DIEP Surgery vs. Implants for Breast Reconstruction

Many women who have undergone a mastectomy for breast cancer opt to undergo a reconstruction procedure for the missing breast or breasts. There are currently three main procedures that can be done in order to reconstruct a missing breast: TRAM (transverse rectus abdominus muscle) flap, DIEP (deep inferior epigastric perforator), or breast implant reconstruction. The TRAM procedure, which involves reconstructing the breast from abdominal tissue, fat, blood vessels, and muscles, is falling out of favor as a complicated, very invasive procedure. More women are now choosing between breast implants and DIEP, which only uses abdominal tissue, blood vessels, and fat, thereby sparing the abdominal muscles and skin.

A study in the August 2011 issue of the Journal of Plastic, Reconstructive & Aesthetic Surgery found that women who opted for breast implant reconstruction were more concerned with surgical issues such as recovery time and scarring. On the other hand, women who opted for a DIEP flap procedure were more concerned with the aesthetic appearance of the new breast.

Advantages for Implant Reconstruction

The major advantage for a breast implant reconstruction over a DIEP flap reconstruction is that the former procedure is much less complicated and lengthy, with less recovery time following the procedure. There will also be less scarring with an implant procedure than with a DIEP flap reconstruction. Additionally, a DIEP flap reconstruction is essentially two surgeries done at the same time. The procedure to harvest abdominal fat, blood vessels, and tissue is similar to a tummy tuck procedure. Some patients may not wish to have an operation on the stomach due abdominal scarring, or they may not have enough abdominal fat to harvest.

Advantages for DIEP Flap Reconstruction

The biggest advantage for a DIEP flap reconstruction over a breast implant reconstruction is the feel and look of the reconstructed breast. As the DIEP procedure uses the body’s own material, no artificial materials are inserted into the breast, which will give a much more natural appearance and feel to the breast. The use of the body’s own tissues will also dramatically lower the risk of rejection and capsular contracture. The patient will also not have to worry about possible implant rupture or leakage, or implants needing to be replaced as they age.

The biggest disadvantage for the DIEP flap reconstruction as compared to a breast implant reconstruction is that the DIEP procedure is relatively new, so not all cosmetic surgeons are properly trained in the procedure. Any microsurgical procedure involving the small blood vessels will be very delicate and precise, with little room for error. The DIEP flap procedure is no exception. Dr. Marcus Crawford and and Dr. Steven Bailey are well trained in the DIEP flap procedure.

The final decision between a breast implant and a DIEP procedure will be very personal for the patient. It will most likely come down to a choice between ease of the surgical procedure and recovery, and the final aesthetic outcome.

Contact Crawford Plastic Surgery today to schedule a breast reconstruction consultation.