DIEP Flap Breast Reconstruction in Austin, TX

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 plastic surgery. 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 reconstruction surgery 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.

 

BRA Christine Fisher MD and John Eggleston MD - DIEP Flap breast reconstruction

(A) The deep inferior epigastric artery (DIEA) and the deep inferior epigastric vein (DIEV), by way of branches called perforators, provide the blood supply to the skin and fat that collectively comprise a DIEP flap. These blood vessels are meticulously separated the abdominal muscle, leaving the muscle intact. (Inset) Cross-sectional view demonstrating perforator branches of the DIEA and DIEV that nourish the DIEP flap. (B) After the DIEP flap is transferred to the chest, the DIEA and DIEV are connected to blood vessels at the recipient site, using microsurgical techniques, in order to restore circulation to the flap. The flap is then sculpted to restore the shape of the breast. (C) The horizontal abdominal scar that results following DIEP flap surgery is similar to that created by a “tummy tuck”; the scar that results on the breast itself will depend on the technique used for the mastectomy. Many women choose to have nipple reconstruction, along with tattooing of the nipple and areola, to have a reconstructed breast that looks as realistic as possible.

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, send us a message or call our office at (512) 815-0123 to schedule a consultation.

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