DIEP Flap Breast Reconstruction
The use of microsurgery and perforator flaps, such as the Deep Inferior Epigastric Perforator (DIEP), is the newest and state of the art technique for breast reconstruction today. Very few plastic surgeons perform this technique due to its complexity, time, and skill involved, but such reconstruction provides the best aesthetic outcome with less morbidity, for those women who are candidates for this unique procedure. It is a procedure that we have refined through fellowship training, and one in which women throughout the United States consult us for to perform this innovative type of breast reconstruction.
Nearly every woman is a candidate for this flap procedure, in which your own tissue is utilized to reconstruct a breast. It is an option for every woman and should be discussed and offered as an option for all women seeking consultation for breast reconstruction. Women should seek plastic surgeons trained in and specialize in breast reconstruction for her breast reconstruction.
Unlike the conventional TRAM flap procedure, the perforator flap DIEP breast reconstruction offers the advantages such as those offered by the TRAM flap, without the sacrifice of the rectus abdominis muscle – only the excess skin and fat from your lower abdominal wall is harvested for the flap. Your abdominal wall strength and integrity is unchanged following this procedure as all muscles remain intact. Also, the chance for hernias and bulges are nearly zero percent. The flap and its blood vessels are disconnected entirely from the body, and the entire flap is then relocated to its new location in the breast area as a free tissue transfer. Its corresponding blood vessels are then reattached to blood vessels in the nearby area, using microsurgical techniques. The advantages are that your own tissue is used, it negates the need for prosthetic implants, and is a lifelong/more durable breast reconstruction that looks, feels, and moves just like your own tissue, which it is.
Much like a tummy tuck, your abdominal incision will be sutured closed, first by repairing the abdominal wall, then by suturing your incision, leaving a single incision at the lower abdomen, hidden within your bikini line. To finish the closure, your umbilicus (belly button) will be brought out through a small incision, and sutured at its normal anatomic location.
There are implant-based as well as flap-based breast reconstruction procedures. Seek a board-certified plastic surgeon who specializes in breast reconstruction to discuss ALL of your options and assist you in deciding which will be the right one for you. Other free flap, microsurgical breast reconstruction procedures that we offer in addition to the DIEP flap include the SIEA, SGAP, IGAP, TAP, ALT, and TUG.