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How Your Weight May Affect Breast Size After DIEP Flap Surgery

Navigating Treatment

December 08, 2023

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Photography by Westend61/Getty Images

Photography by Westend61/Getty Images

by Stacey McLachlan

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Medically Reviewed by:

Catherine Hannan, M.D.

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•••••

by Stacey McLachlan

•••••

Medically Reviewed by:

Catherine Hannan, M.D.

•••••

•••••

DIEP flap surgery uses your own abdominal tissue to reconstruct your breasts. That means your breasts may change size and shape as you gain or lose weight.

Take a deep breath. You’ve made it through your mastectomy — another challenge of life with breast cancer is over. But for those following up this procedure with breast reconstruction, a new part of the journey is about to begin.

The decision to undergo DIEP flap surgery is a big one that can have a profound impact on your life. While the procedure creates natural-looking results, it also has its own set of considerations, especially when it comes to weight fluctuations.

Here’s what to expect during and after DIEP flap surgery and just how weight changes can influence the reconstructed breast.

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What is DIEP flap surgery?

Deep inferior epigastric perforator (DIEP) flap is a sophisticated reconstructive procedure that uses your own abdominal tissue to rebuild your breast.

DIEP flap breast reconstruction is similar but not identical to a tummy tuck. In a DIEP flap, the incision may be higher on the abdomen than a tummy tuck.

Unlike traditional methods of breast reconstruction surgery, which may involve implants, DIEP flap surgery results in a more natural look and feel.

Research from 2019 found that people who undergo this procedure often report higher satisfaction rates compared with other reconstruction techniques.

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How DIEP flap-reconstructed breasts change with weight fluctuations

Weight changes can affect reconstructed breasts and other parts of the body, especially when it comes to DIEP flap surgery.

What happens when you lose weight?

Losing weight after your DIEP flap surgery can lead to changes in breast size and shape. Your reconstructed breast may even become slightly smaller, mirroring the reduction of abdominal tissue.

What happens when you gain weight?

On the flip side, gaining weight can result in an increase in breast size.

While some people may consider this a positive outcome, larger breasts may lead to additional strain on the back and shoulders.

If someone gains weight after a DIEP flap procedure, they may experience more bulging of their abdomen than they normally would.

Is it common to have a muffin top afterward?

One potential concern after DIEP flap surgery is the development of a “muffin top” due to the removal of abdominal tissue.

A 2023 study noted that the procedure may cause a slight bulge above the scar but skilled surgical techniques can help minimize this effect.

What to expect with DIEP flap surgery

The usual process involved in DIEP flap surgery is as follows:

  1. You’ll be placed under general anesthesia to make sure you’re comfortable and pain-free during the procedure.
  2. You’ll receive an incision to your lower abdomen. The surgical team will choose a section of tissue from the abdomen to be used to reconstruct the breast or breasts.
  3. Next, your surgeons will create incisions on your chest and carefully position the repurposed tissue on the breast mound.
  4. With microsurgical techniques, they’ll reconnect blood vessels in the ‘new’ tissue to those in the chest to ensure proper blood circulation.

It’s common to recover in the hospital for several days, followed by a gradual return to your usual activities over a few weeks.

Discomfort and swelling are expected, but diligent postoperative care can help manage your symptoms effectively.

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Common complications

As with any surgical procedure, there are potential complications associated with DIEP flap surgery. These may include infection, flap loss (although rare), or issues related to anesthesia.

This procedure also involves a longer recovery period compared with other methods.

Complications during DIEP flap surgery include:

  • Scarring: You’ll likely have a scar along your abdomen and around your breasts. In some cases, those scars may develop overgrown scar tissue.
  • Lumps: If the fat in the breast isn’t getting enough blood, you may develop breast fat lumps, called necrosis. They may cause discomfort, but they can be removed with surgery.
  • Fluid buildup: Blood or fluid may accumulate postsurgery in the breast.
  • Loss of sensation: According to 2019 research, new breasts will most likely not have the same sensation as before.
  • Vessel failure and tissue death: There’s a 3–5% chance of failure during the vessel connection microsurgery, which may lead to tissue death or necrosis. This would require another operation to reestablish blood supply to the flap.
  • Tissue rejection: A rare side effect of undergoing DIEP flap surgery is tissue rejection, also known as DIEP flap failure. In this case, the entire flap must be removed. The surgery can usually be performed again in 6 months to a year after the area heals.

