Skip to main content
DIEP flap breast reconstruction, highlighting benefits of natural tissue use and long-term advantages.

DIEP Flap vs. Implant Breast Reconstruction (Updated For 2024)

Written by Breast Reconstruction Associates on . Posted in Breast Implants, Breast Reconstruction, DIEP Flap Reconstruction. No Comments on DIEP Flap vs. Implant Breast Reconstruction (Updated For 2024)

Breast cancer patients now have a plethora of options when it comes to reconstructive surgery. Choosing the right type of breast reconstruction can be overwhelming but understanding the differences between the DIEP flap and implant breast reconstruction can help you make an informed decision.

What is DIEP Flap Reconstruction?

The Deep Inferior Epigastric Perforator (DIEP) flap is an advanced method of breast reconstruction that uses your abdominal tissue to replace the soft tissue and skin removed during a mastectomy. Unlike the TRAM flap procedure, the DIEP flap preserves all the muscles of the abdomen, resulting in a less invasive and more natural reconstruction.

Why Choose DIEP Flap Over Implants?

  • Natural Tissue Use

With DIEP flap reconstruction, the patient’s own skin and fat are utilized to replace the breast volume removed during the mastectomy. This eliminates the need for implants, providing a more natural look and feel.

  • Long-term Benefits

Implant reconstruction may lead to complications such as implant ruptures or capsular contracture (breast hardening), often requiring maintenance surgeries over time. In contrast, DIEP flap reconstruction tends to result in softer, more natural-feeling breasts that typically do not require further surgical interventions.

  • Sensory Nerve Reconstruction

One of the advancements in DIEP flap reconstruction is the potential for sensory nerve reconstruction, which aims to restore sensation to the transplanted tissue. While not performed routinely, it is available in select cases, and your surgeon can discuss its pros and cons to determine if it should be included in your reconstruction plan.

  • Pain Management

Post-operative pain is often a concern for patients considering DIEP flap reconstruction. Contrary to popular belief, our experience at Breast Reconstruction Associates shows that recovery and healing post-DIEP flap reconstruction are often easier than anticipated. We employ an effective post-operative pain protocol that usually manages pain without the need for narcotic pain medications.

What to Expect at Breast Reconstruction Associates

At Breast Reconstruction Associates, we pride ourselves on offering state-of-the-art breast reconstruction through individualized and compassionate care. Located in Fort Worth, Austin, Oklahoma City, Bozeman, our experienced team is dedicated to ensuring you receive the best possible treatment.

Many of our patients choose to go home after a one or two-night hospital stay, and they often find the recovery significantly easier than expected. We strive to make your experience as comfortable and seamless as possible, ensuring you feel supported every step of the way.

The DIEP flap is an excellent breast reconstruction option for women, providing a natural-looking and feeling breast after mastectomy while avoiding the use of implants. If you’re looking for the “gold standard” in breast reconstruction, look no further. For more information and to discuss your options, contact us at Breast Reconstruction Associates, your DIEP flap experts in Dallas Fort Worth, Texas.

Sources: BreastCancer.org

Feel free to reach out to us and take the first step toward a natural and confident you.

Patient considering breast reconstruction surgery with a checklist of important factors to discuss with a doctor.

Before Undergoing Breast Reconstruction Surgery, 10 Things to Consider

Written by Breast Reconstruction Associates on . Posted in Breast Cancer, Breast Reconstruction. No Comments on Before Undergoing Breast Reconstruction Surgery, 10 Things to Consider

Breast reconstruction surgery is a crucial step in the recovery process for many breast cancer survivors. But with the overwhelming amount of information available, it can feel like trying to drink from a fire hydrant. Here’s a concise checklist to help you make informed decisions about your treatment plan.

1. Research Thoroughly

When faced with a breast cancer diagnosis, it’s natural to want to expedite your treatment. However, taking the time to understand all your options is vital. Consult reputable sources and discuss your choices with your doctors to ensure you’re making well-informed decisions.

2. Talk to Your Doctor

While online support groups and patient forums can provide valuable support, every patient’s situation is unique. It’s essential to address questions specific to your care directly with your doctor for the most accurate and personalized information.

