This week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.Question: After a DIEP flap reconstruction, the top part of my tummy above the incision protrudes over the scar-especially in the evening. Is this a lymph issue or edema? Are the lymph glands disturbed in the abdomen with this kind of surgery?Answer: Thanks for your question. During a typical DIEP procedure the lymph nodes that serve the tummy area are not removed and the lymphatic fluid can move in the normal direction. It is possible to have lymphedema of the tummy area after a DIEP but it certainly is not very common. It would be more likely if someone had multiple tummy surgeries and scars before the DIEP procedure. In my patients I see that their tummy wall and tummy incision may be swollen for 3-4 months after the surgery. If someone has healing problems, infections or a seroma (pocket of fluid underneath the incision), then swelling can be more prolonged. If someone has persistent swelling and none of the above issues for 6 months then I would consider having a therapist who has experience treating lymphedema see them for possible lymphatic massage treatments. Let me know if you need more information, thanks again.
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