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Optional refinements extend this."},"fly_home_after_days":{"min":10,"max":21,"unit":"days","qualifier":"Once discharged, mobile, drains removed or managed, no flap concerns and team clears travel; take VTE precautions."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":5,"max":10,"unit":"days","qualifier":"After Hospital discharge: First outpatient wound and flap check; drains reviewed if still in place."}},{"purpose":"other","requirement":"conditional","after":{"min":10,"max":21,"unit":"days","qualifier":"After DIEP flap surgery: Drain removal review once output criteria are met."}},{"purpose":"assessment","requirement":"routine","after":{"min":42,"max":84,"unit":"days","qualifier":"After DIEP flap surgery: Healing and activity clearance review."}},{"purpose":"result_review","requirement":"routine","after":{"min":180,"max":365,"unit":"days","qualifier":"After DIEP flap surgery: Result review and discussion of optional refinement."}}],"indications":["Breast absence after mastectomy for breast cancer, immediate or delayed","Breast deformity after lumpectomy or radiotherapy","Risk-reducing mastectomy in high-risk patients (e.g., BRCA mutation)","Prior or planned radiotherapy, where implants are less suitable","Inadequate skin envelope for implants, with adequate abdominal tissue"],"main_risks":["Flap thrombosis or vascular compromise; flap loss uncommon (about 1–3%)","Fat necrosis or partial flap necrosis","Hematoma, seroma, infection, or delayed healing","Abdominal wall weakness, bulge, hernia, or numbness","Mastectomy skin necrosis and altered breast sensation","Asymmetry or contour irregularity needing revision","Venous thromboembolism and anesthesia complications","Long surgery, blood loss, and transfusion"],"pain":"Moderate to significant pain in the first days, mainly at the abdominal donor site, controlled with multimodal analgesia. Discomfort and tightness usually ease over several weeks. Numbness or altered sensation may persist.","preparation":["Oncologic and plastic surgery planning, including timing","Medical assessment, blood tests, and anesthesia review","CT or MR angiography to map abdominal perforators","Stop smoking and nicotine for weeks before and after","Review medications and supplements, including blood thinners","Fasting before general anesthesia","Pre-operative marking and photographs","Arrange home help and nearby lodging after discharge"],"recovery_timeline":[{"phase":"Hospital stay (about 3-6 nights)","description":"Flap monitoring, drain care, pain control, VTE prevention, and early mobilization with sitting and short walks.","restrictions":["No driving","Avoid pressure or tension on flap and abdomen","Nicotine avoidance continues"]},{"phase":"Weeks 1-6","description":"Home recovery with drains managed until removal, gradual walking, and a flexed-hip posture easing as the abdomen heals.","restrictions":["No heavy lifting","No strenuous or core exercise","Wear supportive garments"]},{"phase":"Weeks 6-12","description":"Ordinary function and desk work fully resume; physical work and exercise return stepwise after clearance.","restrictions":["Heavy lifting and high-impact sport only after surgeon clearance"]},{"phase":"Months 6-12","description":"Swelling resolves, the breast softens, and scars mature; optional refinement can be planned.","restrictions":[]},{"phase":"At any time","description":"Seek urgent care for flap color change or coolness, sudden swelling, fever, wound discharge, chest pain, breathlessness, calf swelling, or severe abdominal pain.","restrictions":[]}],"rehabilitation_days":{"min":28,"max":84,"unit":"days","qualifier":"Ordinary daily function returns after uncomplicated unilateral DIEP; slower with complications or adjuvant therapy."},"result_longevity":"The reconstructed breast is made of the patient's own tissue and is generally long-lasting, changing with weight and aging. 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Small drain marks; scars mature over 12 months or longer.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"One primary DIEP free-flap operation with a single hospital admission."},"stages":[{"code":"planning_imaging","label":"Surgical planning and perforator imaging","after":{"min":0,"max":30,"unit":"days","qualifier":"After First consultation: Planning and imaging are scheduled before surgery, counted from the first consultation; timing depends on cancer treatment."}},{"code":"inpatient_monitoring","label":"Inpatient flap monitoring, drain care, and mobilization","after":{"min":0,"max":6,"unit":"days","qualifier":"After DIEP flap surgery: Uncomplicated stay; flap checks continue until discharge."}},{"code":"optional_refinement","label":"Optional contour or nipple-areola refinement","after":{"min":90,"max":180,"unit":"days","qualifier":"After DIEP flap surgery: Conditional, not mandatory; timing depends on healing, swelling, and any adjuvant therapy."}}],"qualifier":"Primary numbers cover only the single DIEP operation. 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