DIEP Flap Candidates for Breast Reconstruction

A breast reconstruction procedure is performed following a mastectomy (surgical removal of the breast) in the treatment of breast cancer. The goal of DIEP breast reconstruction surgery is to reconstruct the breasts and restore a more natural look to the body. Many of the conventional breast reconstructive procedures require a lengthy and unpleasant recovery period, and also place restrictions on patients following surgery. This is why our surgeons perform the deep inferior epigastric artery perforator (DIEP) flap procedure, a new breast reconstruction technique that is associated with a quicker recovery and fewer restrictions. For these reasons, the DIEP approach is becoming more popular as a means of breast reconstruction following mastectomy.

What Is the DIEP Flap Procedure?

In a DIEP flap procedure, fat and skin are taken from the abdominal area and used to reconstruct the breast. It is a type of autologous reconstruction, meaning that it uses the body’s own tissue for the reconstruction process.

DIEP flap procedures can be performed at the time of the mastectomy, or after follow-up treatments are complete. If the procedure is done in stages, a tissue expander is placed into the pectoral muscles at the time of the mastectomy procedure. This will prevent the skin from contracting and maintain a pocket in which the new breast mound can be placed. After several months, the tissue expander is removed and the DIEP flap procedure is performed. A third surgery may be necessary in order to reconstruct the nipple and areola.

Who Is a Good Candidate for the DIEP Flap Procedure?

Patients who have already undergone a tummy tuck procedure are probably not good candidates for a DIEP flap procedure, as patients must have a sufficient amount of  abdominal fat and skin to properly reconstruct the breast. Likewise, patients who are very thin may also not be good candidates for this procedure. Patients who are active smokers are not good candidates for the DIEP flap procedure because the abdominal incision will heal more slowly and the fat is more likely to turn into scar tissue.

What Are the Advantages and Disadvantages of a DIEP Flap Procedure?

One of the biggest advantages of DIEP over earlier procedures is that no abdominal muscle is moved. Therefore, the abdominal wall is not weakened, which may increase the risk for hernia. Other benefits include:

• The removal of the abdominal fat and skin, which slims the stomach area.
• Less pain and a shorter recovery time than with other reconstructive procedures.
• The DIEP failure rate is low.

However, there are also some disadvantages to the DIEP flap procedure. It does take longer than other reconstructive procedures, and the surgery results in scars at two different surgical sites. If the DIEP procedure fails, the tissue will have to be removed, and the patient may have to wait an additional six to 12 months before undergoing another DIEP flap procedure.

Our surgeons are skilled in all forms of breast reconstruction following mastectomy. Patients can discuss options with him during a consultation to determine which reconstructive procedure will give them the results they desire.