Natural Breast Reconstruction
Deep inferior epigastric perforator (DIEP) flap breast reconstruction is a truly leading-edge form of natural breast reconstruction. During this procedure, your surgeon will take excess living fat from your lower abdomen and transfer it to your chest, restoring breast volume and shape. The lower abdominal incision is located below the bikini line.
Before and After Photos
TRAM vs. DIEP
The transverse rectus abdominis (TRAM) flap procedure is similar to DIEP in that they both remove excess tissue between the belly button and pubic hair line to be used for the breast replacement. The TRAM flap was the first type of flap breast reconstruction. It was typically used in the 1980s and was performed without microsurgery techniques.
TRAM is still performed today. However, this procedure involves removal of a significant portion of abdominal muscle and fascia, potentially leading to abdominal core weakness.
The DIEP procedure uses the same excess skin and fat, but preserves the abdominal muscles and abdominal wall fascia. This reduces the risk of hernia and abdominal weakness after surgery.
Benefits of DIEP Reconstruction
This method offers several advantages over older, more traditional methods of breast reconstruction.
- DIEP reconstruction uses excess soft, warm, living fatty tissue from the abdomen, which provides a very similar feel to breast tissue.
- Once finished, DIEP reconstruction does not need maintenance surgery or exchange surgery in the future.
- DIEP does not require the use of a tissue expander as an intermediate step in the reconstruction.
- You may enjoy improved abdominal shape and contour from the flattening and tightening that results from tissue removal.
During the DIEP procedure:
- Incisions are made on the lower abdomen.
- Fatty tissue is lifted up from the underlying abdominal wall.
- Small blood vessels in the abdomen are carefully identified and preserved.
- The fatty tissue is transferred to the chest.
- The blood vessels are carefully reattached using microsurgery techniques.
- The breast form is restored using the fatty tissue.
- The abdominal incision is closed.
- The navel is brought out through a separate incision.
Breast reconstruction may be performed at the same time as mastectomy surgery or at a later time.
- When reconstruction is performed at the same time as the mastectomy, it is referred to as immediate reconstruction.
- Reconstruction performed later, be it weeks, months or years, is known as delayed reconstruction.
Timing of reconstruction is individualized based on your situation and treatment needs. Aesthetic results of reconstruction are not impacted by the timing of surgery.
Benefits of DIEP Reconstruction
- Uses your own natural tissue, avoiding placement of a foreign device into the body
- Reconstructed breast is warm and soft, unlike some implant reconstructions
- Causes minimal muscle trauma in the chest region, typically resulting in less pain following surgery without impact to chest strength
In addition, implant reconstruction can cause chest muscle
contraction, creating abnormal movement of the reconstructed breast skin. Known
as breast animation, this abnormal skin movement is avoided with DIEP