At our Aesthetic and Restorative Breast Center, we will discuss during a private consultation if you are an ideal candidate for DIEP (deep inferior epigastric perforator) or SIEP (superficial inferior epigastric perforator) flap reconstruction, as there are many techniques to choose from depending on your body type, and aesthetic goals. We are proud to offer DIEP flap surgery services, which is our most common autologous free tissue transfer breast reconstruction, to our breast cancer patients and survivors, and want to help each one on their way back to living their lives beyond the diagnosis.
Using microsurgical techniques, our plastic and reconstructive surgeons, Dr. Matatov and Dr. Torabi, can restore your breast(s) with this type of flap by removing tissue and blood vessels from the abdomen to create renewed, live tissue without sacrificing your abdominal muscles and nerves.
When you choose to have a DIEP flap reconstruction, you will not have the same complications after the surgery as you would have with breast implants. This includes issues such as implant rupture, rippling, capsular contracture, or the need for multiple revision surgeries when the implants need exchanged.
The autologous tissue from your abdomen will have a natural look and feel to the breast that you would not achieve with a synthetic implant, especially if you only have reconstruction on one breast.
The DIEP flap surgery does have drawbacks, as well. The surgery for this procedure is longer, and will require the remove of tissue from other areas of the body. This will mean that you will also have multiple incision points with scarring. The good news is that your surgery is being performed by a highly-skilled plastic surgeon, who will do his absolute best to limit your scarring, and make each surgical site look as aesthetically pleasing as possible. Keep in mind that there is also a risk of infection. If the DIEP flap fails, it will require follow-up surgeries to correct the reconstruction, and may involve the use of silicone or saline implants in the place of your own tissue.
The Women’s Health and Cancer Rights Act of 1998 (WHCRA) states that if your health plan or insurance company offers coverage for mastectomies, the plan is required to offer coverage for all stages of reconstruction of the breast(s), including corrective surgeries, insertion of prostheses, and post-mastectomy lymphedema. The group health plan or insurance company can still impose deductibles to the procedures, however, the deductible must be applicable to the services as they apply to a mastectomy.
Our Surgical Requirements
Our DIEP reconstruction at Aesthetic and Restorative Breast Center utilizes a muscle and nerve sparing technique, where only excess skin and fat are harvested from the abdomen. Small blood vessels are left attached to an island of tissue that is transferred and reconnected to the vasculature at the mastectomy site. After it has been revascularized, the tissue is sculpted into a breast mound. This island of tissue, used to create the breast mound, is the same tissue that is typically discarded after a tummy tuck.
With this flap, patients achieve an improved abdominal contour they would have following a tummy tuck, in addition to a natural breast mound. Unlike a traditional TRAM flap, where the muscle is sacrificed, with a DIEP the abdominal wall muscle is preserved, reducing the rate of abdominal wall bulges, and maintaining core strength. For these reasons we preferentially perform DIEP reconstruction in our practice.
You will be taken to the recovery room, where you will be monitored and cared for by our post-operation nursing staff. These nurses will monitor your pain, blood flow, vital signs, and care for your incisions. This procedure requires a stay in the hospital or surgical center. We suggest that your recovery period will be 1 – 6 weeks (including periods of breast tenderness), and you should attend all of your follow-up appointments. Strenuous activity should be avoided for a 6-week period, but light activity can begin as early as 4 weeks.
Follow-up & Considerations
Your reconstructive surgeon will require you to have a follow-up appointment in a week after your surgery to check your incision points, look for abnormalities, and to assess your progress. Follow all of your plastic surgeon's after-care instructions, and call our office if you have excessive bleeding, fever, or any unusual side effect from the medication or surgical procedure.
Plan Your Procedure
- Recovery Time
- 4 – 6 Weeks
- Average Procedure Time
- 4 – 7 Hours
- Post-op Follow-up
- 1 Week
- Procedure Recovery Location
Restore With Your Own Tissue
When you decide to have reconstructive breast surgery, it is a big decision to make, especially after aggressively treating breast cancer. At ARBC, we want to make your surgical decisions as easy as possible, and will answer all of your questions so you can make an informed decision about your care. If you would like a consultation for DIEP flap reconstruction, please contact our office and schedule your first appointment today.