Medically Reviewed by Dustin Eck, MD

When a woman is faced with breast cancer, the first goal is to perform an operation that removes the breast cancer. The second goal is to give the patient a cosmetic outcome that results in the breast looking as natural as it did before the surgery — or even better in some cases.

The most common flap procedure performed is a DIEP (deep inferior epigastric perforator) breast reconstruction. Most women are candidates for this surgery.

A cutting-edge procedure, the DIEP breast reconstruction involves removal of a flap of complete tissue, blood vessels (perforators) and excess living tissue (skin and fat) from the lower abdomen below the navel or belly button. The Plastic Surgeon, aided by a microscope, transfers the flap of tissue from the abdomen to the chest connecting the dissected blood vessels from the abdominal tissue to the patient’s chest blood vessels. Once the vessels are attached, the surgeon works on shaping the breast.

The DIEP flap technique is a much more complex and extensive procedure as opposed to breast reconstruction using an implant. However, this technique avoids some of the complications associated with implants.

An advanced microsurgical technique that is used to rebuild the breast lost to mastectomy, the DIEP flap procedure requires a plastic surgeon with special surgical training, as well as expertise in microsurgery. This form of surgery involves the use of small, specialized instruments to operate on very delicate areas of tissue, such as nerves and blood vessels. The procedure is considered “micro” because the blood vessels are usually under three millimeters (about one-tenth of an inch) in size.

Several benefits of the DIEP flap breast reconstructive technique over other types of reconstruction include:

• Reduced post-operative pain
• Less abdominal wall weakness post-surgery
• Decreased chance of abdominal wall hernia formation

Yet, the greatest benefit of this procedure involves rebuilding the breast with the patient’s own tissue. This technique allows the plastic surgeon to create a more natural-looking breast that is permanent and does not require maintenance or repeat surgery over time.

An additional benefit of the DIEP flap procedure is the resulting “tummy tuck,” which flattens and firms the abdomen by removing excess skin and fat. Since muscle is not used to rebuild the breast, this technique preserves the abdominal muscles and retains more strength in the patient’s abdomen.

If a woman decides to pursue the DIEP flap procedure she can choose to have it performed either the same day as a mastectomy, which is known as immediate reconstruction, or the surgery may take place at a separate time, known as delayed reconstruction.

For more information on microsurgical breast reconstruction, please call McLeod Plastic and Reconstructive Surgery at 843-777-7255.

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