DIEP FLAP SURGERY

DIEP flap surgery (pronounced like “deep flap”) stands for deep inferior epigastric perforator surgery. This procedure takes skin, soft tissue, and blood vessels from the lower abdomen to reconstruct the breast. A specialized DIEP flap surgeon like Dr. Garza in Nashville will remove the donor soft tissue and reattach it to the mastectomy site.

During a Diep flap procedure, the surgeon takes skin, fat, and blood vessels from the lower abdomen, specifically the area below the belly button, called the “lower abdominal flap.” This tissue is carefully dissected and removed while preserving the blood vessels that supply it.

The surgeon makes an incision in the lower abdomen along the bikini line from hip to hip and takes donor fat and tissue. They will then match the blood vessels from the abdomen to the breast using a microscope to reconnect blood flow to the living tissue. A skilled surgeon may also transfer sensory nerves from the donor tummy tissue to restore sensation in the breast.

Diep flap surgery is considered a highly specialized procedure and requires a skilled microsurgeon. It offers several advantages over other breast reconstruction methods, such as the use of the patient’s own tissue, resulting in a natural look and feel of the reconstructed breast. Additionally, it avoids the potential complications associated with implants and provides the added benefit of abdominal contouring, similar to a tummy tuck.

DIEP flap surgery is often called a tummy tuck since it provides similar benefits. DIEP flap surgery also offers the potential advantage of returning sensation to the reconstructed breast.

DIEP FLAP VS. TRAM FLAP

Both breast flap surgery procedures involve using tissue from another part of the body to reconstruct the breast, but there are some key differences between the two. DIEP flap surgery is less invasive than TRAM flap surgery, as it doesn’t require cutting through muscle tissue. As a result, DIEP flap patients tend to experience less pain and have a shorter recovery time.

However, DIEP flap surgery is not an option for everyone, as it requires a certain amount of fatty tissue to be successful. For patients who don’t have enough fat for DIEP surgery, a TRAM flap may be a better option.

TRAM flap surgery is more invasive, but it can be performed even if only a small amount of fat is available. So, TRAM flaps are a more versatile option for breast reconstruction. Ultimately, the best choice for each patient will depend on their individual needs and preferences.

Many candidates have questions about what qualifies them for the DIEP Flap procedure. One of the most common concerns is previous abdominal surgeries, especially cesarean section birth, or C Section.
However, one or two C Sections usually will not impact DIEP Flap. In fact, a plastic surgeon can take the donor tissue off the top of the abdominal muscles so it will not disturb anything else.

It is important to note that not all women are suitable candidates for Diep flap surgery. Factors such as the patient’s overall health, body shape, and previous abdominal surgeries can impact eligibility. It is best to consult with a qualified plastic surgeon who specializes in breast reconstruction to determine the most appropriate surgical option based on individual circumstances.

Below are a couple of things you should consider before DIEP flap reconstruction.

Current Health

You should be in good health at the time of your procedure. When you meet with Dr. Garza for your initial consultation, you should review your medical history thoroughly. You should review any health risks like allergies, history of smoking, and especially any previous procedures for breast cancer treatment.

Medical History

Another concern relates to receiving radiation therapy for breast cancer. One side effect of radiation therapy is a condition called fibrosis, which occurs when non-cancerous cells sustain damage during radiation treatment.

Because of the hardened scar tissue, some plastic surgeons have turned away candidates for flap breast reconstruction, saying that the remaining tissue might be too firm to use.

With DIEP flap, however, that’s not a necessary concern. We can solely use soft tissue to restore volume to the breast.
Also, if you don’t have enough tissue around your tummy, we can take tissue from another donor area, such as the buttocks or the thigh.

This procedure is also called a free flap or fat transfer.

DIEP flap surgery is a major surgical procedure and requires special training. Usually, reconstructing one breast takes between 3-4 hours to complete. An operation on both breasts will usually take about 6-7 hours. You can also receive DIEP flap surgery immediately after a mastectomy.

If you plan to receive a mastectomy before your DIEP flap surgery, expect to add 1-2 hours per mastectomy.

DIEP flap surgery can mean longer downtime than other breast reconstruction procedures. After the procedure, you can expect to stay in the hospital for recovery for around five days. After that, you may spend eight weeks recovering and resting at home.

In addition to rest, you must wear supportive clothing to help the reconstructed breast heal properly. Dr. Garza, a DIEP flap surgeon in Nashville, will instruct you on which clothing brands to wear after surgery.

An implant-based reconstruction may only take around four weeks, in contrast. You will have surgical drains on your body at both surgical sites for one to two weeks after surgery. When you have healed enough, your doctor will recommend at-home stretching exercises to help your body fully recover.

If you’ve had DIEP flap surgical breast reconstruction on only one side of your body, avoiding stress on the operated side is crucial. To get out of bed safely:

1. Bend your knees.
2. Let your knees fall over to your side that was not operated on, and let your knees hang over the side of the bed.
3. Slide your lower legs off of the bed.
4. Use your good arm to push yourself up into a sitting position.
5. Plant your feet on the floor and stand up.

Until your breasts have healed sufficiently, you must avoid putting any strain on the reconstructed breasts. Most patients can expect to start sleeping on their side again at least four weeks post-operation.

Yes! We offer several options at Garza Plastic Surgery in Nashville, TN. Some of these differ depending on the type of reconstruction you need. For example, DIEP flap surgery solely focuses on restoring volume but does not include nipple reconstruction. However, we offer nipple and areola reconstruction surgery as a separate option.

We also offer breast implant surgery, with two different types of breast implants. We offer saline-filled implants and silicone gel “gummy bear” implants.

What are the risks of DIEP Flap Surgery?

Occasionally, there can be some fluid build-up after the procedure. Therefore, your provider will place surgical drains around the treatment sites.

Additionally, some patients may experience scarring or lumping in the reconstructed breast. If scar tissue builds up, there can be some loss of feeling in the new breast. Finally, there is a small risk that patients can develop a condition called tissue necrosis. This condition occurs when the donated soft tissue is rejected and begins to die off.

Careful monitoring and check-ups will help you catch any signs if you are worried about tissue necrosis. If necrosis occurs, a plastic surgeon can remove the decayed tissue. After removal, you should wait about one year before receiving another reconstruction surgery.

A tummy tuck is another name for a plastic surgery procedure called abdominoplasty. This procedure removes unwanted fat cells, reinforces the abdominal muscles, and tightens loose skin.

In comparison, DIEP flap surgery takes tissue from the abdomen and helps reconstruct the breast mound removed during a mastectomy. As a result, less attention goes into tightening and strengthening the skin or abdominal muscles.

So, while you may see some slimming and toning in the abdominal area after a DIEP flap surgery, a full tummy tuck surgery will provide better and more focused results.