DIEP Flap Reconstruction
DIEP Flap Reconstruction
What is DIEP Flap Reconstruction?
DIEP flap stands for deep inferior epigastric perforator flap. This is a new, innovative type of flap breast reconstructive surgery that spares the abdominal muscles, unlike other techniques such as a TRAM flap. [Link to TRAM flap] In DIEP flap surgery, skin and fat from the abdomen are carefully transferred to the chest to create a natural-looking breast mound. This method offers the advantage of using the patient's own tissue, providing long-lasting results with minimal risk of abdominal muscle weakness or hernia. Recovery may take several weeks, but the outcome is often a soft, natural-feeling breast that restores both physical appearance and confidence for the patient.
What are the Benefits of DIEP Flap Reconstruction?
DIEP flap breast reconstruction is a sophisticated surgical method that uses the patient's abdominal tissue to rebuild the breast following mastectomy. It has all the benefits of flap reconstructions, [Link to Flap Reconstruction] including:
- Reduced Risk of Implant-Based Complications: DIEP flap breast reconstruction avoids the use of breast implants, eliminating the risk of implant-related issues such as rupture or leakage. Also, since the procedure uses the patient's own abdominal tissue, there is no need for additional surgeries to replace implants.
- Preserves the Abdominal Muscles: Unlike some other procedures, such as TRAM flap reconstruction, DIEP flap breast reconstruction does not disturb the abdominal muscles. The surgeon detaches small blood vessels supplying blood to the skin and fat in the lower abdomen without removing muscle tissue. This preservation of abdominal muscles reduces the risk of complications like hernias or abdominal weakness and facilitates quicker recovery with less pain.
- Provides a More Natural-looking Breast Contour: By utilizing the patient's own skin and tissue, DIEP flap reconstruction results in a breast mound that closely resembles the original breast. The robust blood supply and preservation of abdominal nerves enhance the viability and sensation of the transferred tissue, leading to excellent cosmetic outcomes.
- Improves Self-Esteem and Body Image: Restoring femininity and self-confidence is a priority for many women undergoing mastectomy. A DIEP flap reconstruction can help patients feel more comfortable in their bodies and clothes by restoring natural softness and sensation.
- Sensations in Your Reconstructed Breast: The advanced micro-surgical techniques used in DIEP flap reconstruction aim to maintain sensation in the reconstructed breast. To achieve this, abdominal nerves supplying sensation to the skin and fat tissue are carefully preserved during surgery. Retaining breast sensation has significant psychological benefits for breast cancer survivors, contributing to their overall well-being post-surgery.
Who is a Good Candidate for DIEP Flap Reconstruction?
Many women who opt for autologous breast reconstruction (that is, using their own tissue) are eligible for DIEP breast reconstruction. The DIEP procedure utilizes the patient’s own extra abdominal skin and fat to create a new breast. Several factors should be considered when determining if DIEP is suitable for an individual.
- Current Health: Autologous breast reconstruction is offered to all healthy patients. However, if you are a current smoker or have multiple medical issues, you must understand that your risk of complications may be higher. Efforts will be made to minimize risk in collaboration with your doctor.
- Body Shape: For very thin patients with minimal abdominal tissue, the abdominal donor site can be extended to maximize tissue volume harvested. If needed, other donor sites like the thigh or buttock may be considered to supplement abdominal tissue.
- Past Surgeries: Prior abdominal surgeries, such as cesarean section or laparoscopic procedures, are usually not problematic as they typically do not disrupt the main blood vessels supplying the DIEP. However, the condition of abdominal blood vessels will be examined to determine if past surgeries have affected DIEP viability.
- Treatment Needs: Most thin women require minimal volume for breast reconstruction, but if a larger reconstruction is desired, the DIEP may need augmentation with another flap procedure. Additionally, breasts reconstructed with DIEP can be augmented with fat grafting later on.
