Delayed DIEP flap Phenomenon, Breast Reconstruction

[@Andearea]

This guy is SO interesting to listen to. I wish all surgeons were like him. He is a critical thinker, and is obviously very dedicated to his work, his patients and to the success of his procedures. This is the kind of Dr. that every patient hopes to encounter. Keep up the amazing work, and thanks so much for these videos. They are just priceless.

[@DiepCFoundation]

Dr. Alan is a gem. Thanks for the kind words Nikki.

[@jenniferwood9896]

This was very informative and I do have a question: I recently had a single mastectomy and delay Diep 2 weeks ago, my reconstruction was scheduled for end of this week, however I had developed a DVT blood clot in my calf after 1st surgery and now have to postpone 2nd surgery, I had thought that the two surgeries needed to be done within a few weeks from each other, is it safe and okay to wait a few months to do the 2nd surgery. Thank you

[@DiepCFoundation]

Hi Jennifer. If you are talking about phase 2, which is the symmetry/fat grafting phase, then yes, you can wait to have this phase done. Am I understanding you correctly?

[@jenniferwood9896]

@@DiepCFoundation yes, thank you

[@AuditioningByHeart]

I had a free flap surgery 3 months ago, but the radiated breast is much smaller and it hurts. No infection and no seromas, but it’s so tight! Why does it hurt so much?

[@mysharona6754]

Is there some way to roughly estimate how much belly fat they need. I spent past two years eating well and exercising and lost weight..just to find breasts cancer. I don't want implants for sure. I don't want to gain weight after working hard to lose it so I want to gain as little as possible. My reconstruction will be after chemo so it's going to be a while but I need to think about this now. I'm a 36D, was, and want to look exactly the same as I did before size wise. I know nobody can tell me exactly but is there some kind of way to have an estimate...like how the rice test is an estimate for implant ccs.

[@DiepCFoundation]

Sharona, first of all congratulation on the weight loss and getting in shape. To my knowledge, the only way to determine if you have enough belly fat is through a physical exam. Microsurgeons who perform DIEPflap determine this with a "pinch test" but it involves so much more, really. The beauty of microsurgery, these surgeons have been doing telemedicine for years since many patients have to travel to find a skilled microsurgeon. Have you considered a consult to begin the process? This video may help you understand the process. You can find information to contact this group at the end of the video: kzbin.info/www/bejne/iGKlnI2keLilhbM

[@jeanetteg2]

I'm wondering how exactly to ask my plastic surgeon if she does (or will do) this delay procedure - it sounds like a really good plan, but I'm not getting a clear way of phrasing my question about it. I'm 3 years post-bilateral mastectomy and scheduled for Diep on 5/15/23 with Dr Marisa Piper at UCSF. Thank you so much for these resources as I try to finalize my questions for my next consult with her.

[@DiepCFoundation]

I understand that not many surgeons do this. You would simply have to ask her if she has heard of it or has ever done it. I am guessing she has heard of and knows the surgeon in this video, Dr. Bob Allen, who is considered the pioneer of DIEP flap surgery. Thanks for your comment.