Potential side effects of DIEP flap breast reconstruction surgery

Deep inferior epigastric perforator artery (DIEP) flap surgery is a muscle-sparing surgery in which part of the lower belly is surgically removed and used to reconstruct your breasts following a mastectomy.

With DIEP flap surgery, your surgeon does not use any muscle to reconstruct your breast. Instead, it uses skin, fatty tissue and blood vessels. This distinguishes it from other breast reconstruction surgeries such as the transverse rectus abdominis myocutaneous (TRAM) flap. Even though the TRAM flap is largely muscle-sparing, it does in fact use a small amount of muscle to create your reconstructed breast tissue.

In this article, we will look in more depth at the possible (but very rare) side effects you may encounter after undergoing the DIEP flap procedure. We will also explore how you can prevent these from happening, and they can be treated if they do happen. Finally, we cover some frequently asked questions you may have regarding DIEP flap reconstructive surgery.

Click on one of the links below to jump to that section:

• What are the possible side effects involved with DIEP flap surgery?
• How can you prevent these from happening?
• How can you treat them if they do happen?
• Frequently asked questions

What are the possible side effects involved with DIEP flap surgery?

DIEP flap surgery will inevitably result in some scar tissue. However, there are some other potential side effects that you should be aware of before undergoing this type of surgery.

During recovery after the procedure, you may develop some lumps or hernias. There is also a small risk of tissue rejection or loss due to blood supply issues, a loss of sensation in the areas which have been operated on. Other side effects to be aware of include long term abdominal strength issues and the possibility of fluid build-up.

While this is a major procedure, which means there are risks involved in undergoing it, major DIEP flap surgery side effects are uncommon. Your skilled and qualified surgeon will do their best to ensure that your surgery is as smooth as possible, which reduces your chances of suffering from these issues afterwards.

How can you prevent these from happening?

Before the surgery, you will want to stick to a healthy diet consisting of a balanced menu of protein, healthy fats and all the necessary vitamins. Stay away from processed foods beforehand, as they can cause inflammation. You should also try to undertake some exercise such as walking or running in weeks before your surgery, as this can regulate your blood pressure and give you a better chance of healing properly.

To reduce your odds of encountering a postoperative complication, you should not smoke pre-surgery and control your blood sugar levels if you are diabetic. This gives you the best chance of having a completely smooth surgery and recovery.

Immediately after the surgery, it is recommended you rest in bed but with frequent short periods of mobilisation. You will be in hospital for two to four days. You will then be able to go home where you should continue to rest with gradual increase in exercise during this time.

You should also continue to follow your healthy diet plan with lots of water, incorporating plenty of fruits and vegetables as well as proteins such as fish, nuts or tofu. During this time, smoking and consuming alcohol and caffeine should be avoided to allow your body the best opportunity to heal.

For an even better chance of healing successfully, you may want to take advantage of the services provided by a physiotherapist. Your abdominal area will be sore some weeks after the procedure, so a physio will be able to advise and assist you with appropriate gentle exercises that promote the healing and rebuilding of abdominal wall tissue.

Bear in mind that, while you can contribute to the success of your surgery by adopting these actions and behaviours, your surgeon will advise you further about how you can reduce your chances of encountering any issues. Ultimately, your surgeon is responsible for the success of your procedure, so following their advice is imperative to a smooth-running DIEP flap reconstruction. They will have your best interests in mind before, during and after your surgery to keep you safe and assist your short- and long-term recovery.

How can you treat them if they do happen?

Thankfully side effects are rare in DIEP flap reconstruction surgeries, but they do occasionally happen. Fortunately, if you do experience issues with your breast reconstruction, there are some simple steps you can take to manage and treat them.

Should you find that you are experiencing fluid build-up, in many cases, this will absorb back into your body. However, if you find that it is not doing so on its own, it will need to be drained.

You should seek medical advice if you suffer from lumps or hernias, as this may require surgical intervention. You may want to relieve this as soon as possible, as the tissue which forms lumps and hernias can be uncomfortable.

Similarly, if you encounter any issues with blood supply, this is an emergency situation and you will require surgery. In the case of tissue rejection, the tissue will need to be removed and you will need to wait between six months to a year to attempt the surgery again.

With abdominal complications such as long-term loss of strength, in most cases this can be recovered with the support of doctors and physiotherapists. There are some gentle exercises that you can do at home around eight weeks after your surgery.

Frequently asked questions

How painful is DIEP flap surgery?

DIEP flap surgery tends to be less painful than alternative reconstruction surgeries such as breast implants or the TRAM flap procedure. While it is invasive, it causes less muscle trauma than other procedures.

How long does it take to recover from DIEP flap surgery?

On average, it takes between six and eight weeks to make a recovery from DIEP flap breast surgery.

Will your nipples have feeling after a mastectomy and breast reconstruction?

During a mastectomy, the nerves between your breast and nipple will be severed, which causes a loss of feeling. This cannot be restored through nipple reconstruction, and if feeling does return, it will most likely be fairly minor.

Are you considering DIEP flap surgery?

If you have any questions or concerns about opting for the DIEP flap operation, speak with the Stephen McCulley team to explore your options.