After going through cancer and a mastectomy, Barbara Rosebrock just wanted to feel normal again.

So when it came time to do reconstructive surgery on her breast after a mastectomy, she chose an option selected by about 10 percent of patients.

Rosebrock didn’t want an implant. She didn’t want something foreign in her body, and she didn’t want the complications that could come with it.

“When you put something foreign in your body, there’s more chances something can go wrong,” Rosebrock said. “After it was all over, I wanted to feel normal again.”

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Rosebrock chose the option of DIEP flap surgery, or deep inferior epigastric perforator flap, in which the surgeon uses the patient’s own lower abdominal tissue to reconstruct the breast.

The surgery is another option for patients who are having breast reconstruction and does not require an implant to be used, said Dr. Eugene Hsiao, a plastic surgeon at Community Hospital South in Indianapolis.

About 10 percent of patients choose that surgery, and more surgeons are learning the technique than they did 15 years ago; but it is still rare. Community Hospital South is the only southside hospital with its own surgeons who perform the technique, he said.

The biggest benefit to the surgery is that patients will not have to deal with complications that can come with implants. For example, some patients who have radiation as part of their treatment can have complications with implants later, he said.

Some patients also say their breast looks and feels more natural, since the procedure uses their own skin, fat and tissue, Hsiao said. For example, some patients with implants will notice later that their breast is not the same temperature as the rest of their body, such as when they have been swimming or in cold temperatures, and takes longer to warm up.

“Using this reconstruction is beneficial to no longer have to deal with implant issues. Implants are definitely still the most popular method,” Hsiao said.

The procedure also can come with some risks and isn’t right for all patients, he said.

Doctors have to consider whether a patient has had previous abdominal surgeries, if they use tobacco products, since that does not make them a good candidate, and their body structure.

If someone is too thin, there won’t be enough tissue to use for the procedure. If someone is obese, they can have issues with wound healing, he said.

The surgery and recovery time are also longer, he said.

When a patient has a surgery with an implant, they usually are kept in the hospital no longer than overnight and have a recovery time between a week and three to four weeks, depending on whether they also had to have expanders.

But with the DIEP flap reconstruction, patients stay in the hospital for three days, and their recovery lasts two to three months, Hsiao said.

Hsiao also doesn’t recommend patients get the surgery if they are hoping it will also make them look thinner in their abdomen, he said. Other surgeries are much more effective, he said.

“There is some improvement with contour, but the goal should be that they want their breast made out of their own tissue, if people don’t want an implant, or can’t have one,” he said.

But for patients without complications, the decision on which surgery should be done is up to them, he said.

Hsiao sits down with his patients and explains the risks of each surgery, the timeline of surgeries, and their hospital stay and recovery time.

“Pretty much the decision is made based on their wants,” he said.

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Annie Goeller is managing editor of the Daily Journal. She can be reached at or 317-736-2718.