Breast Reconstruction – DIEP Flap

The DIEP flap utilizes state-of-the-art surgical techniques to transfer excess skin and fat from the lower abdomen to build a soft, natural-appearing breast after mastectomy. A narrow scar in the bikini line, abdominal results much like a tummy tuck, and avoidance of implants or foreign materials are some of the attractive benefits of this procedure. First described nearly 30 years ago, the DIEP flap procedure has evolved into one of the most preferred and safe breast reconstruction methods.

In the DIEP flap procedure, Dr. Webb meticulously disconnects the 1-3mm artery and vein blood vessels that supply the lower abdominal skin and fat and carefully connects them to blood vessels in the chest using the microscope, thereby ensuring there is adequate blood flow to the reconstructed breast. The tissue is then carefully sculpted into the breast form. No rectus abdominus muscle is removed with this procedure so patients do not have to worry about abdominal wall weakness, bulges, hernias or mesh placement as they might with the traditional TRAM (transverse rectus abdominus muscle) flap which does take part or all of the muscle. Because no muscle is sacrificed with the DIEP flap, patients have far less postoperative pain and a much faster recovery period. Many patients that have experienced both tissue expanders and DIEP flap will say the DIEP flap recovery process was easier.

Patients typically stay overnight in the hospital for two nights to allow for close monitoring of the blood flow in the flap. Exparel, a local numbing medication that lasts about three days, is used to help take the edge off the first few days but prescription pain medication and muscle relaxers will be available as needed. Patients are up walking the day after surgery to encourage healthy blood flow and a short course of blood thinner may be prescribed to decrease the risk of blood clots. Drains will be used for a period of time to prevent build-up of fluid. Sleeping up in a recliner or with pillows in a “beach-chair” position is often helpful for the first week or two. Patients will be placed into a soft supportive bra and abdominal binder or compression garment to help with swelling and support. Typically, patients are cleared to return to full exercise starting six weeks after surgery.

Subsequent nipple reconstruction, 3D areolar tattooing, adjustments in the flap shape or abdominal scars may be performed at a later stage, if needed. Using one’s own body tissue or autologous tissue reconstruction is often recommended when a patient has undergone chest wall radiation or have had difficulty tolerating implants. Not all patients are candidates for this procedure and other autologous tissue donor sites like the back, inner thighs or buttocks may be options.

Breast reconstruction options after mastectomy have come a long way, but the DIEP flap provides a natural, realistic breast shape without need for implants. Schedule your consultation with Dr. Webb in our Atlanta office today at 404-661-6865 to discuss DIEP flap breast reconstruction.