3. Make the Best Decision for You

Breast reconstruction is a highly personal decision influenced by various factors. Involve your spouse, family, or support system in consultations to help weigh your options. Ultimately, the decision must be best for YOU in your current situation.

4. Plan Ahead

Surgery requires a recovery period that varies depending on the type of work you need to resume. Discuss the expected recovery time and post-op restrictions with your surgeon to adequately plan with your support system and employer.

5. Choose Your Breast Size

Your pre-operative body habitus will influence the size of your breast reconstruction. During your consultation, your surgeon will discuss your ideal breast size and show you photos of patients with similar body types to help set realistic expectations.

6. Know Your Timeline

At Breast Reconstruction Associates, our goal is to complete your reconstruction in as few surgeries as possible. Ask your surgeon how many surgeries they anticipate and the timing of each one. This timeline may need adjustment to prioritize your cancer treatment.

7. Understand Your Post-Surgery Appearance

Looking at photos of other patients who have undergone the surgery can alleviate fears. At Breast Reconstruction Associates, we review photos with patients to provide an accurate visual of what to expect regarding scar patterns and overall appearance.

8. Ask Questions

Don’t hesitate to ask any questions you have. Make a list of all your concerns and go through them with your doctor to ensure you have clarity and peace of mind.

9. Consider Your Nipples

Some patients may have the option of keeping their nipples through a nipple-sparing mastectomy, depending on the tumor’s location and nipple position. If not, options like nipple reconstruction or 3D nipple areola tattoos can complete your reconstruction.

10. Understand the Goal of Reconstruction

Discuss realistic expectations with your plastic surgeon and understand the difference between reconstructive and cosmetic surgery. The goal is to restore what cancer took away, allowing you to fit clothing evenly without needing a prosthesis. It’s a life-changing experience that requires time and perspective to accept and love your new reconstructed self.

Conclusion

Take the necessary time to research and understand your options before moving forward with breast reconstruction surgery. For more information, visit Breast Reconstruction Associates.

Smiling woman with curly hair having a conversation during a consultation, seated indoors with a clipboard visible in the foreground.

Answers to Your Breast Reconstruction Questions

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction. No Comments on Answers to Your Breast Reconstruction Questions

Undergoing breast reconstruction surgery can be a daunting experience, filled with uncertainty and anxiety. Even if you think you’re well-prepared, it’s natural to have questions. At Breast Reconstruction Associates, we’ve been caring for patients like you since 2014. We aim to make you feel comfortable and well-informed about what autologous breast reconstruction can offer. Below are some of the most common questions we receive to help you better understand your decision to undergo breast reconstruction.

What to Expect After Breast Reconstruction Surgery

How Much Pain Can I Expect After Surgery?

Most patients experience a very manageable level of post-operative pain. Our pain management regimen, aligned with the Enhanced Recovery After Surgery (ERAS) protocol, has proven to be remarkably effective. Most patients can carry out their regular activities and sleep with mild to moderate discomfort. Generally, patients stop needing regular pain medication after about two weeks.

What Will My Breast Size Be?

During the initial reconstruction surgery, the width and height of the flap can be controlled to create the breast. The depth, or projection, of the flap largely depends on the abdominal tissue’s depth. Your surgeon should be able to estimate how close to your current breast size you will be during your consultation. Adjustments to size and shape can be made after the initial reconstruction if needed.

Will I Have Drains After Surgery?

You can expect to have a drain in each operated breast and 1-2 drains in your abdomen. Typically, patients go home with all drains in place. While inpatient, your nurse will educate you on emptying, recording drainage, and general care of your drains before you go home. Once at home, our team is available to address any questions or concerns. Most patients have their drains removed 1-2 weeks after surgery.

What Kind of Bra Should I Wear After Surgery?

You will be given a hospital-issued post-surgical bra after surgery, eliminating the need to purchase one beforehand. After surgery, you may be fitted for a compression bra in our office for proper sizing and comfort.

When Can I Start Exercising Again?

