Diep Flap FAQs
The DIEP (Deep Inferior Epigastric Perforator) Flap procedure is a surgical technique commonly used in breast reconstruction following a mastectomy. It is a microsurgical procedure that utilizes the patient’s own abdominal tissue, specifically the lower abdominal skin and fat, to recreate a natural-looking breast mound. Unlike other flap procedures that may involve muscle sacrifice, the DIEP Flap preserves the abdominal muscles, resulting in a faster recovery and reduced risk of abdominal wall weakness. This procedure offers several advantages for breast cancer patients, including the ability to restore breast shape and volume, improve body contour, and achieve long-lasting results. By utilizing the patient’s own tissue, the DIEP Flap procedure provides a more natural and harmonious outcome, both aesthetically and functionally, helping women regain confidence and a sense of wholeness after breast cancer surgery.
Below, you’ll find commonly asked questions regarding the Diep Flap procedure as well as information surrounding breast health and breast cancer.
General Questions
What is DIEP Flap breast reconstruction?
The DIEP Flap procedure is a new and innovative treatment option that provides mastectomy patients with an alternative option for breast reconstruction. The process involves removing fat, skin, and blood vessels from the lower abdominal wall and transferring them to the breast area, where the surgeon delicately attaches the blood vessels to the chest wall.
If you have undergone a mastectomy or are considering reconstruction, the DIEP Flap procedure offers a less invasive technique for rebuilding your breast contour and achieving a natural silhouette without the use of implants.
What are the benefits of this procedure versus other reconstructive methods?
The DIEP Flap procedure is a revolutionary new breast reconstruction option for mastectomy patients that offers many advantages over traditional reconstruction. Unlike other methods, the DIEP Flap procedure uses the patient’s tissue – so there is no need for implants or foreign materials. Since this procedure does not require harvesting muscle tissue, DIEP flap recovery times are shorter than other flap-based reconstruction methods. Any risk of complications from implants are eliminated since this technique does not require silicone or saline implants.
Another major benefit of the DIEP Flap procedure is the ability to create a natural-looking silhouette. Because the fat, skin, and blood vessels are taken from the lower abdominal area, the shape and contour of the breast can be closely matched to the patient’s existing anatomy. This means that the reconstructed breast can look and feel as close to the original as possible.
Additionally, this procedure offers aesthetic benefits beyond restoring breast shape. By using excess or unwanted tissue as donor tissue, your surgeon can create a more sculpted abdomen and renewed breast contour at the same time.
What is the surgical process for DIEP Flap procedures?
A DIEP Flap procedure is a surgical technique that involves relocating fat, skin, and blood vessels from the lower abdomen to the chest area to reconstruct the breast contour. The procedure does not involve the removal or cutting of any muscle. Because of this, DIEP flap procedures have shorter recovery periods and lower risks for complications than other breast reconstruction procedures.
The surgery generally takes between six to eight hours and is performed under general anesthesia. The abdominal incision line is located within the bikini line for minimal visibility, near the top of the pubic bone. From here, fat, skin, and blood vessels are excised from the donor area, and the belly button is relocated through a separate incision in its new location. The abdominal skin is then tightened and anchored into place with internal sutures. The blood vessels of the donated flap are then carefully attached to blood vessels within the chest wall to supply the flap with adequate blood flow.
The surgeon then shapes the new breast with the flap, creating a new and natural-looking contour. Then, incisions are closed using sutures and/or surgical adhesive. Although the incision lines are permanent, they can be concealed under clothing and scars will gradually fade over time.
What are the risks with DIEP Flap?
Surgery always comes with inherent risks, which can be reduced by meticulously following the pre-surgical instructions. If you have any underlying medical conditions or other factors that heighten your risk, we will collaborate with you to ensure that you are adequately prepared and that your clinical care regimen is optimized for your safety and speedy recovery.
Patients may experience post-operative pain, which should subside within a week and can be managed with over-the-counter pain medication. Swelling, bruising, tenderness or sensitivity at the surgical sites are to be expected and should resolve on their own over time.
There are several potential risks involved with DIEP flap surgery, such as bleeding, asymmetry, tissue death or necrosis, adverse or unsightly scarring, hernia, loss of sensation or muscle weakness, changes in texture, infection, and the potential need for revisional surgery.
Prior to consenting to surgery, patients will be fully informed about these risks and any other potential complications. Your surgeon will be available to answer any questions you may have before and after the procedure. Anesthesia is required for this procedure, which has its risks to consider.
How should I prepare myself for surgery?
There are several things you should do to prepare for surgery, and all patients are required to follow specific guidelines before their procedure. Shower the night before your procedure, as you will need to avoid submerging the surgical site for several days. Do not wear makeup, contact lenses, or jewelry to your appointment. Do not ingest food and drink after midnight on the night before your procedure.
Avoid alcohol and nicotine, as these substances significantly increase the risk of bleeding. Certain medications such as pain relievers, anti-inflammatory agents, blood thinners, and certain supplements can affect the body’s reaction to surgery and should be avoided for at least two weeks before the procedure.
Patients will not be able to drive after this procedure, and should also arrange for someone to stay with them after the surgery. It is recommended to plan for childcare or pet care for a few days to weeks after the procedure to avoid lifting.
Who is not a good candidate for DIEP Flap?
While most people are good candidates for DIEP flap procedures, there are several patient types that are not recommended for this treatment. Patients who have already had an abdominoplasty or certain other abdominal procedures may not be eligible. Patients with low body mass may not have enough extra tissue to create the flap, but other autologous flap-based reconstruction procedures may be applicable in these situations.
What is the recovery process like for a DIEP Flap procedure?
DIEP Flap is a surgical breast reconstruction procedure that will permanently alter your silhouette, but results are not guaranteed to last forever. The aging process does not stop after surgery. Following your procedure, you will be required to stay for a period of observation for 3-5 days. During this period the incisions will be bandaged, and small tube drains will help to reduce fluid buildup.
A supportive compression bra will help support the new breast and should be worn for six weeks after your procedure to allow the flap tissue to conform to the new contour. After that, wear a non-underwire bra for an extra two weeks. Avoid standing upright or laying down flat for at least two weeks to prevent tension at the incision. Do not put pressure on your breasts. Place pillows under your head and knees, and sleep on your back in an upright position for at least four weeks.
The final results of your procedure will start to appear after the swelling has subsided, usually within one to two months. Recovery times may vary based on the patient’s history, treatment area size, and other factors. While most patients can return to normal activities within two weeks, strenuous activities and exercise should be avoided for four to six weeks. Major swelling should subside on its own, and complete healing requires several months.
Incision lines will fade but will not disappear entirely. Follow all instructions provided by your surgeon to minimize scarring and expedite the healing process.