Dr. Ochoa Explains Why a Small Portion of Rib is Removed During the DIEP Flap
By: Dr. Oscar Ochoa
Why is a portion of rib removed during DIEP flap breast reconstruction?
The reason why a small portion of the rib is removed (1-2 centimeters) where it meets the sternum is because we need to get access to the blood vessels that will be providing blood flow to the tissue that is moved over from the abdomen to the chest. Removing this small portion of rib allows good exposure to the blood vessels which are very small and very delicate. There are some surgeons that do this procedure by going between the ribs instead of removing a portion of the rib. The problem with that is that it can potentially injure the blood vessels because of the limited exposure and it makes the connections of the blood vessels much more significant—adding more time to the surgery.
The removal of the rib does not hinder the mechanics of the lungs so a woman would not experience any problems breathing after surgery. There is sometimes some pain that lingers in that area for a few weeks after surgery. Ultimately that pain resolves completely and the woman never really has any long term complications from the removal of that small portion of rib.
Hope this helps!