Share
DIEP flap surgery is one of the most advanced techniques for natural breast reconstruction, and preserving the strength and function of the abdominal muscles is just as important as restoring the chest. Our surgeons at PRMA Plastic Surgery take extra care to minimize nerve damage during flap harvest, helping patients heal more quickly and with fewer long-term complications.
How PRMA Minimizes Abdominal Complications During DIEP Flap Surgery
At PRMA, our mission is to provide the most advanced breast reconstruction techniques while prioritizing patient safety and long-term function. For patients undergoing DIEP flap surgery, that means not only preserving muscle, but also preserving the nerves that make that muscle work.
A landmark study published in the National Library of Medicine offers critical insight into how specific nerves supply the abdominal muscles. This research guides PRMA’s meticulous approach to nerve-sparing during flap harvest, helping patients maintain strength and avoid complications like bulging or hernia.
Why Protecting Abdominal Muscles Matters in DIEP Flap Surgery
From a patient’s perspective, successful breast reconstruction isn’t just about the reconstructed breast—it’s also about how your body feels and functions afterward. That’s why PRMA’s surgeons go beyond cosmetic outcomes and prioritize preserving your abdominal strength and stability.
When nerves supplying the abdominal wall are damaged during surgery, patients may experience:
- Decreased core strength
- Persistent abdominal “pooching” or bulge
- Risk of hernia
- Extended recovery time and reduced mobility
These are known as donor-site complications, and they’re avoidable when nerve preservation is treated with the same level of precision as flap survival.
What Is Denervation in Breast Reconstruction?
Denervation means the loss of nerve supply to a muscle. In DIEP flap breast reconstruction, the concern is abdominal muscle denervation, where the nerves that power the rectus abdominis muscle are accidentally cut or damaged during surgery.
Even if the muscle itself is preserved, it won’t function properly without its nerve supply. This can lead to lasting weakness and cosmetic changes in the abdominal area. That’s why DIEP flap nerve preservation is crucial—not just to how you look, but to how strong and supported your core remains after surgery.
How PRMA Avoids Nerve Damage During DIEP Flap Harvest
The 2008 study by Rozen et al. used intraoperative nerve stimulation to map how nerves interact with the rectus abdominis muscle. Here’s what it revealed, and how PRMA applies those findings today:
- Type 1 nerves are small and innervate narrow, vertical strips of muscle. They tend to overlap with each other, which means some of these nerves can be safely sacrificed without functional loss.
- Type 2 nerves are larger and usually found near the arcuate line—a key anatomical landmark. These nerves control the entire width and length of the rectus muscle with no overlap.
PRMA uses microsurgical techniques to visually identify and preserve these Type 2 nerves whenever possible. This nerve-sparing strategy ensures that muscle strength and tone are maintained, lowering the risk of donor-site complications and supporting a faster, stronger recovery.
Potential Risks of Nerve Damage After DIEP Surgery
If nerve preservation isn’t prioritized during DIEP flap breast reconstruction, patients may face:
- Donor-site morbidity (complications related to tissue removal)
- Bulging or abdominal hernias at the donor site
- Significant core weakness, especially in daily activities
- Long-term dissatisfaction with recovery and aesthetic outcomes
While the DIEP flap is considered the gold standard in natural breast reconstruction, its full benefits can only be realized when the technique is executed with precision, including the preservation of key nerve structures.
PRMA’s Commitment to Optimal Outcomes and Aesthetic Results
PRMA Plastic Surgery is recognized nationally for its expertise in microsurgical breast reconstruction. Our team of experienced surgeons in San Antonio performs over 700 flap surgeries annually, offering unmatched expertise in nerve-sparing DIEP flap techniques, achieving natural-looking breast reconstruction outcomes, and minimizing donor-site complications.
While many plastic surgery centers offer DIEP reconstruction, not all take the same nerve-preserving approach. PRMA’s dedication to preserving both function and form ensures that patients get the best possible results.
Considering DIEP Flap Surgery? Choose a Center That Prioritizes Your Long-Term Health
If you're planning breast reconstruction after mastectomy, choose a team that understands how to protect your whole body. PRMA’s nerve-sparing DIEP flap approach minimizes complications, preserves muscle strength, and helps you return to life feeling confident and strong.
Ready to learn more?
Contact the DIEP flap experts at PRMA Plastic Surgery in San Antonio and schedule your consultation today.
This research was published in the “Plastic and Reconstructive Surgery” journal:
Plastic and Reconstructive Surgery: Volume 122(5) November 2008 pp 1321-1325.
Avoiding Denervation of Rectus Abdominis in DIEP Flap Harvest II: An Intraoperative Assessment of the Nerves to Rectus by Rozen W, Ashton M, Kiil B, et al.
.png)