Flap Breast Reconstruction: DIEP Technique

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. Following is information about the DIEP flap microsurgical breast reconstruction method, including the pros and cons of the procedure for mastectomy patients to consider.

DIEP Flap Breast Reconstruction after Mastectomy

Like TRAM flap breast reconstruction, the DIEP free flap technique utilizes the patient’s abdominal region as the donor tissue site. However, DIEP flap breast reconstruction uses only skin and fat, sparing the muscles. DIEP flap breast reconstruction after mastectomy is more complicated to perform than reconstruction with pedicle flaps, but it does provide the potential for more rapid recovery of abdominal strength. Deep Inferior Epigastric Perforation (DIEP) refers to the name of the tissue that is used to create the new breast; it is the tissue found beneath the rectus abdominus (the so-called “six-pack” muscles of the abdomen). Rather than taking part of this muscle, the surgeon transfers only sections of its blood vessels which have branched out to the underlying abdominal fat. Ultimately, the abdominal muscle tissue is preserved and the patient ends up with a tummy tuck of sorts due to the removal of extra fat and skin from the abdominal area — just two of the benefits of microsurgical breast reconstruction.

Free Flap: Microsurgical Breast Reconstruction

DIEP flap microsurgical breast reconstruction differs from other methods of reconstruction in that the tissue used to make the breast is completely removed (or “free”) from its original blood supply and then reconnected to a new supply at the breast area. For example, blood vessels from the DIEP flap tissue can be joined with blood vessels within the armpit region or near the sternum. Because of this, the DIEP technique is sometimes called a “free flap” reconstruction. Gluteal flap reconstruction is another type of free flap surgery.

During microsurgical breast reconstruction, an incision similar to that which begins an abdominoplasty procedure is made along the bikini line. From this incision, the necessary skin, fat, and blood vessels are taken and placed into the breast area at the point of mastectomy, where the surgeon forms them into the desired shape. Finally, the abdominal skin and underlying fat are tightened and the incision is closed. The entire procedure takes approximately six to eight hours. Recovery from breast reconstruction surgery takes some time, but DIEP flap breast reconstruction has proven to be a less painful process for patients than most other reconstructive methods.

Not all candidates for breast reconstruction after mastectomy are candidates for the DIEP flap technique; a lack of adequate abdominal tissue can prevent some women from having the procedure. However, there is a variety of other methods available, including breast reconstruction with implants and TRAM flap reconstruction.

Considerations for DIEP Flap Patients

With so many surgical options available today, knowing which method is right for you can be difficult. Patients who are considering DIEP flap breast reconstruction after mastectomy should carefully evaluate the pros and cons of the technique. One major downside is the additional abdominal scarring due to the removal of DIEP tissue. A second downside is that this type of free flap surgery can only be performed once; if another breast is removed at some point in the future, alternative reconstruction techniques will need to be utilized.

DIEP flap patients generally have a shorter recovery time and experience less abdominal weakness than TRAM flap recipients. Additionally, unlike implant reconstruction, free flap microsurgical breast reconstruction does not require the placement of foreign materials into the body.

Exploring answers to common breast reconstruction questions can also assist patients in choosing the right reconstruction procedure, and provide them with information to discuss with their cosmetic surgeon.

Find a Cosmetic Surgeon through DocShop

If you are interested in learning more about DIEP Flap breast reconstruction after a mastectomy or in discussing other microsurgical breast reconstruction techniques with a cosmetic surgeon in your area, DocShop can help. Use DocShop’s online directory of medical professionals to find an experienced breast reconstruction surgeon near you.