DIEP Flap Breast Reconstruction

DIEP flap breast reconstruction is one of the most advanced techniques for recreating the breast after mastectomy. DIEP, an acronym for Deep Inferior Epigastric Perforator, has a number of advantages over other breast reconstruction techniques, including the capacity to form a softer, more natural breast. Below are details about the DIEP flap microsurgical breast reconstruction method, including the pros and cons of the procedure for mastectomy patients.

DIEP Flap Reconstructive Surgery

DIEP flap breast reconstruction involves the removal of skin and fat from the patient’s abdominal area to be used in the creation of a new breast mound. This procedure is similar to the TRAM flap procedure, except unlike TRAM, this method does not migrate any muscle from the abdomen. Deep Inferior Epigastric Performation (DIEP) refers to the name of the tissue that is used to create the new breast; it is the main blood vessel found beneath the rectus abdominus (the so-called “six-pack” muscles of the abdomen). The surgeon will detach the skin and fat of the stomach and re-attach it to the breast area. He or she will then connect blood vessels in the tissue to blood vessels in the chest in order to provide proper circulation. In addition, the skin of the stomach will be tightened and closed with stitches. The surgery is complete when the doctor places drains in the breast area to aid with the body’s natural healing process. On average, surgery takes about 5 hours.

The Pros and Cons of DIEP Flap Reconstruction

DIEP flap reconstruction is a unique procedure, and one that is more invasive than implant reconstruction. Not all candidates for breast reconstruction after mastectomy are candidates for the DIEP flap technique. For example, this surgery is not suitable for individuals who lack adequate abdominal tissue, have blood vessel problems, or those who smoke. For those individuals that are able to undergo this type of reconstructive surgery, there are a number of pros and cons.

Pros

• Abdominal strength is preserved
• Breasts tissue feels more natural than implants
• Patients generally experience less discomfort than TRAM flap
• Long-lasting solution, will not have to be replaced like implants
• Shorter recovery time than other treatment options

Cons

• Permanent scarring on the breast, abdomen, and belly button
• Highly specialized procedure – not all surgeons can perform it
• Newly reconstructed breast will have little sensation

The “Free Flap” Reconstruction

DIEP flap reconstruction is sometimes referred to as a “free” flap reconstruction method because the skin and fat of the abdomen are completely detached from their original blood supply and then reconnected to a new supply in the breast area. The TRAM flap procedure, however, doesn’t actually detach tissue of the belly from its original blood vessels. The other main difference between TRAM and DIEP flap is that DIEP flap does not involve the grafting of any muscle tissue.

Many Patients Want to Know…

Am I a Candidate for DIEP Flap?

Before undergoing any type of breast reconstructive surgery, it is important to speak to your surgeon about all of your options. There are several different techniques used in breast reconstruction and your surgeon can help you decide which is best for you. Your candidacy for DIEP flap will depend on a number of factors including your cancer treatment, amount of available abdominal tissue, and personal preference. Learn more about what makes a good breast reconstruction candidate.