Reconstruct Your Breasts Using Abdominal Fat and Skin
The deep inferior epigastric perforator (DIEP) flap is a breast reconstruction procedure that uses fat and skin from the lower abdomen to recreate a breast mound and restore breast shape after mastectomy or lumpectomy.
This natural tissue flap reconstruction technique is common, as the abdomen allows for more significant fat and skin harvesting than some other flap techniques.
Dr. Ali Sadeghi brings a focused intensity to his breast reconstructive patients. His primary interest is in advancing the quality of breast reconstruction, and he is an expert in the revolutionary DIEP flap breast reconstruction procedure.
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What Are the Benefits of a DIEP Flap Procedure?
Women may choose the DIEP flap procedure for their breast reconstruction because:
- It provides natural-looking results
- Many patients have adequate fat to harvest in the lower abdomen
- It helps achieve the aesthetic results of a tummy tuck while recreating the breasts
- It spares the all-important core muscles
- It can be performed with or without implants
How Is a DIEP Flap Procedure Done?
Also known as the “tummy tuck flap,” the DIEP flap procedure removes fat from the abdomen to reconstruct your breasts. DIEP flap surgeries should last around two to three hours for a unilateral procedure and four to five hours for a bilateral procedure.
During this technique, tissue is harvested and regrafted into the newly recreated breasts (following mastectomy or lumpectomy). Usually, this tissue is detached from its original blood supply and then reattached once moved to the breasts.
How Is a DIEP Flap Different From a TRAM Flap?
The DIEP flap only takes fat and skin from the abdominal wall in your lower abdomen for your breast reconstruction, based on that area’s deep blood supply. The abdominal muscle is left intact, allowing you to continue to use the abdominal muscles to maintain your core strength.
In the past, abdominal tissue flaps sacrificed some or all of the rectus abdominis muscle (the “six-pack” muscle). This was known as the TRAM flap. In addition to being very invasive, the TRAM flap also contributed to core strength weakness, abdominal hernias, or bulges.
Because of this, Dr. Sadeghi never uses the TRAM flap in his practice.
What Is SIEA Reconstruction?
Another way the abdominal tissue can be used for breast reconstruction is the superficial inferior epigastric artery (SIEA) flap.
Like the DIEP, this procedure allows Dr. Sadeghi to use the fat and skin from the lower abdominal wall. Again, the abdominal muscle is left intact, allowing you to continue using the abdominal muscles to maintain core strength.
What Should I Expect After My DIEP Flap Breast Reconstruction?
You should expect to stay in the hospital one to two days for a unilateral procedure and two to four days for a bilateral procedure.
Most patients can expect to return to work within two to four weeks after the procedure. Full recovery
What Are Stacked DIEP Flaps?
Because breast reconstruction after mastectomy requires so much tissue to rebuild the breasts (especially in double mastectomy instances), standard DIEP flap practices are not enough.
Stacked DIEP flaps use tissue from both halves of the abdomen.
Additionally, tissue flaps may be taken from the buttocks (GAP flap) or posterior thigh (PAP flap).
This combination of tissue flaps makes up a stacked DIEP flap.
Will I Need to Combine My DIEP Flaps With Implants?
Patients with inadequate abdominal fat to reconstruct both breasts can pose a challenging issue in breast reconstruction.
Fortunately, options are available to deal with this problem. Patients can either choose stacked flaps or implants. DIEP reconstruction with implants allows for significant volume enhancement following breast cancer treatment.
Implants can be used along with your tissue at the time of your reconstruction or in a delayed fashion after DIEP surgery.