body. While the initial flap transfer is obviously
the “big procedure,” we believe that the subsequent procedures are absolutely essential
to getting the results most patients to feel confident and pain-free.

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