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How is DIEP Flap Breast Reconstruction Performed?

Posted Feb 22 2012 7:31am
DIEP (deep inferior epigastric perforator) flap reconstruction is advanced reconstructive surgery to mold the breasts using skin and fat from the patient’s abdomen. This procedure is widely opted for by women who have had a mastectomy, are seeking to correct congenital breast asymmetry. It is also the best option for women planning to have children, irradiated women, and those leading an active lifestyle. It’s important to know how DIEP breast reconstruction is performed so as to be prepared for the procedure.

DIEP Flap Breast Reconstruction – the Procedure

The DIEP flap procedure was developed as an improvement over the TRAM (transverse rectus abdominis myocutaneous) procedure which involves removal of abdominal muscle. The surgeon first determines if you are a good candidate for this relatively minimally invasive surgery. The steps involved in DIEP flap surgery

•    CT scans are performed to locate and identify blood sources within the abdominal tissue. These scans will help the surgeon decide the patient’s candidature for the surgery
•    The patient is put under general anesthesia
•    The plastic surgeon makes an incision in the muscle and removes a flap of skin from the lower abdominal region, which contains tiny blood vessels, skin and subcutaneous tissue. No muscle is removed
•    The surgeon performs microsurgery to transfer the free flap to the chest and connect it to the blood vessels there
•    The flap is used to mold new breast mounds
•    The nipples and areolas are created or reconstructed as necessary

By sparing the rectus muscle, DIEP flap reconstruction ensures that there are no abdominal complications such as structural weakness in abdominal walls. This prevents abdominal herniation.

Advantages of DIEP Breast Reconstruction Surgery


DIEP flap reconstruction ensures many benefits when compared to other methods:
•    Natural-looking and soft breasts
•    Keeps all the abdominal muscles intact to ensure abdominal strength
•    Reduces donor site trauma such as abdominal herniation, bulging and weakness
•    Ideal for women needing replacement of a large amount of breast skin,  reconstruction of both breasts and the delayed reconstruction of a large, droopy breast
•    Use of the patient’s own tissues allows the surgeon more freedom to design and shape the breasts to meet the patient’s goals
•    Short hospital stay of 3-4 days, with healing time of 4-5 weeks
•    Comparatively faster recovery than with TRAM breast reconstruction surgery

One of the major additional benefits of DIEP flap reconstruction is that the removal of fat and tissue from the abdomen offers a tummy effect.

The Right Plastic Surgeon


Only a surgeon with vast experience in reconstructive plastic surgery can offer the desired results for DIEP flap breast reconstruction. So choose your surgeon wisely. If you are having a mastectomy, it may be a good idea to see a plastic surgeon first, so that he gets an idea about your natural breasts and how you want your new, reconstructed breasts to look. In fact, the success of the DIEP flap procedure largely depends on the skill and expertise of your surgeon as well as on your health.
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