Common DIEP Flap Breast Reconstruction Misconceptions
By: Courtney Floyd
What are common DIEP flap breast reconstruction misconceptions?
I cannot tell you how many times I have heard the words, “I wish I had gone with DIEP flap breast reconstruction the first time.”
There are many misconceptions that lead patients to believe the DIEP flap is too risky or painful. Some women choose to go with implant reconstruction believing the journey will be easier. However, many of these patients will go on to experience common implant related complications (such as pain, capsular contracture, rippling, cold feeling breasts, etc.) and will require multiple revision surgeries. As you may gather from my opening quote, many women who experience these complications go on to have their implants removed and undergo DIEP flap reconstruction. We see this regularly at PRMA.
Although the DIEP flap may not be the best option for all patients, we believe it is important to dispel common misconceptions so women can make an informed decision for their breast reconstruction journey.
Misconception #1 - DIEP Flap is more painful compared to implant reconstruction.
Many patients believe DIEP flap breast reconstruction is more painful compared to implant surgery. While every patient experience is different, studies show patients report more pain following sub-pectoral tissue expander/implant surgery compared to DIEP flap. The DIEP flap reduces muscle trauma and preserves all patient abdominal and chest muscles. Most implant-based reconstruction procedures involve placing an implant under the chest muscle. This requires releasing and lifting the muscle off the chest wall to create a pocket for the implant which is painful and adds to patient recovery. For patients needing tissue expanders, the overlying breast tissue will be stretched over a period of time causing discomfort. At PRMA, our patients experience minimal pain after DIEP flap surgery thanks to our ERAS Protocol. In fact, most patients are able to control their post-operative discomfort without the use of narcotics!
Misconception #2 - DIEP flap has a higher complication rate compared to other reconstruction methods.
Any surgery carries a risk of complications. In the hands of experienced surgeons, DIEP flap breast reconstruction is safe. At PRMA, our DIEP flap success rate is over 99%. I feel it is important to note here that when radiation therapy is a part of cancer treatment, about 1 in 3 implant reconstructions fail. The DIEP flap provides a safe and natural alternative.
Misconception #3 - You will need to stay in the hospital for a long period of time after DIEP flap surgery.
Again, thanks to the implementation of our ERAS protocol, patients are recovering faster after DIEP flap surgery. Patients can expect to be up and walking the day after surgery and back at home after 2-3 days. There is no extended stay period in the hospital following DIEP flap surgery.
Misconception #4 - Any Plastic Surgeon can perform the DIEP flap successfully.
This is a DANGEROUS misconception! Most plastic surgeons do not perform advanced perforator flap procedures like the DIEP flap on a routine basis (if at all). Experience matters for a successful outcome! Seek out a board-certified plastic surgeon who performs at least 100 DIEP flaps a year with a very high success rate. At PRMA, we perform over 700 perforator flap procedures a year with a success rate of over 99%! Because of the small number of surgeons routinely performing this procedure, many women may have to travel for surgery. Although travel may seem overwhelming, it’s worth it!