Breast Reconstruction using the Abdominal tissue – DIEP Flap
“Autologous” Breast Reconstruction
The most common “autologous” breast reconstruction (using your own tissue including skin and fat) is the use of abdominal tissue, also known as the DIEP flap (Deep Inferior Epigastric Perferator flap).
DIEP Flap Breast Reconstruction
The most common “autologous” breast reconstruction (using your own tissue including skin and fat) is the use of abdominal tissue also known as the DIEP flap (Deep Inferior Epigastric Perferator flap). The DIEP flap requires a microsurgical technique to transfer skin and fat from the abdomen to create a new breast. This skin patch’s blood supply is provided by a network of small blood vessels that travel within your rectus abdominus muscle (the 6-pack muscles). These networks of blood vessels could be teased out and separated from the rectus muscle allowing preservation of this important abdominal muscle. Dr. Goldberg will, in effect, give you a “tummy tuck” while harvesting this abdominal skin patch and transferring it to your mastectomy site. Then she will meticulously reconnect the tiny 1 to 3 millimeter recipient vessels in your chest so blood can flow and tissue can grow. She uses your own skin and fat to artistically mold a new breast mound.
*Individual Results May Vary
This is a 49-year-old mother of 3 who was diagnosed with right breast DCIS measuring 6 cm. She also has a significant family history of breast cancer. She elected to have right breast mastectomy. She desires to have breast reconstruction using her own tissue and also staying the same size as her native breast. Her breast reconstruction journey is as follows:
Surgery 1: Right breast nipple-sparing mastectomy and reconstruction with DIEP flap (her own tissue)
Surgery 2: Right breast scar revision and left breast augmentation with small silicone implant (250cc) in fascial pocket. The reconstruction results showed improve breast shape, size, and symmetry compared to her native breasts.
By understanding the choices for breast reconstructions, a woman is empowered in her fight against breast cancer. Dr. Goldberg provides a full spectrum of breast reconstructions using the latest techniques in microsurgery. We hope Dr. Goldberg’s website will give you a basic understanding of breast reconstructions.
WHAT IS THE RECOVERY PROCESS?
The DIEP flap surgery could take anywhere from 4 to 5 hours per breast depending on the anatomy and size of the reconstruction. You will be closely monitored in the hospital for 3 days post-operatively. You will go home with some tube drains, one in your breast and one in the abdomen. You will be off work for 3 to 4 weeks, depending on the type of work you do. A young patient who performs desk work may return to work as soon as three weeks. For the donor site on your abdomen, you will have a scar that is similar to a tummy tuck scar which could be hidden within your undergarment or swimsuit, as seen on our Before and After photos of our actual patient.
Length of Surgery:
4-5 hours per breast
Length of Stay:
3-4 days in-patient stay
6 weeks of absolute no heavy lifting (anything > 5 lbs.)
8 Weeks prior to return to light duty
Who is a candidate for DIEP flap reconstruction?
Patients who have excess abdominal tissue are a candidate for breast reconstruction using DIEP flap. The ideal candidate is a patient who has a BMI (Body Mass Index) of less than 30 kg/m2. Patients with BMI >35 kg/m2 may have a higher complication rate, such as fat necrosis (hardening of the fat), seroma (fluid collection), and wound healing problems in the abdominal donor site.
You could have DIEP flap reconstruction as an immediate procedure versus a delayed breast reconstruction. Patients who require radiation to the chest wall after their mastectomy would especially benefit from the DIEP flap reconstruction. The flap will replace radiation-damaged skin and bring healthy fat and tissue to help promote healing of the chest after radiation.