What is DIEP Flap Reconstruction?The DIEP flap (deep inferior epigastric perforator) is a tissue flap procedure that uses fat and skin from your tummy to create a new breast mound after a mastectomy. This procedure takes its name from the deep inferior epigastric perforator artery in your tummy area and is a form of autologous reconstruction -- a surgery that uses your own tissue.
Your reconstructed breast won't be just the same as your natural breast, and you will need additional reconstructive surgery to create a nipple and areola.
DIEP Flap MethodYour surgeon will move the skin and fat from your tummy area to your chest. No abdominal muscle will be cut or moved during this process. Most women have enough extra tissue in their tummy area to create a new breast. If not, a small implant can be placed under your tissue flap to create the breast size that you want. The removal of skin and fat from your tummy is similar to the procedure for a tummy tuck (abdominoplasty). A DIEP flap, however, also includes the movement of an artery and vein from your tissue flap to the chest so that the transplanted tissue can be supplied with blood.
Advantages and Disadvantages
- no muscle is moved (unlike a TRAM flap)
- almost no risk of developing an abdominal hernia as a result of this procedure
- less pain, faster recovery time than a TRAM flap
- removal of abdominal skin and fat results in a tummy tuck
- DIEP flap procedure has a less than 1% failure rate
- DIEP requires more time in surgery than a TRAM flap
- two scars result from a DIEP, as you will have two surgical sites
- if a DIEP procedure fails, the tissue flap may die and have to be completely removed
- if the tissue dies, new reconstruction may not be done for 6 to 12 months
You're Not a Good Candidate If:
- not enough tummy fat (you have already had abdominal skin and fat removed)
- you are very thin (you don't have ample skin and fatty tissue on your abdomen)
- you're an active smoker (your abdominal scar will heal slowly, and your fat tissue will more likely develop into scar tissue)
Breast Reconstruction Immediate or Delayed?Breast reconstruction can be done during a mastectomy or after chemo and radiation. If you need radiation treatments aimed at your underarm area or chest, you would be wise to delay having reconstruction. It is worth your wait: Having the procedure done before radiation is completed really limits a radiation therapist's ability to properly treat your cancer.
Reasons to Consult a Plastic Surgeon Before a Mastectomy
If you are thinking about reconstruction, it's a good idea go see your plastic surgeon before having mastectomy surgery. This gives you the chance to have precise measurements and pictures taken of your natural breasts. A plastic surgeon will use this information to make your reconstructed breast as close to natural shape and size as possible. If you've consulted with him beforehand, your plastic surgeon will give you a range of choices, help you save breast skin and prevent unnecessary scars.