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The DIEP flap is the most advanced form of breast reconstruction available today and is the preferred reconstructive technique at PRMA.
The procedure uses the patient's own abdominal skin and fat to reconstruct a natural, warm, soft breast after mastectomy. Unlike the TRAM flap, the DIEP preserves all the abdominal muscles. Only abdominal skin and fat are removed similar to a "tummy tuck". Saving the abdominal muscles means patients experience less pain, enjoy a faster recovery, maintain their core strength long-term, and have a lower risk of complications.
The skin and fat below the belly button feels very similar to breast tissue. It is the perfect choice to replace the breast tissue removed by the mastectomy.
The blood vessels ("perforators") that keep this skin and fat alive travel just beneath or within the abdominal muscle. A small incision is made in the abdominal muscle to access these vessels. The prepared tissue ("flap") is then disconnected from the body and transplanted to the chest using microsurgery. The surgeons then shape the tissue to create the new breast.
Women also enjoy the added benefit of a flatter abdomen with results that mimic a “tummy tuck”. The risk of abdominal complications such as bulging and hernia is also very small, much smaller than with the TRAM flap.
Most patients are also candidates for sensory nerve reconstruction. This reconstructs the nerves that supply feeling to the breast that are cut by the mastectomy. Sensory nerve reconstruction leads to improved return of feeling to the reconstructed breast. PRMA is one of only a few centers in the world to offer this procedure.
Sometimes all the lower abdominal tissue is needed to reconstruct one breast. Occasionally this cannot be performed as a single flap. For example, the patient may have a previous midline abdominal scar or may be too thin. In these cases, the lower abdominal tissue can be transplanted as 2 separate flaps which are then reconnected on the chest using microsurgery to create one breast. This technique is known as the stacked DIEP flap procedure.
Patients that have arm lymphedema as a result of previous breast cancer surgery may also be candidates for Vascularized Lymph Node Transfer in combination with DIEP flap reconstruction, as long as they have already maximized conservative therapy (lymphedema therapy).
A team of two microsurgeons performs every procedure. This ensures you benefit from the expertise of two specially trained surgeons and also significantly decreases the length of the surgery and anesthesia time.
PRMA is the only center in San Antonio, Texas and one of only a handful of centers worldwide providing breast reconstruction on such a large scale. Our surgeons treat patients from across Texas and across the US, as well as international patients, and have built tremendous reputations for breast reconstruction excellence.
There are many reconstructive breast surgeons in the United States, however very few perform this procedure routinely due to the technical difficulty of the surgery. To date, our surgeons have performed thousands of microsurgical breast procedures and perform over 600 DIEP flap surgeries every year. Our success rate is over 99%.