Has anyone gone to an A/small B cup size with DIEP?

there are a couple things to consider when going with natural tissue reconstruction when it comes to size:

1) they tend to go a little bigger with stage 1 then reduce if needed in stage 2. Why? The fat from the flap "takes" better than fat from grafting. Fat from grafting is susceptible to being reabsorbed. Additionally some of the flap tissue may become necrotic and that small section require removal if it can't be broken up in stage 2 which would result in loss of volume. So better success rate and patient satisfaction when all is said & done this way. 3 months minimum between the 2 stages.

2) the fat they use to make your new breast mounds has a memory. It will gain and lose volume at the same rate as it did in the old location. So if you've put on some weight and do the flap surgery then lose weight your breasts will lose accordingly. If going with DIEP and your tummy is where you normally gain/lose first, then your new breast mounds will gain/lose first. On the flip side, if you tended to gain/lose first in any area other than your tummy then your breasts would experience minimal impact. You need to plan for this if you're planning to lose/gain weight moving forward. A B or C cup after surgery could become an A or B cup after weight loss and be perfect for you. Where if you went with A or B cup to start you could end up pretty well flat or an A cup after weight loss.

When you meet with your flap surgeon be very upfront about what you want as your end result. Make sure you tell them if you're still losing weight/planning to lose weight after the surgery so they can plan accordingly.

On surgeon selection-finding one that listens is really important. Finding one that takes your future plans concerning your body into account from the start is really important. And making sure you've looked at their before/after pics and researched them thoroughly and would be very happy to look like those pics after and are satisfied with the research results are all very important. The group that I know does all this is The Center for Breast Restoration Surgery in New Orleans. If you don't live there it's no problem. Women from all over the world (literally) travel to them for their flap recon. They even correct botched recons from other docs. Their results are amazing, they listen, they plan ahead based on your plans, they have the lowest flap failure rate (1% vs 10% national average) and a super low infection rate (2%). They even help with travel discounts through various partnerships. I'm happy to answer any questions you might have about them - I'm headed back there for my stage 2 in Nov. Here's a link to their site. They have lots of before and after pics on their site too that include women of all shapes and sizes.

www.breastcenter.com