DIEPflap Breast Reconstruction: Aesthetic Questions to Ask Your Plastic Surgeon
DIEPflap breast reconstruction & aesthetic questions to ask your plastic surgeon involves more than you may or may not have given much thought to. You have had a mastectomy due to breast cancer. You have tested positive for the BRCA gene and are facing the decision to have a prophylactic bilateral mastectomy to significantly decrease your chances of getting breast cancer. Perhaps you are even going in for a consult to repair damage done at another practice and are looking for better results. Now you’re researching and thinking about breast reconstruction options. You found a board certified plastic surgeon with great skill and a high rate of success. The consult appointment has been set up. You write down as many questions as you can and hope beyond hope that you will be given the time to have all of them answered. Your main concern might be moving beyond the diagnosis or possibility of getting cancer if you are BRCA positive. It was for me.
The truth is that you simply won’t think of everything in that first visit. This is an important consult and I want to share with you points of discussion and what to ask your surgeon about the aesthetic outcomes of your surgery.
Honoring our Bodies
The aesthetic work alone done on your body during this intensive surgery is extensive and complex. Here is a list of questions that I hope will help in the discussion with your plastic surgeon if you’re having DIEP flap breast reconstruction. I will speak specifically to this procedure since it is what I had done and what I can reference through my own experience.
- How long will my abdominal scar be?
- How high up will the scar be on my “new, flat, tummy”? If I choose to wear a bikini will it show? Fair question!
- What will the scar look like after surgery; a year from surgery? A qualified plastic surgeon knows about the progression, makeup and life of scars. Ask! Scars heal differently for everyone depending on your skin color, elasticity, lifestyle, and in particular if you’re a smoker. If you’re seriously considering DIEP flap surgery, stop smoking now. It is a must for this surgery.
- What will the scars on my breast look like? Will they be straight? Curved? Thick? Thin? Where will you make the incisions?
- Where will they be placed? A plastic surgeon knows how to strategically hide those scars for wardrobes. Remember, a good plastic surgeon is a perfectionist and artist and has a keen eye for body contouring and outcomes for this surgery.
- Will the flaps become a bit smaller or closed up for phase 2?
- Will I need physical therapy to help heal the scars to avoid adhesion?
- Will the skin from my belly used to make the flap be the same color as my breast when it is transferred to make the new breast mound?
- How about that tummy hair? Will it be on my new breast flaps? If so, what can I do about it? Electrolysis or any other suggestions?
- I have some divots (areas that are sunken in on your chest after a mastectomy). Will these go away or look better after my reconstruction? This will depend on how much breast tissue you had removed and if you are a delayed or immediate reconstruction.
- What kind of stitches can I expect and will they be dis-solvable or not?
- What will my belly button look like? Can you explain to me the process of rebuilding my bellybutton?
- How long will my belly button take to heal and when can I see it?
- Will my pubic hair line be changed? Trust me… the pulling up and pulling down of the abdominal wall will change that line of pubic hair. It’s a fair question and the change is one that many women are surprised by after surgery! Your plastic surgeon has probably been asked questions that are this intimate and even more so.
- For those who have had a NSM (nipple sparing mastectomy): Will the color of my areola change after surgery?
- For those who did not have NSM: If I have my nipples rebuilt what will they look like? Will they have that “headlights on” look all the time? Again, I’ve spoken to others about this concern. It’s a fair question, ladies! Some like that look and some don’t.
- What size cup will I be after reconstruction?
- How will my breast look after phase 1 and how will that look improve or change after phase 2 when symmetry and fill from fat grafting is done?
- Will I be able to wear under-wire bras?
- Will my breasts be soft, warm, and natural feeling?
Your consult should also include the risks and possible complications of this surgery. I know there are many more questions others will likely think of but this is a good start for now. Remember, this is only the aesthetic questions.