Restorative Techniques

DIEP Flap Breast Reconstruction

Deep Inferior Epigastric Perforator flap

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Women who choose to undergo breast reconstruction with a DIEP flap have skin and fatty tissue removed from the lower abdominal area through an incision similar to that used for what’s known as a “tummy-tuck.” The skin and fatty tissue transferred with a DIEP flap is essentially identical to that which is transferred with a TRAM flap--but, importantly, no muscle is removed from the abdomen with a DIEP flap. As a general rule, women who are good candidates for a TRAM flap are generally good candidates for breast reconstruction using a DIEP flap. In addition, some women who may be too thin or too heavy to be good candidates for a TRAM flap may be candidates for a DIEP flap breast reconstruction.

Muscle-Preserving Surgery

Preservation of the muscles at the donor site is possible because, during the preparation of the tissue, the tiny blood vessels that supply the skin and fat of the DIEP flap are meticulously separated from muscle using microsurgical techniques. Once transferred to the chest, these tiny blood vessels of the DIEP flap are connected to blood vessels at the mastectomy site; the surgeon does this with the aid of an operating room microscope. After the blood vessels of the flap are connected, the skin and fat of the DIEP flap are shaped into a new breast. Whenever possible, a sensory nerve in the DIEP flap is connected to a sensory nerve at the mastectomy site to help maximize return of sensation in the reconstructed breast.

Abdominal Contouring

By virtue of the fact that the tissue removed from the abdomen during the harvest of a DIEP flap is similar to that removed during a tummy-tuck, the contour of your abdomen is often improved after breast reconstruction with this flap. Most women appreciate the slimmer abdominal contour that occurs with DIEP flap surgery. The horizontal scar on the lower abdomen, similar to that of a tummy-tuck, can generally be concealed in most clothing. This contouring is similar to the results of other abdominal flap procedures as well.

Optimizing Aesthetics

Approximately three months after the initial stage of breast reconstruction surgery, Dr. Greenspun will reconstruct the nipple (when mastectomy includes its removal), and refine the breast shape so that it is symmetrical with your untreated breast. These optional additional procedures are performed on an outpatient basis and are referred to as Stage II.

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DIEP Flap Surgery in New York and Connecticut

Contact us if you would like more information about DIEP flap breast reconstruction or other options for breast reconstruction after mastectomy. Our practice has offices in New York City and Fairfield County, Connecticut.