Healty | Are you lot a DIEP Flap candidate?

The DIEP flap physical care for has apace buy the farm the "gold standard" inwards pectus reconstruction today. While non every adult woman is a candidate for DIEP flap surgery, many are turned away when inwards fact they needn't be. The most mutual areas of confusion include:


1) Previous Abdominal Surgery

While to a greater extent than or less types of previous abdominal surgical physical care for tin brand the DIEP flap physical care for impossible to perform, most of the fourth dimension previous abdominal surgical physical care for actually isn't an issue.

Many women these days bring had a previous c-section or hysterectomy. It is possible for these procedures to drive impairment to the blood vessels needed for DIEP flap surgery, simply this is rare. Influenza A virus subtype H5N1 previous c-section, hysterectomy, or tubal ligation is non a contra-indication to having the procedure.

If your surgeon is worried well-nigh potential impairment from previous surgical physical care for in addition to thence for sure tests tin live performed to examine the anatomy to a greater extent than closely. This tin include a elementary doppler ultrasound assay inwards the component subdivision or a to a greater extent than involved assay similar a CT angiogram.

So which previous surgeries DO drive a problem? Women that bring had a previous TRAM flap, tummy tuck or really extensive abdominal wall surgeries (like complex repairs of huge hernias) cannot bring a DIEP or SIEA flap reconstruction because the lower stomach tissue that is needed has already been removed, disconnected or moved around.

While previous abdominal surgeries may non forbid DIEP flap reconstruction, women that bring had multiple previous abdominal procedures are at increased guide chances of abdominal complications similar bulging in addition to fifty-fifty hernia afterwards DIEP flap surgical physical care for when compared to women that bring never had prior abdominal surgery.


2) An Umbilical Hernia

It is really unlikely that an umbilical hernia would forbid DIEP flap surgery. Most umbilical hernias are small. Influenza A virus subtype H5N1 really large umbilical hernia tin brand the surgical physical care for harder simply fifty-fifty this is non commonly a contra-indication to having the procedure.


3) Previous Chest Radiation

One of the most of import things for the reconstructive surgeon to arrive at is to supervene upon the damaged, theatre irradiated tissue alongside normal, healthy, soft tissue. If the irradiated tissue is non good for yous plenty to live used equally component subdivision of the reconstruction (as is the instance inwards many instances), it volition live removed in addition to replaced yesteryear the good for yous (DIEP) tissue.

I bring visited alongside a fair number of patients who bring previously been told they are non candidates for DIEP flap reconstruction because they received pectus radiations afterwards their mastectomy. I do not portion this opinion.

Most of the fourth dimension this advice seems to stalk from fearfulness that the radiations may bring caused impairment to the internal mammary vessels inwards the chest. These are the blood vessels that are commonly used to connect the DIEP flap to the chest. In reality it is exceptionally rare for us to uncovering these blood vessels are damaged in addition to cannot live used.


4) Not the Right Amount of Tissue

You don't quest to live overweight to live a candidate for a DIEP flap. What matters is the distribution of the fat. We bring performed DIEP flaps on smaller breast, sparse women alongside a BMI (body volume index) of twenty (and fifty-fifty less) because the fatty that they did bring was "in all the correct places". Having said that, in that location is an upper boundary beyond which the risks of surgical physical care for outweigh the benefits - At PRMA nosotros laid an upper BMI boundary of twoscore equally nosotros bring institute that performing the physical care for on women alongside BMIs greater than this significantly increases the rates of complications (especially injure healing problems).



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Dr Chrysopoulo is a board certified plastic surgeon specializing inwards the latest pectus reconstruction techniques . He in addition to his partners are in-network for most the U.S. of A. insurance plans. Learn to a greater extent than well-nigh your breast reconstruction options in addition to connect alongside other pectus reconstruction patients here. You tin likewise follow Dr C on Twitter!

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