DIEP Flap Reconstruction
What is a DIEP flap?
A flap is tissue (usually skin, fat and sometimes muscle) which is moved from one place to another on your body, with its own blood supply. The tissue most commonly used to make a new breast is the tissue from your lower abdomen. The DIEP Flap is named after the Deep Inferior Epigastric artery Perforators (branches), the blood vessel to the tissue of your lower abdomen which is used to recreate your breast.
Who is a DIEP flap suitable for?
Your surgeon will assess the distribution of fat on your body and your surgical risk factors such as obesity (being overweight), smoking or scarring before recommending a reconstruction using abdominal tissue. The DIEP flap is usually suitable for women who have a small to moderate amount of tissue volume of their tummy wall, between their umbilicus (tummy button) and pubic hair, which large enough to recreate the volume of a new breast. DIEP flaps cannot be performed on women who have previously had an abdominoplasty or a prior DIEP flap.
Why is a DIEP flap done?
The DIEP flap is used to recreate a new breast after mastectomy. The abdomen can be an ideal area to take tissue from, as a large amount of skin and fat can be taken to recreate the breast. It can provide a natural looking and feeling breast. The main advantage of this operation is that no implant is needed for breast volume. This means the reconstructed breast is entirely your own tissue. This also means the result is long lasting with no implant-related complications in the longer term.
What is the process?
The operation is performed under a general anaesthetic and commonly takes between six and eight hours to recreate one breast. Bilateral (both sides) reconstructions take longer. In this operation, one or more perforators (blood vessel branches) are carefully dissected out from the rectus abdominus (“6 pack”) muscle of your abdomen as the flap is raised. The lower abdominal tissue is transferred to the breast area without your muscle being taken. The DIEP flaps blood vessels are then re-attached to blood vessels in your chest, which run under the ribs, using the microscope. This allows the tissue to survive in your breast area. The success of the reconstruction depends on maintaining a good blood supply to the tissue.
The implant is placed, and the incisions on the back and breast area are closed.