For patients who require a mastectomy, the DIEP flap reconstruction is an advanced, effective option for breast reconstruction. “DIEP flap” is short for deep inferior epigastric perforator flap--a flap of the skin and tissue from the lower abdomen. A DIEP flap reconstruction is a microsurgical technique that provides a natural-looking breast reconstruction by harvesting skin and fat from the lower abdomen to create a new breast. The blood supply to this tissue (the DIEP flap) comes primarily from small blood vessel branches, called perforators.
During a DIEP flap reconstruction, only the skin and fat from the abdomen with perforating vessels will be removed, leaving the abdominal muscles in place. Since the DIEP flap procedure does not take actual abdominal muscle, the abdominal muscle strength can be preserved. With preservation of the abdominal muscle and fascia (the thin tissue surrounding the muscle structure), patients have a lower chance of developing a hernia.
The flap is harvested in an oval or elliptical shape extending from hip to hip, across the entire lower abdomen. This leaves a scar low on the abdomen, similar to the scarring of an abdominoplasty (tummy tuck).
Who is a candidate for the DIEP Flap?
Almost any woman who has had a mastectomy and also has adequate skin and fat in the lower abdomen is a candidate for DIEP flap reconstruction. After a single mastectomy, the entire flap can be used. After a double mastectomy, reconstruction requires the harvested flap to be split to restore each side.
To ensure you are a candidate for DIEP flap reconstruction, a special CT or MRI scan is done to evaluate where the best blood vessels feeding the lower abdominal skin and fat exist. This scan ensures that you are a good candidate for the surgery, and it reduces operating time.
What happens during the DIEP flap reconstruction surgery?
A breast surgeon will perform the mastectomy while your Regency surgeon begins harvesting the tissue from your abdomen for the DIEP flap. The flap of lower abdominal skin and fat and connected blood vessels are harvested with the help of high powered magnification glasses, called loupes.
After the mastectomy is completed, chest blood vessels will be identified to connect with the blood vessels of the DIEP flap. This connection is what restores blood flow to the DIEP flap, so the tissue can thrive with proper circulation, which provides the needed nutrients and oxygen to the area.
Once the chest blood vessels that will be connected to the flap are identified, the DIEP flap with its blood vessels is transferred to the chest. With the use of the operating microscope, microsurgery is done to connect the flap blood vessels to the recipient blood vessels in the chest. Following the connection, the flap is shaped to form a soft, natural breast.
Length of procedure and recovery
Your surgery will take extra time, about 6-8 hours for the procedure to be completed, because the careful work to connect the tiny blood vessels is so meticulous. However, because the human body tolerates surgery on the skin and fat very well, recovery is generally smooth. Patients will need only a two or three-night hospital stay. Your first night will be spent under close nursing observation to ensure the success of your surgery and that you’re doing well.
It can take about 6-8 weeks to recover from DIEP flap reconstruction surgery. To reduce swelling, fluid build up and bruising, you will wear a compression girdle for up to eight weeks after surgery. You'll have drains in your reconstructed breast(s) and in the donor site in your lower abdomen. Take time to heal and recover, and avoid lifting anything heavy, or doing any rigorous exercise or activity for about six weeks. Once you are healed, you will have an abdominal scar low on your abdomen that can be hidden by your underwear line.
Benefits of DIEP procedure
There are many benefits to the DIEP flap breast reconstruction:
- Looks and feels like a natural breast
- Spares the abdominal muscles resulting in a very rare rate of abdominal hernia
- Scarring is hidden in the underwear line
- Procedure is done simultaneously with the mastectomy
- The breast reconstruction responds to weight gain and loss the way natural breast tissue would
- Harvesting from the lower abdomen has a slimming effect in the area
Why Choose Regency Specialties?
Regency Specialties is a patient-centric practice delivering the very best in reconstruction surgery. We understand that this can be an uncertain and challenging time for women. We make it a priority to help you understand your options and feel secure with your treatment plan. Our skilled surgeons keep your safety and wellbeing in mind at all times and dedicate themselves to not only your outstanding results, but to ensuring you feel completely welcome from the moment you enter our door to your very last follow-up appointment. Call today for a consultation.
