When natural tissue (flap) reconstruction is performed, tissue is taken from another part of the body—such as the abdomen, thigh, buttock, or back—to rebuild the breast. This donor site usually heals well, but sometimes the area can weaken, leaving behind a bulge.

A donor site bulge is not the same as a true hernia (where tissue pushes through a hole in the muscle wall). Instead, it happens when the abdominal wall or other donor site is weakened or stretched, creating an uneven contour. Donor site bulge repair is a procedure designed to flatten and strengthen the area, restoring comfort and appearance.

Why a Bulge Can Develop

• Muscle removal or weakening: Some flaps, like the TRAM flap, use part of the abdominal muscle, which may leave the area weaker.

• Tissue removal: Even in muscle-sparing flaps (like DIEP), the area where tissue is taken can sometimes stretch or thin during healing.

• Healing differences: Weight changes, scar tissue, or natural healing can affect how the donor site settles.

How Bulge Repair Works

The approach depends on the size and cause of the bulge:

• Tightening or reshaping the area: The surgeon can repair stretched tissue to flatten the bulge.

• Mesh reinforcement: A supportive mesh may be placed under the skin or muscle to strengthen the area and prevent recurrence.

• Surgical contouring: Tissue is reshaped to restore a smoother, more natural body contour.

• Outpatient or short hospital stay: Most bulge repairs are same-day procedures, but complex cases may require an overnight stay.

Signs You May Benefit from Bulge Repair

• A visible or noticeable bulge at the donor site (abdomen, thigh, buttock, or back).

• Discomfort or pressure in the donor site area.

• Difficulty wearing clothing comfortably due to the bulge.

• Concern about body appearance or symmetry.

Benefits of Donor Site Bulge Repair

• Restores a smoother contour: Helps your donor site look and feel more natural.

• Improves comfort: Reduces pressure or pulling sensations at the site.

• Strengthens the area: Mesh reinforcement or tightening adds support.

• Boosts confidence: Helps many women feel more comfortable in fitted clothing or swimwear.

Things to Keep in Mind

• Not the same as a hernia: Bulges are less severe, but they can still be bothersome and may need repair.

• Scarring: Revision leaves a new or extended scar, but it often replaces or overlaps the original one.

• Recurrence risk: While repair lowers the chance of bulge returning, it is still possible.

• Recovery: Healing is generally quicker than the original flap surgery—most women recover in 2–4 weeks.

Emotional Considerations

After going through mastectomy and reconstruction, dealing with a donor site bulge can feel frustrating. It may feel like an unwanted reminder of surgery when you’re ready to move forward. Repairing the bulge isn’t just about appearance—it’s about restoring comfort and confidence in your body.

A Personal Choice

Donor site bulge repair smooths and strengthens weakened areas—helping your body feel more balanced, comfortable, and whole again. It is one of the ways to refine your reconstruction journey and address changes that happen along the way. It’s not required, but for many women, it provides relief and peace of mind.