- Personal Preferences: Patients should understand all options and choose based on their anatomical limitations and personal preferences. Some patients may opt for a different donor site due to reasons like avoiding abdominal scarring. Ultimately, the decision should be made after weighing all options and understanding the pros and cons of each.
What Should I Expect From My Surgery?
During DIEP flap reconstruction surgery, the surgeon carefully removes skin and fat from the lower abdomen without cutting the abdominal muscles. This tissue is then transferred to the chest area to create a new breast mound. The surgery typically requires advanced microsurgical techniques to ensure adequate blood supply to the transferred tissue. Overall, DIEP flap reconstruction offers patients a natural-looking and feeling breast reconstruction option with fewer abdominal side effects compared to other procedures.
Before Surgery
Before your surgery, you'll have a meeting with your surgical team to go over the details of your operation. This is a great opportunity to ask any questions you may have and ensure you fully understand the procedure, its purpose, associated risks, and any alternative treatments available.
Your healthcare team will provide you with specific instructions to prepare for surgery, which may include:
- Informing your healthcare team about any medications, vitamins, or supplements you're currently taking, as certain substances may interfere with the surgery.
- Stopping certain medications, such as aspirin or other blood-thinners, as advised by your healthcare team.
- Following guidelines regarding fasting before surgery, which may involve refraining from eating for several hours beforehand and only drinking liquids up to a certain time.
- Planning for post-surgery arrangements, such as whether you'll need to stay in the hospital overnight or go home the same day. Arrange for transportation if you're discharged the same day and prepare a bag with essentials for your hospital stay, including toiletries and items for comfort and entertainment.
During Surgery (Procedure Overview)
You will typically have DIEP flap reconstruction at the same time as a mastectomy. This is major surgery that will normally involve staying in the hospital for 2 to 5 nights. The procedure can vary based on your personal circumstances and your doctor's methods.
- You'll be asked to change into a gown.
- An IV (intravenous) line will be inserted into your arm or hand to give you medication that will help you relax and put you to sleep during surgery.
- You'll lie on your back on the operating table.
- Your vital signs, like heart rate and blood pressure, will be monitored throughout the surgery.
- The skin around the surgical area will be cleaned with a sterile solution
- Your surgeon will make a long incision in your lower belly. The incision is from hip bone to hip bone, between your belly button and the start of your pubic hair.
- A single flap of skin containing fat and blood vessels will be removed from your abdomen. Your surgeon will not remove any muscle.
- Your surgeon will transfer the flap to the breast site and carefully attach blood vessels from the flap to blood vessels in your chest.
- Your surgeon will then reconstruct the shape of the breast.
- Drainage tubes may be inserted into the area.
- The incisions will be closed with stitches or adhesive strips and a sterile bandage or dressing will be applied over both the surgery sites.
After Surgery & Recovery
During your hospital stay, you'll be taken to the recovery room after the procedure. There, you'll be closely monitored until your vital signs like blood pressure, pulse, and breathing are stable, and you're awake and alert. Once you're stable, you'll be moved to your hospital room.
Typically, you'll stay in the hospital for 2 to 5 days after this procedure.
Once you're home, it's important to keep the surgical area clean and dry, following your doctor's instructions. You'll also need to care for the drainage tubes, which are usually removed after about 2 weeks at your first follow-up exam.
You may experience some pain, which can vary depending on the surgery. Your healthcare team will recommend pain relievers, but be cautious about taking aspirin or certain other pain medicines that may increase the risk of bleeding.
You can typically resume normal activities in a few weeks, but you should avoid strenuous activities in the meantime. Your surgeon will advise you on when you can drive again and return to work.
If you're having difficulty coping with your recovery, you may find it helpful to speak to your loved ones or to join a support group for assistance. This can help you cope with the emotional aspects of undergoing this type of surgery.
Contact your doctor if you experience fever, chills, increased pain, swelling, or any other concerning symptoms after surgery.
Contact us today [Link to Contact] for a confidential conversation by video call directly with one of our expert surgeons. We are more than happy to discuss your treatment options with you if you are interested in a flap breast reconstruction.