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Breast Reconstruction (DIEP Flap) Archive Questions

Below are Dr. Rodriguez’s answers to Breast Reconstruction (DIEP Flap) questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.

Now displaying records 1 to 3 of 3.


Q : 1

I really want to have a breast reduction. I do not have cancer, but I am very uncomfortable due to pain in my breasts. If I were to have a reduction, would they also have to remove lymph nodes from my armpit?

Breast reduction does not require removal of the lymph nodes under the axilla (armpits). Depending on the size of your breasts and well documented evidence of pain secondary to your breast size, some insurance companies may cover the cost of reduction. I would suggest you see a plastic or reconstructive surgeon of your choice to determine whether or not you may benefit from a breast reduction.

Q : 2

I have heard DIEP Flap is a 14-hour surgery. Is that correct?

Free tissue tranfer, such as a DIEP flap typically can last from 8 to 12 hours... and up to 14 hours if it is a complicated case or the patient is having both breasts reconstructed with the DIEP flap from the abdomen. This is secondary to the skill needed to find the vessels of the donor and recipient sites as well as connected these vessels under a microscope.

Q : 3

I had a tram flap to reconstruct my right breast 4 years ago. I often have had a sharp, contraction-like pain on the left side of my umblical area where the scar from hip to hip is. It hurts also when I cough from my recent cold. Could this be a hernia or something else, and what do I need to do about it?

Your pain could have several causes. To begin to decipher the cause, I would consider visiting your surgeon first. He or she is already familiar with your past medical and surgica history. That being said, there is always a theoretical risk for a hernia after abdominal surgery. This could be an incisional hernia, ventral hernia, or an umbilical hernia. My advise would be to be evaluated by your surgeon or your family doctor. They should be able to determine if you indeed have a hernia by a simple physical exam. Hernias, depending on their size, have a risk for potential bowel incarceration or strangulation. (simply put, your small bowel or intestine can become "stuck" in a weakened part of the abdominal wall.) Again, I would recommend seeing your surgeon or family doctor to make that determination. Another source of chronic pain is from a "neuroma" or "neuropathic pain". After surgery, some surgical patients may go on to develop a benign abnormal growth of nerve endings that may have been transected during surgery. The nerves are essentially "trying to repair themselves". This may happen with any surgery or trauma. It may also result in a burning, numbness, pins and needle type of pain. This type of pain can resolve on it's own or be treated with medication. I hope this helps to begin to potentially answer your questions and gives some direction as to where to start seeking answers.


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