After surgery, we ask that you limit your activities to light walking, avoiding core muscle use, and lifting weights less than 10 pounds. Once you reach four weeks post-op, you may start cardio activities such as using a stationary bike or elliptical machine. After this point, consult your surgeon to guide you on how and when to resume more strenuous activities. Generally, most patients are free of restrictions and may use their core muscles again 12 weeks after surgery.

Additional Resources and Support

Have more questions? Make a list! We are happy to be your resource for breast reconstruction information. Contact one of our offices in Fort Worth, Austin, Oklahoma City, Bozeman for more information or to schedule a consultation.

Keywords

  • Breast Reconstruction FAQs
  • Post-Surgical Recovery
  • Surgical Pain Management

Feel empowered to make informed decisions about your breast reconstruction surgery. We’re here to support you every step of the way.

When Should You See A Breast Reconstruction Surgeon? | DIEP Flap TX

When Should You See A Breast Reconstruction Surgeon?

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction.

The timing of breast reconstruction is often determined by the stage of cancer and the oncologic treatment recommendations. However, in general, we refer to the timing as immediate or delayed.

Immediate breast reconstruction

Refers to reconstruction occurring at the same time as the mastectomy. There is a two-fold benefit of immediate reconstruction. The first, it provides a breast mound and avoids a flat chest wall. The second, the skin envelope can be utilized via a skin-sparing mastectomy, thus allowing for a potentially better aesthetic outcome.

Delayed breast reconstruction

Refers to reconstruction that is performed at another time following the mastectomy. A mastectomy without reconstruction is frequently performed when a woman has advanced cancer, requires radiation therapy, or has multiple medical comorbidities.

In general, it is best to see a breast reconstruction surgeon soon after your diagnosis. Many factors contribute to the timing of reconstruction, and involving the plastic surgeon early in this decision making will help to provide the best outcome. This is true regardless of your type of cancer or expected treatments.

Lastly, if you have already had a mastectomy and have completed the recommended adjuvant treatments, you are still a candidate for reconstruction. We are happy to assist you with your reconstructive needs at any point along your journey. If you would like to get in touch with a plastic surgeon regarding the best timing for your reconstructive breast surgery, please contact us in Fort Worth, Austin, Oklahoma City, or Bozeman.

How Do You Make a Nipple?

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction.

Nipple reconstruction is usually a part of the final stage of breast reconstruction. A nipple reconstruction can be done as an office procedure, but sometimes is incorporated with revision of the reconstruction in the operating room. In our practice we perform the nipple reconstruction, and then tattooing of the areola as a separate procedure.

In simple terms, the nipple is made from elevating skin and folding it in a way that leaves a ‘nub’ of skin that looks like a nipple. In medical terms we refer to the skin elevation as “elevating a flap”, and the flaps described for nipple reconstruction are numerous. We may use a different flap design based on the needed size, width, or projection – either to match the other side (for one–sided reconstruction) or based on the patient’s goals (for two–sided reconstruction). Importantly, though the final product may strongly resemble an actual nipple, the reconstructed nipple does not have sensation or ability to change with temperature changes, and lacks erogenous sensation.

You can also watch the following 9 min video to see the specific steps involved in a nipple reconstruction done in the office.

Oncoplastics Breast Surgery | Breast Reconstruction Associates

Oncoplastic Breast Surgery: What Is It? Am I a Candidate?

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction, Womens Health.

Oncoplastic breast surgery is a surgical approach that integrates breast cancer surgery with plastic surgery techniques. Historically, breast conservation therapy, or the combination of a lumpectomy and radiation therapy, was performed to preserve a portion of the breast and still offer patients equivalent survival rates as a mastectomy. However, a traditional lumpectomy often leads to deformity of the breast; this is why combining lumpectomy with a plastic surgery technique has potential benefit for patients. The goal of oncoplastic breast surgery is to improve aesthetic outcomes without compromising the resection and treatment of breast cancer.

In general, ideal candidates for breast conservation are those who have a small tumor relative to total breast size. Oncoplastic breast surgery can be integrated with any lumpectomy procedure, but patients with large breasts or breasts with a fair degree of ptosis (or “droop”) are the optimal candidates. In these cases, the tumor can be safely removed using standard breast reduction or breast lift techniques while also improving the overall appearance of the breast. A balancing breast lift or reduction of the other breast is typically performed simultaneously for symmetry purposes.

