If you’re considering breast reconstruction after a mastectomy, you may have heard about DIEP flap surgery. This advanced surgical technique has gained popularity in recent years due to its natural-looking results and potential benefits over other reconstruction methods. However, as with any surgery, it’s essential to understand the potential effects on your body, particularly your abdominal strength. In this blog post, Sydney Specialist Plastic Surgeon Dr Bish Soliman will explore the relationship between DIEP flap surgery and abdominal strength, as well as provide exercises to help you regain strength during your recovery journey.
DIEP (Deep Inferior Epigastric Perforator) flap surgery is a type of breast reconstruction that uses skin, fat, and blood vessels from your lower abdomen to create a new breast mound. Unlike the more traditional TRAM (Transverse Rectus Abdominis Muscle) flap procedure, DIEP flap surgery preserves the abdominal muscles, resulting in a faster recovery and reduced risk of long-term abdominal weakness.
During the DIEP flap procedure, Dr Soliman carefully selects and removes a portion of skin and fat from your lower abdomen, along with the associated blood vessels. This tissue is then transplanted to your chest and shaped to form a new breast. Dr Soliman reconnects the blood vessels to ensure proper blood supply to the transplanted tissue. The abdominal incision is then closed, typically resulting in a scar that can be hidden beneath most clothing and swimwear.
DIEP flap surgery offers several benefits compared to other breast reconstruction methods. Firstly, it provides a natural look and feel to the reconstructed breast, as the tissue used is from your own body. Additionally, since the abdominal muscles are preserved, patients often experience less post-operative pain and a quicker return to normal activities compared to TRAM flap surgery. However, not everyone is an ideal candidate for DIEP flap surgery. Factors such as previous abdominal surgeries, insufficient abdominal tissue, and certain medical conditions may make other reconstruction options more suitable. Dr Soliman will assess your individual case and discuss the best approach for your unique circumstances.
One of the most common concerns among patients considering DIEP flap surgery is the potential impact on their abdominal strength. While DIEP flap surgery is designed to preserve the abdominal muscles, it’s essential to understand that some temporary weakness and changes in abdominal function are to be expected following the procedure.
During DIEP flap surgery, Dr Soliman carefully dissects the skin and fat from the abdominal wall, taking care to preserve the underlying muscles. However, the process of separating the tissue from the muscle can lead to some degree of muscle trauma and inflammation. Additionally, the removal of skin and fat from the abdomen can alter the way the muscles contract and function in the short term.
You may experience a feeling of abdominal tightness, weakness, or a reduced ability to perform certain movements, such as sitting up from a lying position, in the initial weeks following surgery. This is a normal part of the healing process and should gradually improve over time.
Several factors can influence the extent and duration of abdominal weakness after DIEP flap surgery. These include:
Most patients can expect to see a gradual return of abdominal strength within 6-12 weeks following DIEP flap surgery. However, it’s important to remember that every patient’s recovery journey is unique, and some may take longer to regain full strength.
In rare cases, patients may experience more prolonged abdominal weakness or develop an abdominal bulge or hernia. These complications can often be managed with additional surgical procedures or specialised physical therapy.
To promote optimal recovery of abdominal strength, it’s crucial to follow Dr Bish Soliman’s post-operative instructions carefully. This may include:
It’s important to remember that while temporary abdominal weakness is a common side effect of DIEP flap surgery, the vast majority of patients are able to regain their pre-operative strength with time and appropriate care.
Engaging in a safe and effective exercise program is essential for regaining abdominal strength after DIEP flap surgery. However, it’s essential to approach exercise with caution and under the guidance of Dr Bish Soliman and a qualified physical therapist. Rushing into strenuous activities too soon can lead to complications and setbacks in your recovery.
Before discussing specific exercises, it’s important to emphasise the value of pre-surgery preparation. Patients who engage in regular exercise and maintain a strong core prior to surgery often have an easier time with recovery. If you have time before your scheduled surgery, consider incorporating core-strengthening exercises into your routine, such as planks, bridges, and gentle abdominal crunches. Always consult with Dr Soliman beforehand to ensure these exercises are safe for you.
After surgery, your exercise program should be gradual and progressive, allowing your body adequate time to heal. The following phases provide a general guide to post-surgery exercise, but always defer to Dr Soliman’s specific instructions.
During the initial weeks after surgery, your primary focus should be on rest and recovery. Gentle walking is usually encouraged to promote circulation and prevent complications like blood clots. Avoid any exercises that target the abdominal muscles directly, as your incisions need time to heal.
Some gentle exercises that may be appropriate during this phase include:
Remember to listen to your body and stop any activity that causes pain or discomfort.
As your incisions heal and Dr Soliman gives you the go-ahead, you can begin incorporating more targeted exercises. During this phase, the focus is on gently activating the abdominal muscles and gradually building strength.
Exercises that may be appropriate during this phase include:
Aim for low repetitions and multiple sets, gradually increasing as your strength improves. Remember to breathe normally throughout each exercise and avoid holding your breath.
As you continue to heal and your abdominal strength improves, you can begin incorporating more advanced exercises into your routine. However, it’s still essential to progress gradually and avoid overexerting yourself.
Exercises that may be appropriate during this phase include:
In addition to these specific exercises, it’s important to incorporate abdominal strengthening into your daily life. Simple actions like sitting up straight, engaging your core while walking, and using proper form when lifting objects can all contribute to improved abdominal strength over time.
Incorporating abdominal strengthening exercises into your daily routine can help you maintain the progress you’ve made during your recovery and continue to improve your core strength over time. Here are some tips to make exercise a natural part of your day: