Any advantage of A-cup breasts with DIEP?

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Lea7777
Lea7777 Member Posts: 274
edited August 2018 in Breast Reconstruction

I would think less is more or at least better when PBMX with DIEP flap construction is the topic. Less mass to take out of the breasts. Less fat to remove from elsewhere to fill the breasts back up. Is this thinking too simple? Does nipple sparing put this simple equation on a whole different plane? Thanks for your thoughts and experiences.

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  • Runrcrb
    Runrcrb Member Posts: 577
    edited July 2018

    Not sure what you are getting at Lea7777. My mastectomy was nipple and skin sparing. I had DIEP reconstruction with no issues. I'm a D cup. If you aren't aware, DIEP is a once and one surgery - as in, they don't leave fat behind for use a second time so regardless of your cup size, the same amount of tissue is taken from your belly.

    Interesting question if yours is really do I have less risk with less breast tissue. On that I have no idea.

    Rereading you question, I see that the P is probably for prophylactic. One of my girl friends had a prophylactic nipple sparing double mastectomy. At the time, tissue expanders were placed as she went with implants. That was two years ago. She was very large breasted and the surgery was well over 9 hours. She said that the nipple sparing added to the complexity and therefore the length of surgery. Knowing what she knows now, she would not have spared nipples. She is glad she had the surgery - multiple scares, some genetic risk, and a mother who had one of the earliest bone marrow transplants to cure breast cancer.


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  • Lea7777
    Lea7777 Member Posts: 274
    edited July 2018

    Thanks Runrcrb for your comments regarding yourself and your friend. That is great you had no issues with DIEP flap. Always good to "hear."

    The same amount of tissue is taken from your belly, regardless of cup size? Interesting. I would have thought more fat would need to be taken from the belly to make size D cup breasts than to make size A cup breasts. Does our anatomy and physiology mean that when the belly flap is cut out, it always is way, way more fat than we need to form breasts of any size--A through DD or beyond? I thought fat removal was calibrated with the resulting reconstructed cup size.

    Also for the mastectomy part, I would have thought it takes more time when dealing with a large pair of breasts compared to a small pair with less mass.

    I realize these are questions to ask a surgeon, but it is nice to have an idea in advance of how to tailor questions and what type of surgery/reconstruction to consider. Also, the "dumb" stuff can be asked here and then spruced up into a more intelligent format when posed to the experts. That is why this site is so helpful.

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  • CallieGirl
    CallieGirl Member Posts: 14
    edited August 2018

    Lea

    Your question is a good one. I'm also in smaller cup size club. From what I understand from my reading, larger breasts may have more issues with blood supply on the skin flaps when doing skin and/or nipple sparing mastectomies. I have had three different surgical oncologist opinions about nipple sparing. Two said no problem and would be able to do everything with an inframammary approach. The third said due to small breast size, he wasn’t comfortable with that approach as he would have difficulty being able to access the top portion of my breasts to remove all the tissue.

    I will be having BMX with immediate PAP flaps as I am blessed with more fat there than on my tummy. At my consult yesterday I asked about what would be proportional to my frame. My PS held what I think was about a 400 cc implant up to my chest for an example. It looked huge to me! His comment was that was good as therefore he had to take less tissue and I would hopefully have less likelihood of incisional problems from my donor site. I anticipate ending up slightly larger than my A/barely A size I currently am.

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  • Leatherette
    Leatherette Member Posts: 448
    edited August 2018

    Not sure about this, but I think they need to take all of the fat, no matter whether they are making one or two, small or large, because they are removing the blood supply to that fat. Otherwise, you'd have necrotic fat in your abdomen.

    I guess the advantage to being a-cup is that they will be more likely to get all the tissue they need to match the original size of your breasts. If I got a double diep, my breasts would have been much smaller than my original, but there was enough to make one.



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  • Lea7777
    Lea7777 Member Posts: 274
    edited August 2018

    Thanks CallieGirl and Leatherette for your responses on reconstruction. Good luck with yours, CallieGirl, and I hope you are doing well after your DIEP flap, Leatherette.

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  • mustlovepoodles
    mustlovepoodles Member Posts: 2,825
    edited August 2018

    "Leavin' on a jet plane..." Heading to NOLA in an hour. Pre-op tomorrow, surgery Friday. Fingers crossed.

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  • Trishyla
    Trishyla Member Posts: 1,005
    edited August 2018

    Good luck, Must Love Poodles! I hope everything goes smoothly, with great results.

    Trish

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  • Lula73
    Lula73 Member Posts: 1,824
    edited August 2018

    must love poodles- the day has finally come around for you!! It’s been a long journey to get here. I’m so happy for you! Good luck and keep us posted!! Are you on the NOLA patients FB page?

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  • mustlovepoodles
    mustlovepoodles Member Posts: 2,825
    edited August 2018

    Yes, I am, Lula. Those ladies have really given me the boost I needed to get on with this.

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  • JoniB
    JoniB Member Posts: 346
    edited August 2018

    mustlovepoodles - I have been following your journey and I am so excited that your surgery day will be here tomorrow. Wishing you a great outcome and an easy recovery. I look forward to hearing good news from you soon.

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  • Meow13
    Meow13 Member Posts: 4,859
    edited August 2018

    I ask if they used everything they took because my stomach was very flat afterwards. They said they did use it all no excess to discard. Well I was really happy the size and shape matched the real side. Never considered a different size either smaller or bigger. I think I am happy with my normal size.

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  • Lea7777
    Lea7777 Member Posts: 274
    edited August 2018

    Best wishes to you, Mustlovepoodles.

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