Before the operation, the surgeon will discuss the risks of a flap reconstruction with you. Some of these risks are covered below.
Loss of the flap
Blood vessels supplying the flap may kink or get clots, leading to bleeding and a loss of circulation. This may cause the tissue to die, leading to a partial or complete loss of the flap. This is more common in women who smoke or have recently quit. Quitting before surgery will help you to decrease the risk.
In rare cases, the fat used to make a TRAM or DIEP flap doesn’t get enough blood supply and dies. This is known as fat necrosis. The affected areas in the reconstructed breast can feel firm and are easily seen and diagnosed on a mammogram. They can be left in place or surgically removed. Women who smoke or have had radiation therapy are more at risk of fat necrosis.
Problems with the donor site
After having an abdominal flap reconstruction, some women find it takes a while for the wound to heal. After an LD flap reconstruction it’s common for fluid to build up (seroma).
Hernia (abdominal bulge)
Women who have a TRAM or DIEP flap have a small risk of having a hernia. A hernia occurs when part of the bowel juts out through the abdominal wall. The risk is greater with a TRAM flap than with a DIEP flap reconstruction because the muscle that is removed in a TRAM flap can weaken the abdominal wall and cause a hernia.
Learn more about side effects and what to expect after surgery.
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More resources
A/Prof Elisabeth Elder, Specialist Oncoplastic Breast Surgeon, Westmead Breast Cancer Institute and Clinical Associate Professor, The University of Sydney, NSW; Dragana Ceprnja, Senior Physiotherapist and Health Professional Educator, Westmead Hospital, NSW; Jan Davies, Consumer; Rosemerry Hodgkin, Consumer; Gillian Horton, Owner and Director, Colleen’s Lingerie and Swimwear, ACT; Ashleigh Mondolo, Clinical Nurse Consultant Breast Care Nurse, Mater Private Hospital South Brisbane, QLD; Dr Jane O’Brien, Specialist Oncoplastic Breast Cancer Surgeon, St Vincent’s Private Hospital, VIC; Moira Waters, Breast Care Nurse, Breast Cancer Care WA; Sharon Woolridge, Consumer; Rebecca Yeoh, 13 11 20 Consultant, Cancer Council Queensland.
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