Talk with your healthcare team promptly to address any concerns in the recovery stage.

Recovery from DIEP flap surgery: 6 months and beyond

Recovering from DIEP flap surgery is a gradual process that spans several months. While you can get back to most of your regular activities within 12 weeks or so, full tissue healing takes around a year.

Over time, the swelling will subside, and the reconstructed breast will settle into its final form. Regular follow-up appointments with your healthcare team are crucial during this period.

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Frequently asked questions

What happens if you gain weight after DIEP flap surgery?

If you gain weight after DIEP flap surgery, it can lead to an increase in breast size.

This is because your reconstructed breast is made from abdominal tissue, which may respond to weight gain similarly to natural breast tissue.

What causes ‘swelly belly’ after DIEP?

‘Swelly belly,’ or abdominal swelling, can occur after DIEP flap surgery due to the manipulation and repositioning of tissue during the procedure.

The body’s natural response to surgery is inflammation, which can lead to temporary swelling in the abdominal area. Gasses and fluids in the tissues may also contribute.

This swelling typically subsides over time as the body heals. It’s important to follow postop care instructions provided by your healthcare team to manage this symptom effectively.

What are the long-term side effects of DIEP flap surgery?

According to a 2019 study, DIEP flap surgery is generally considered safe with minimal long lasting side effects.

However, as with any surgical procedure, there may be potential risks, including:

  • scarring
  • lumps
  • fluid buildup
  • changes to or loss of sensation
  • vessel failure and tissue death
  • tissue rejection

That’s why follow-up appointments with your healthcare team are essential so they can monitor for any potential issues and address them quickly.

Do you lose weight with DIEP flap surgery?

No, DIEP flap surgery is not a weight loss procedure.

In fact, according to a 2015 study, patients may experience a temporary increase in weight due to swelling and fluid retention immediately after surgery.

The primary purpose of DIEP flap surgery is breast reconstruction and using the patient’s own tissue to create a natural-looking breast.

Can you do yoga and other exercises after the DIEP flap surgery?

Yes, you can participate in exercise after you have healed enough and been cleared by your healthcare team.

It’s generally safe to engage in low impact exercises like yoga and other forms of gentle exercise. These activities can promote overall well-being and aid in the recovery process.

However, it’s important to avoid strenuous activities that may put excessive strain on the surgical site, especially in the early stages of recovery.

How much fat is needed for DIEP flap surgery?

The amount of fat needed for DIEP flap surgery depends on your individual anatomy and the desired size of the reconstructed breast.

According to a 2023 study, it’s common that enough tissue can be harvested from the abdominal area to create a breast of similar size to the one being replaced, even if you have a low BMI. Your surgical team will carefully assess and plan the procedure to ensure an optimal outcome.

Takeaway

DIEP flap surgery is a transformative procedure for breast reconstruction, offering natural-looking results using your own tissue from your abdomen.

Just like with weight gain without breast reconstruction, the shape and size of your breasts may change if your weight changes.

Communicate openly with your healthcare team to get a clear picture of how DIEP flap surgery may affect your body.

Medically reviewed on December 08, 2023

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About the author

Stacey McLachlan

Stacey McLachlan is a writer, editor from Vancouver, B.C. specializing in design, food and travel writing. She earned her BA in Communications from Simon Fraser University and is editor-at-large for Western Living and Vancouver magazines. Stacey is a regular contributor to Dwell and has been published by the Globe and Mail, Montecristo, and Healthline, among other outlets. Find her on her website.

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