DIEP Flap Breast Reconstruction

DIEP flap breast reconstruction procedure diagram picture

During DIEP Flap breast reconstruction the skin and fat of the lower abdomen is harvested but the muscle is preserved. The blood supply to the skin and fat is dissected through the muscle and the muscle is left in its original place.This more advanced technique offers several advantages over the more traditional TRAM flap reconstruction.

The muscle preservation that occurs with the DIEP helps to reduce abdominal weakness that occurs when the abdominal muscles are removed. It also preserves the fascia which helps to reduce the hernia and bulging that can occur after the rectus muscle is taken. Finally by minimizing the muscle injury there is often less pain. Reducing the pain helps reduce the amount of narcotics needed postoperatively as well as reduce the side effects associated with pain medicine.

Who is a candidate for DIEP?

Most women are candidates for this type of surgery. Because of the length of surgery you must be in good health. Conditions such as diabetes, heart disease and obesity may increase risks associated with this type of surgery. These risks are reviewed to ensure that you are a good candidate for surgery. Certain types of previous abdominal surgery, such as abdominoplasty, may not make this an option. As with other procedures cigarette smoking should always be stopped before surgery.

What is the timing for the surgery?

After the first surgery recovery and healing needs to occur. The second surgery is typically performed 3 months after the first. This involves revising the reconstructed breast to create a more conical natural breast shape. Surgery on the opposite breast such as a reduction or lift may be done for symmetry. A final third surgery is done for nipple reconstruction. Both second and third stages of reconstruction are outpatient procedures.

What should I expect?

Breast reconstruction is performed in stages. The first stage is the DIEP flap to recreate the breast mound. Even when the same procedure is performed on both breasts there may be asymmetry. This may be related to the mastectomy defect created. For this reason a second surgery is performed for symmetry. Finally the nipple/areola is reconstructed.

WHAT HAPPENS IF I NEED CHEMOTHERAPY OR RADIATION?

Chemotherapy and radiation is completed before the second stage of surgery. Occasionally patients are advised by their oncologist to delay reconstruction until their cancer treatment is completed. We will follow the guidelines established by your oncologist.

WILL MY INSURANCE COVER ALL THE SURGERIES?

Chemotherapy and radiation is completed before the second stage of surgery. Occasionally patients are advised by their oncologist to delay reconstruction until their cancer treatment is completed. We will follow the guidelines established by your oncologist.

For more information or to make an appointment call now: 757.483.6550

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