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Breast reconstruction after mastectomy: advantages of the DIEP flap procedure

Written by Drs. Klein, Lee and Feiner of UF Health Cancer Center at Orlando Health’s Plastic and Reconstructive Surgery Center

The past decade has ushered in major technical advancements in autologous breast reconstruction, which is done using a patient’s own tissue. The most common techniques include the use of skin, muscle, fat, or artificial implants to reconstruct the breast. The use of abdominal skin and fat has gained in popularity, offering patients a more natural look and feel, similar to that of the natural breast. Other advantages of using a patient’s own tissue in reconstruction includes: the avoidance of artificial breast implants, the body contouring that comes with removal of excess abdominal fat, and the possibility of restoring sensation to the new breasts.

What is the DIEP flap?

The deep inferior epigastric perforator (DIEP) flap is the latest technical advancement performed by a select group of plastic surgeons. This is a muscle-sparing, microvascular surgical procedure that uses the skin, fatty tissue, and blood vessels of the abdomen to create a breast.

What are the pros and cons of the DIEP flap procedure?

One major advantage to the DIEP flap procedure is the preservation of abdominal muscle function and strength. The fat and vessels are harvested, shaped, and transferred to the chest. The vessels are then reconnected using microsurgical techniques to create natural appearing breasts. The use of a patient’s own fat most closely replaces the breast tissue removed by mastectomy. Another added benefit to the DIEP procedure is the opportunity to remove the same excess abdominal skin and fat that is typically removed as a tummy tuck, contouring the lower abdomen for a more appealing outcome.

While DIEP flap reconstruction offers many advantages, there are important considerations, as with any surgical procedure. The DIEP flap is a very technically demanding surgical procedure requiring general anesthesia, a five-day hospital stay, and a six to eight week recovery period. Medical clearance may be required. Eligibility is based on a thorough medical evaluation and assessment of individual factors, including the results of a CT scan obtained prior to surgery to assess available blood vessels. Significant risks include: delayed wound healing, flap loss, scar formation, asymmetric appearance, infection, and the need for additional revision surgeries. The process typically involves several smaller procedures to fine-tune the visual appearance, and to reconstruct the nipples. Patients with reconstruction to only one side may require symmetry and balancing procedures performed on the breast that was not removed during a mastectomy.

DIEP flap procedure offered at UF Health Cancer Center at Orlando Health

Due to the complexity of the DIEP procedure, it is crucial that the physician performing this technique be a skilled and experienced microvascular surgeon. The experience and training of the surgical team is equally important. The Plastic and Reconstructive Surgery Center at UF Health Cancer Center at Orlando Health has a dedicated team of surgical specialists and nurses specially trained to facilitate the surgery, and to monitor the patient after the operation.

We are the most experienced microsurgery team in the state of Florida, specializing in breast reconstruction with multiple techniques, including the DIEP flap procedure. Our high flap success rate and low operative return rate demonstrate our commitment to excellence.

Choosing a DIEP surgeon and center is an important step in your journey to defeat breast cancer and restore your body image. We are here to support patients and family members through our comprehensive multidisciplinary approach, encompassing services such as nutritional support, psychological support, physical rehabilitation, and social services.

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