Hi- I had a double MSX a year ago with TEs. Both failed. One several weeks after my Masectomy and the second after radiation treatment. The surgeon I saw recommended a diep flap but said are can’t save the nipple on the radiated breast. Why? Is there anyway to save it?
Also, I was told I couldn’t do implants with a diep flap. Is this true too as well? I have read online that it is possible.
It’s dependent on how the tissues are weather the nipple can be saved. Sometimes too scarred for that. And for the implant part we do implants with DIEP with radiation and without most of it is dependent on skin and soft tissues
Dear NFaye76, DIEP flap is not the only option for breast reconstruction. I perform total breast reconstruction after mastectomy + radiotherapy with autologous fat injections. But I have to see your recent appearance of the operated breast and body fat distribution before making a decision.
A lot of things can be done, a lot should not be done and somethings can not be done. Without an exam of your tissues we are just speculating. If they told you they can not save the nipple the thing to do is ask the surgeon why not.
There may be too much scar tissue to get the nipple back into an aesthetic position.
It is an very high risk 80-100% failure rate of doing an implant alone after radiation.
However, the risk significantly decreases if a procedure called a "hybrid DIEP Flap" is done. In this situation an implant can be placed under the DIEP flap and the failure rate is much lower than doing an implant alone. For my patients, I usually do the DIEP Flap first, then perform at least 1-2 rounds of fat grafting first before putting in an implant.