The questions below are answered by Charleston breast surgeons, Dr. Richard Kline and Dr. James Craigie of The Center for Natural Breast Reconstruction.
How long does a DIEP flap breast reconstruction last?
Reconstruction of one breast with a DIEP usually takes 4 – 6 hours, and reconstruction of both breasts usually takes 6 – 8 hours. The individual patient’s anatomy accounts for most of the variability. The surgery is usually followed by a 4-day stay in the hospital. Just in case you meant “last” as in will you have to have it redone like with implant reconstruction, the answer is: a successful DIEP breast reconstruction is designed to “last” a lifetime. You may desire aesthetic improvements over time as your reconstructed breasts will behave much like your natural breasts.
Will I have to have another surgery at a future date for maintenance?
Probably not for “maintenance,” but most patients require at least 2 surgeries total (sometimes more) to complete their reconstruction. The second stage of the reconstruction is typically performed 3 months or more after the first stage, taking 2 – 4 hours, and is usually an outpatient procedure. Common things done during the second stage include reshaping the breast mounds, improving the shape of the donor site (tummy or buttocks), and often making new nipples.
For an avid athlete, softball and running, what breast reconstruction do you recommend as the least limiting to continuing sports activities?
All methods have their potential downsides.
Reconstruction with an implant requires elevating the pectoralis major muscle to put the implant under it, as the skin alone is usually not strong enough to hold the implant. While this is usually well-tolerated, it could potentially affect the function of the muscle.
Flap reconstruction using the body’s own tissue usually involves taking extra fat from the abdomen (DIEP flap) or buttocks (GAP flap). No muscle is removed in either case, but it is still possible for muscle function to be affected. While there is room for debate in this area, my feeling is that some disruption of the buttock muscle is probably better tolerated than disruption of the abdominal muscle (rectus abdominus).
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