Question: I’m currently seeking a surgeon for Phase 2 DIEP. My plastic surgeon here did a great job for Phase 1, but doesn’t seem interested in correcting what I think is a problem for Phase 2. My breast size is currently a DD and I do not like the size. Heavy and my back hurts by the end of the day. I’m seeking a C cup. Also, my abdomen is hard and bloated from under the breast until past my bellybutton, which makes it hard to breathe. Is this something you have seen and something you could fix?Answer:For some reason, we fairly commonly run into patients who have had Phase 1 DIEP elsewhere, but end up coming to us for the “finishing” work. Of course, we are delighted to help, no matter who has operated on you, and no matter what condition you are in. Breast size can certainly be reduced, symmetry can often be improved, and the donor site can often be optimized. It is important to remember that for the optimal result, several procedures are often necessary, although they typically decrease in size and complexity as the process progresses. A typical scenario would be Stage 2 would include open revisions of the breast mounds and donor site, and Stage 3 would involve free fat grafting to further refine the shape of the breast mounds and lower body. While the initial flap transfer is obviously the “big procedure,” we believe that the subsequent procedures are absolutely essential to getting the result that most patients want. - Dr. Richard Kline