The below questions are answered by Dr. James Craigie ofThe Center for Natural Breast Reconstruction.(opens in a new tab)Do you perform a stacked combination DIEP/SGAP(opens in a new tab) using both to make a breast(s)? We do on occasion. It may be needed when one area of the body does not have enough tissue to achieve the desired result. This is an unusual situation in our practice we can usually achieve our goals with one area of the body. There is a lot of discussion about a maximum BMI what about a minimum? BMI is a guide line that helps the surgeon(opens in a new tab) determine who is at a higher risk for complications. It is not a strict guideline and the final decision is left to the surgeons judgment among other things. Safety is our first priority and studies have definitely linked high BMI to an increased rate of complications without a doubt. Unfortunately  BMI is not a perfect calculation and different doctors may use the information differently. A low BMI is not linked to complications if someone is otherwise fit for surgery. Someone with very little body fat will have a low BMI and possibly not enough tissue to make a very large breast. This does not mean they cannot have a good result. It  may mean they require and combined or stacked flap approach. We have seen many patients(opens in a new tab) who have been told they “don’t have enough tissue” but after consultation can reassure them they can get a very proportional result. Dr. James Craigie The Center for Natural Breast Reconstruction

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