DIEP Flap Surgery And How To Find A DIEP Surgeon

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DIEP flap surgery - so why all the hype? If you are a woman facing mastectomy due to breast cancer, one of the decisions you face is whether you want breast reconstruction. If you do, the DIEP flap may be a very good option for you. 

Most female breast cancer patients think that breast implants are their only reconstructive option. That's absolutely not the case. The DIEP flap is the best natural alternative to breast implants and is actually the gold standard in breast reconstruction today.

Although reconstruction cannot replace the breast(s) you were born with or allow you to breastfeed, it can restore your natural silhouette and make you feel "whole" again following mastectomy. Depending on your health, breast reconstruction can be performed immediately after your mastectomy so you can wake up with new breasts already in place. While the cosmetic results with immediate reconstruction are generally superior (particularly when combined with nipple-sparing mastectomy), reconstructive surgery can also be performed at a later time once the cancer treatment has been completed.

DIEP flap surgery uses excess skin and fat from the abdomen (like the tissue removed during a tummy tuck) to construct a new, "natural" breast without the need for implants or the sacrifice of abdominal muscle. The DIEP (Deep Inferior Epigastric Perforator) flap is a sophisticated modification of an existing surgery known as the TRAM (Transverse Rectus Abdominus Myocutaneous) flap.

TRAM surgery is a common breast reconstruction technique that requires the rectus abdominus (sit-up) muscle to be sacrificed and relocated to the upper abdomen. Unfortunately, this technique can be associated with significant post-operative pain, prolonged recovery, loss of abdominal muscle strength (up to 20%), abdominal bulging (or "pooching"), and even abdominal hernia.

DIEP breast reconstruction is superior to the TRAM procedure because it spares the rectus abdominus muscle completely. ONLY SKIN AND FAT are removed from the abdomen, transplanted to the chest and connected using microsurgery to create the new breast. Saving the abdominal muscles means patients experience less pain, enjoy a faster recovery, maintain their core strength long-term, and have a much lower risk of complications.

During a mastectomy, nerves providing feeling to the breast are severed causing loss of feeling to the breast area. Patients undergoing mastectomy must understand they may lose all feeling to the area, regardless of whether they choose to have breast reconstruction or not. Over time, some sensation may return but unfortunately for many patients it is minimal, if any.

Mastectomy patients choosing to have DIEP reconstruction may also be candidates for an additional procedure called a "microneurorrhaphy". This repairs the nerves cut by the mastectomy and significantly improves return of feeling to the reconstructed breast. Unfortunately, most breast reconstruction centers do not offer this additional procedure. At PRMA, sensory nerve reconstruction is performed routinely with the DIEP and SIEA flap procedures. 

Knowing the significant advantages of DIEP flap surgery it is easy to understand the reason for all the hype, especially for active individuals who don't want to sacrifice their abdominal muscle strength. A breast that has been reconstructed with a DIEP flap will also look and potentially feel more natural than an implant reconstruction. It will also last longer without the long-term risks that can be associated with implants. Unlike an implant, the reconstructed breast is warm and also ages like a natural breast. 

As with most types of breast reconstruction, 2 or 3 stages performed a few months apart are often required to complete the reconstruction process and to obtain the best cosmetic result. 

Unfortunately, due to the complexity of the surgery, few centers in the US perform the DIEP procedure routinely so some patients will have to travel for the procedure. 

At PRMA we have performed thousands of DIEP flap procedures and perform 500 - 600 flaps every year. Our success rate is over 99%. Patients from across the US and other countries travel to PRMA for breast reconstruction surgery because of our extensive experience and extremely high success rates.

You can learn if you are a DIEP flap candidate by completing a FREE virtual consultation here

To find a DIEP flap surgeon near you, check this directory.

Learn More About DIEP Flap Breast Reconstruction

4 Comments

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  • Joy Noble

    I have DCIS in one breast and have been told I will need a mastectomy. Unfortunately, there is no surgeon in my area that performs an Diep Flap procedure with nerve reattachment. I need the mastectomy soon. Is it possible to do the Diep Flap and nerve reattachment a few months after a nipple sparing mastectomy with nerve reattachment?  Are the results the same a doing the reconstruction in the same operation as the mastectomy? I cannot travel right now because of my job, but could come for an extended time during the summer.
    Thank you!

    Reply
    • PRMA

      Great question Joy!  As long as the surgeon can locate the nerve we can perform the sensory nerve reconstruction during DIEP flap reconstruction.  Results can vary patient to patient and we can never guarantee sensation results, but sensation can still be regained even if reconstruction is delayed.  You are more than welcome to fill out our free virtual consultation form at https://prma-enhance.com/schedule-a-consultation/.  Once received, one of our surgeon can review your needs and provide you with their surgical recommendations all from the comfort of your home.

      Reply
  • Cynthia J Noble

    I would love to discuss my reconstruction options with a consultation. I am having a left-side mastectomy in late January to remove several sites of DCIS. I can have a DIEP Flap procedure, but no one near me reattaches nerve sensation. I would like to know of the pros and cons of only getting the mastectomy and traveling there for reconstruction.

    Reply
    • PRMA

      We would love the opportunity to discuss your options with you Cynthia! You are able to have the mastectomy performed locally and then travel for reconstruction if that is what works best for you.  Immediate breast reconstruction (performed at the same time as the mastectomy) is typically associated with the least amount of scarring and the best cosmetic results. Delayed reconstruction usually leaves more scarring and the final breast is less likely to look like the breasts Mother Nature provided.

      Reply
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