DIEP MICROSURGICAL BREAST RECONSTRUCTION

Painted DIEPRestoring the appearance of a breast after mastectomy is known as breast reconstruction.  Although the function of the breast is is lost when it is removed for breast cancer, the appearance, shape and texture can be reconstructed to closely approximate a natural breast. Microsurgical advances in just the past few years allow for improved and safer reconstruction than was available even ten years ago. One of the newer reconstructions is known as the DIEP flap.

DIEP flap microsurgical breast reconstruction uses your own abdominal skin and fat to reconstruct a breast after mastectomy. Using your own tissue is known as autologous breast reconstruction. The tissue that is used in DIEP breast reconstruction is the same area of abdominal tissue that is discarded in patients that undergo cosmetic surgery for a 'tummy tuck'. This area of tissue provides a large amount of skin and subcutaneous fat with an excellent blood supply.  You only need to pinch your belly skin and fat to see that there is usually lots of tissue there in most people. DIEP reconstruction can provide excellent aesthetic results with superior post-operative recovery and abdominal wall function than seen with the TRAM flap.

DIEP BREAST RECONSTRUCTION PRESERVES ABDOMINAL MUSCLES

The DIEP breast reconstruction uses the abdominal skin and subcutaneous fat without sacrificing the strong abdominal supporting tissue known as fascia or the rectus muscles.  By contrast, fascia and muscle removal are performed in the TRAM flap, and are a considerable disadvantage to that type of surgery. For this reason, we recommend the TRAM flap only very rarely..

The DIEP flap is transplanted to the chest for breast reconstruction by microsurgically attaching the circulation to blood vessels in the chest.  By giving the tissue circulation, it can remain soft and feel more like a normal breast. Because it is technically more complex than implant and TRAM flap surgery, it should only be performed in medical centers that routinely perform microsurgery.

ABDOMINAL TISSUE IS USED FOR THE RECONSTRUCTION

Flap Outline

Tissue from the abdomen, outlined in blue in the illustration above, is used to reconstruct the breast. After this tissue is transplanted to reconstruct the breast, a tummy tuck is performed. Advantages of the DIEP flap include:

  • Preservation of the rectus muscle

  • Preservation of the rectus sheath

  • Less post-operative pain compared to the TRAM

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