Oncoplastic breast surgery can also be a good strategy for women who are wanting mastectomies and reconstruction but also would require post-mastectomy radiation (usually for an advanced cancer or cancer in the lymph nodes). In order to prevent radiating a total breast reconstruction, oncoplastic surgery is followed by radiation. Completion mastectomies and total breast reconstruction can then be performed at a later time after the patient has recovered from radiation therapy.

The Advantages of Having a Mastectomy | Breast Reconstruction Associates | Dallas Forth Worth

The Advantages of Having a Mastectomy

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction.

Breast cancer is one of the most common types of cancer among American women — nearly one in eight women develop it in the course of their lifetime. Treatment of breast cancer involves a multidisciplinary approach and therapies are selected based on biology, size, and location of the tumor. In most cases, surgical intervention is recommended, and patients are faced with the decision to undergo lumpectomy followed by radiation (known as breast conservation therapy) or mastectomy.

A mastectomy is the complete surgical removal of breast tissue. This surgical approach is appropriate for patients with breast cancer that does not meet the criteria for breast conservation therapy, patients who prefer mastectomy over BCT, or for prevention of breast cancer in high risk patients.

Historically, mastectomies included the removal of the overlying breast skin. Strategies to preserve the breast skin have now been developed that have significantly improved the cosmetic outcome of immediate breast reconstruction following a mastectomy. Patients who have a mastectomy followed by breast reconstruction can now have equivalent or superior cosmetic outcomes compared to breast conservation therapy.

There are other advantages of having a mastectomy over breast conservation. By choosing a mastectomy, patients have the potential to avoid the need for radiation therapy. This allows women to forgo the skin changes and other effects caused by radiation. Patients also no longer require regular mammograms following a mastectomy. And lastly, while research has demonstrated equivalent survival outcomes between mastectomy and breast conservation therapy, the risk of local recurrence is lower in patients who undergo mastectomy.

The decision to choose a mastectomy over other surgical treatment approaches is difficult and includes many variables. To determine the best plan for you, talk to your breast surgeon in Fort Worth.

Breast Reconstruction Associates – North Austin Area

Breast Reconstruction Associates – Austin TX

Preparing for Diep Flap Breast Reconstruction | Breast Reconstruction Associates

Preparing for DIEP Flap Breast Reconstruction

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction, DIEP Flap Reconstruction.

Patients who have opted for mastectomy with DIEP flap reconstruction often ask what they can do to best prepare for the recovery process. The amount of time between deciding on the right surgery for you and the surgery date varies from patient to patient. Some patients have only a few weeks between their diagnosis and surgery; others have months to years depending on other treatments or life circumstances. In either situation, the following recommendations apply.  

1. Maintain a healthy diet

Eating a balanced diet of protein, healthy fats, fruits and vegetables will help you get the proper macronutritents, vitamins and minerals needed for healing and recovery after surgery. Try to minimize your intake of sugar, foods with added sugar, or highly processed foods. These foods can be pro-inflammatory and are unlikely to be nutrient-rich sources of food. Most patients do not need any type of supplements prior to surgery

2. Optimize cardiovascular status

Exercise in the form of aerobic activities (i.e. walking, jogging, biking, etc.) strengthens your cardiopulmonary system to better tolerate surgery and anesthesia, helps control blood pressure, and contributes to a faster post-operative recovery. Some patients have high blood pressure, coronary artery disease or other cardiac issues. It’s important to optimize the management of these issues with your cardiologist prior to surgery. If you have a history of heart problems or are not currently physically active, check with your doctor before beginning exercise routines.

3. Minimize risk factors of surgical complications

Many patient factors that contribute to surgical complications, such as poor wound healing and infection, are modifiable. If you are an active smoker, the best thing you can do for your recovery would be to completely eliminate nicotine use. If you are overweight or have diabetes, it’s also extremely beneficial to lose weight and/or control your blood sugar as much as possible prior to surgery. Talk to your doctor about strategies to reduce risk factors of surgical complications before surgery.

