A deep inferior epigastric perforator, DIEP flap, is an advanced breast reconstruction technique in which Dr. Fisher uses your own excess abdominal tissue, not an implant, to create your new breast without removing any underlying muscle or damaging your motor nerves. The advantages are a natural-looking and feeling breast made of healthy, soft, living tissue that will heal and will not need to be replaced. The reconstructed breast looks, feels, and moves like a natural part of your body — because it is. Other living tissue breast reconstruction options include use of the inner thigh (PAP/TUG flap) or buttock (GAP flap).
Many options exist for breast reconstruction after mastectomy, and nearly all patients are candidates for some form of breast reconstruction. The decision to reconstruct a breast that has been lost due to breast cancer, the BRCA gene for breast cancer, or damaged by radiation or infection is personal.
In the DIEP flap procedure, the incision is placed low, much like a tummy tuck, with a secondary benefit of a flatter postoperative stomach. Dr. Fisher then carefully shapes the flap to replace the removed breast tissue and transplants it to your chest to reconstruct the breast with living tissue. Your recovery requires several days of rest in the hospital to monitor the flap before you are sent home.
Dr. Fisher will listen to your goals and concerns, and will work with your oncologist and your breast cancer surgeon to develop a safe treatment plan that fits your body type and your lifestyle. Dr. Fisher is a skilled reconstructive breast surgeon, adept at both traditional implant techniques and advanced breast reconstruction techniques that use a woman’s own living tissue to restore the breast.
Some patients are candidates for nipple-sparing mastectomy. For these patients, the nipple can be preserved and the DIEP flap can be placed underneath the skin to replace the volume lost. If the nipples must be removed, three months after your initial surgery the nipple will be reconstructed as part of a second touch-up surgery. Three-dimensional areola tattooing is also available in the office to add color to the areola and the appearance of texture to the reconstructed nipple.
If you are very thin or if the size demand of your reconstructed breast requires more tissue, it may be necessary for your surgeon to perform a Bipedicle DIEP or Stacked DIEP flap, in which flaps of fat and skin are taken from both sides of the abdominal area to make a single larger breast. Alternatively, a slim patient who undergoes a double mastectomy and has an immediate DIEP flap reconstruction of both breasts can have fat graft injections at the time of the second-step nipple reconstruction surgery to improve the contour and enhance fullness of the new breasts.
Although most patients are candidates for this type of breast reconstruction, it requires a thorough evaluation by a surgeon who is experienced with these procedures.
To find out more about a DIEP flap, or any other breast reconstruction option, call our office to schedule a consultation.