DIEP Flap Revision & Second Opinion

Is DIEP flap revision normal, or did something go wrong?

DIEP flap revision is one of the most important, and most underappreciated, stages of the breast reconstruction journey. We do not view revision surgery as a sign of failure. We view it as an expected and essential step toward your best possible result.

It is exceedingly uncommon for a woman to achieve her best possible outcome from the initial DIEP flap alone. A well-executed primary reconstruction can produce a very good result. But secondary revision is what takes it from good to great. In the primary setting, there is only so much that can be done to refine shape, position, and symmetry. Revision allows us to address these elements deliberately, with the full picture in front of us. This philosophy applies to every flap type, not only DIEP.

What does DIEP flap revision involve?

These cases sit at the intersection of reconstructive and aesthetic surgery. An excellent outcome requires deep microsurgical expertise combined with the aesthetic judgment and technical toolkit of a cosmetic surgeon. No two women are alike, and the combination of techniques varies accordingly. The most common goals:

• Improving breast shape, symmetry, and position
• Refining the donor site, including scar placement and abdominal contour
• Addressing the nipple-areolar complex, from reconstruction to [restorative tattooing](link: nipple reconstruction page)
• Fat grafting, reshaping, and scar revision, frequently as part of the same plan

‍

Why is a single surgery rarely enough?

Too many women are told their reconstruction looks fine, even when they feel it does not. We do not accept that standard.

Achieving a truly excellent result requires time. Time in the consultation to genuinely listen. Time in preoperative planning to analyze the anatomy carefully. Time in the operating room to execute with precision. In large healthcare systems, these time constraints are a significant barrier to exceptional outcomes. We structured Altris specifically to remove those barriers.

When does a second opinion make sense?

If you have been told your result is as good as it gets, but it does not feel that way to you, a second opinion is appropriate, whether your DIEP was performed here or anywhere else. We welcome women who want an honest, experienced assessment of what is achievable. Our goal is never to tell you what you want to hear. It is to give you an accurate picture of your options and work toward the best possible outcome. That is the whole point of a second opinion: not reassurance, but truth, delivered with care.

‍