DIEP flap breast reconstruction

Once you have decided that breast reconstruction is right for you, a specialty surgeon from U of M will discuss your surgical options and help you choose a procedure best for your body type and personal goals. Some reconstruction options are “flap” procedures, during which your own tissue, taken from a different area of your body, is used to recreate the breast. Using your tissue instead of implants typically makes for more natural results and avoids unique complications associated with breast implants.

There are several different flap procedures available. As surgical techniques have advanced over the past few decades, our breast reconstruction experts offer newer flap surgeries that are designed to minimize potential side effects associated with older flap techniques.

One of the newer flap techniques is the DIEP flap, or Deep Inferior Epigastric Artery Perforator flap. To perform a DIEP flap procedure surgeons use skin and fatty tissue from the lower abdomen to reconstruct a breast, leaving the abdominal muscle intact. Some women know this as a “tummy tuck” donor site procedure because the removal of some skin and fat tissue in the lower abdomen. In many patients the abdominal contour improvement is an added benefit.

How is DIEP flap reconstruction done?

DIEP thumb image

An incision is made in the lower abdomen, spanning from hip to hip, from which your surgeon will remove a section of skin, fatty tissue and blood vessels that will be used to reconstruct the breast. The abdominal incision is closed by pulling down the abdomen skin, and the belly button is positioned to naturally fit the improved contour of the abdomen. Using a microscope, the blood vessels in the flap are then connected to vessels in the chest found within the mastectomy site. This connection allows the flap to thrive as a healthy and functioning part of the new breast. DIEP flaps can also be performed on both breasts, known as a bilateral reconstruction, using a single donor site if you’ve undergone a double mastectomy. Since these flaps require the use of abdominal tissue, women with very low body fat may be better candidates for other flap procedures.

Outcomes and Recovery

Our experienced plastic surgeons will do everything they can to achieve a natural look and feel for your newly reconstructed breast. Since DIEP flap uses your natural tissue, the reconstructed breast will be able to change alongside your natural breast, like during weight changes. Being a free flap reconstruction, surgeons can shape the flap and outcomes tend to be more favorable. You will have a scar across your abdomen, around the bellow button, and on the reconstructed breast. Many patients have procedures following DIEP flap that include shaping of the reconstructed breasts, breast lifts or reductions of their natural breast, and nipple reconstructions to achieve the best symmetry possible. Our clinic also provides areola tattoo services. You should address all your concerns and appearance goals with your plastic surgeon. The surgeon will be able to provide example photos, describe options and set reasonable expectations.

After surgery, you will remain under close observation for three to five days. This allows the surgical team to closely monitor blood flow to the newly constructed breast, ensuring that the flap is healthy. Drains placed in the breast and donor area of the abdomen stay in place for two to three weeks while the patient recovers at home, and are taken out during an office visit. Within four weeks, patients may return to driving, some work (depending on job requirements) and light exercise. Most patients are back to their regular routines and full activities in six weeks. Because DIEP flap preserves the muscle wall, unlike TRAM flap procedures, most patients are able to return to their normal exercise and activities after recovery.

Risks and Complications

As with any surgery, there are some risks associated with DIEP flap. Patients face the risk of bleeding, infections or poor wound healing. Flap patients have the potential for partial or total flap loss cause dby a lack of blood flow to the flap, sometimes known as “flap death.” Your surgeon will be able to discuss any potential risks and concerns you may have.

Is this right for me?

The DIEP flap procedure can work well for many patients, but it is important that your choice takes into consideration your body type, health, lifestyle, and personal reconstruction goals. You will want to explore all reconstruction options, before making a decision. We suggest scheduling a consultation with one of our experts in breast reconstruction. During the visit, you will have a chance to ask questions, choose a surgical plan, and discuss preparation and recovery.

Your surgeons and care team

The plastic surgeons and care team members who perform breast reconstructions and help patients recover from the procedure are experts in their field. All surgeons including the plastic surgeons and surgical oncologists work very closely to plan your surgical treatment and reconstruction. All of our surgeons are board-certified in plastic surgery and have years of experience in breast reconstruction procedures. Learn more about the team through the profiles below.

Make an Appointment

If you are ready for a consultation, call 734-998-6022 to schedule an appointment with one of our specialty plastic surgeons.