4. Mental preparation

Undergoing breast reconstruction surgery can be stressful mentally and emotionally, especially if you are also processing a new breast cancer or gene mutation diagnosis. Having emotional and spiritual support systems in place in the form of family and friends is also important. You may also find it helpful to have some personal coping mechanisms in place prior to surgery such as journaling, meditation, support groups or prayer. Lastly, it’s important for you to have a positive relationship with your surgeon. Open communication about the surgery, recovery and expectations will help you feel comfortable and confident with your decision to undergo breast reconstruction surgery.

Nipple Reconstruction and 3D Nipple Tattoos | Breast Reconstruction Associates

Nipple Reconstruction and 3D Nipple Tattoos

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction, DIEP Flap Reconstruction.

Breast reconstruction surgery is designed to restore the volume and shape of the breast after mastectomy. Some women may be candidates for nipple-sparing mastectomy but in many cases, this part of the breast must be removed. To complete the reconstruction and restore the aesthetic unit of the nipple and areola, women have the option to choose from 3D nipple and areola tattoos vs nipple reconstruction followed by tattooing of the areola pigment.

3D nipple and areola tattoos are done by a professional tattoo artist that specializes in this trade. ‘Before’ photos are reviewed, and careful consideration is given to the color selection, size and placement of the nipple and areola. The pigment is then applied in the form of a tattoo with additional shading techniques to create the appearance of a 3D nipple. This means that in the mirror, the visual aesthetic unit of a nipple is present, but to the touch, the breast is smooth and flat.

Nipple reconstruction followed by NAC tattoos involves a minor procedure of nipple reconstruction that can be done at the time of breast reconstruction, in combination with a second stage revision, or alone as an office procedure. The procedure involves cutting and suturing a small amount of skin into the shape of a nipple with proper placement and symmetry on the breast mound. After this reconstructed nipple has healed, tattoo pigment can be applied to restore the color and shape of the areola. This results in restoration of the visual aesthetic unit of the nipple and areola, as well as the physical projection of a nipple. It is important to note that a nipple reconstruction does not have sensation and will always remain erect.

These procedures are not mandatory but encouraged to achieve the most optimal and the most natural aesthetic result. If you have questions, please consult your breast reconstruction experts of Austin, North Texas and Oklahoma at Breast Reconstruction Associates. You may also find it helpful to review some of our before and after photos. The surgery and completion details are indicated for each photo.

Pain After Breast Reconstruction | Breast Reconstruction Associates

Pain After Breast Reconstruction

Written by Breast Reconstruction Associates on . Posted in Breast Reconstruction, Womens Health.

Most surgical interventions come with some degree of postoperative pain or discomfort. This can be a source of fear and anxiety for many patients facing mastectomy and breast reconstruction surgery. At Breast Reconstruction Associates, we use a specific pain control protocol that has proven efficacy, and we work together with patients to achieve the optimal degree of pain control. Most of our patients have been pleasantly surprised that their pain was less than expected. Here is some insight into the way we approach pain control.

While it is not feasible to guarantee a pain score of 0/10, even with adequate pain medications, we are committed to helping you remain as comfortable as is safely possible after surgery. Our goals are to reduce your discomfort to a degree that is tolerable so regular activities of daily living can be performed, to avoid over-sedation, and to avoid adverse medication side effects.

There are many different types of pain that are experienced after mastectomy and breast reconstruction—general post-operative pain of incision sites, neuropathy (nerve-related pain) and musculoskeletal pain. In our pain control protocol, we prescribe medications that target each type of pain to yield better overall pain control.

The post-operative pain medication regimen used at Breast Reconstruction Associates is aligned with the ERAS (Enhanced Recovery After Surgery) protocol.  This protocol was developed to be a perioperative strategy that promotes quicker recovery after surgery and helps patients avoid opioid-based pain medications. The medication regimen associated with this protocol is supported by evidence-based research and is used worldwide.  Our practice takes a patient-centered approach to the use of this regimen and we have had great success with our patients’ post-operative recovery.

Our patients are our priority. Your post-operative comfort and care are important to us. If you are considering DIEP flap breast reconstruction and have questions about post-operative pain, reach out to our plastic surgeons at Breast Reconstruction Associates.