DIEP (Deep Inferior Epigastric Perforator) Flap
DIEP Flap Frequently asked questions
Common myths and misconceptions about DIEP flaps
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What is a DIEP Flap?
The DIEP flap, which is short for Deep Inferior Epigastric Perforator Flap, represents the state of the art in breast reconstruction. The procedure allows the tissue normally discarded in a tummy tuck to be transformed into a reconstructed breast, improving the shape and appearance of both breast and abdomen.
The DIEP flap permits the creation of a new breast with tissue which closely resembles the breast tissue removed with a mastectomy. This results in a reconstructed breast that is soft, warm, and naturally changes with the patient's body over time.
The skin and fat used are taken from the abdomen and are almost the same tissue normally removed in an abdominoplasty (tummy tuck). The major difference is that an artery and vein which supply this tissue are carefully dissected free from between the abdominal muscle fibers and taken with the flap. The tissue is transferred to the chest, where the artery and vein are reconnected to recipient vessels and the tissue carefully formed into a breast.
Unlike the traditional TRAM flaps, the DIEP flap does not sacrifice the rectus abdominis (belly “six pack”) muscle.
In the hands of a skilled microvascular surgeon, this tissue can be made into a breast which is alive and will grow, shrink and sag with the body’s natural changes over the rest of the patient’s life. A “side effect” of the procedure is that the remaining abdominal skin is pulled together into a flatter stomach, similar to that seen in an abdominoplasty (tummy tuck).
Many plastic surgeons advertise that they are familiar with this operation. However, Dr. Granzow is on of only about 40 such surgeons in the US who routinely perform the operation and have a success rate of about 99%.
What is a perforator flap?
A DIEP flap is the most common type of perforator flap. A perforator flap is skin and fat which is removed from another area, such as the abdomen or buttock, with a specially attached artery and vein which will later provide blood supply to this tissue in the reconstructed breast. The underlying muscle is carefully preserved and the excess skin and fat transferred to the chest wall to allow creation of a new breast. Dr. Granzow then carefully shapes and insets this excess tissue to create a newly formed breast from the transplanted tissue (the perforator flap).
The Surgery
The procedure usually takes two stages to complete. In the first stage, Dr. Granzow transfers the tissue (the perforator flap) from the abdomen and connects it to the chest using a microsurgical technique. This flap is allowed to firmly heal to the chest wall.
A second procedure occurs, after healing is complete, to aesthetically refine and shape the breast and the sides of the abdomen. The procedure is typically performed through the same incision that would be used for a breast lift (mastopexy) and a tummy tuck (abdominoplasty) and delivers a result that resembles the two. The work performed in this second stage tends to improve with time for a more aesthetic and natural appearance.
Dr. Granzow spends a significant amount of time and effort during the first and second stages of the operation not only to provide a safe and successful surgery (success rate 98-99%), but also to shape both breast and abdomen for the best overall aesthetic result possible.
What is microsurgery and why is it important for breast reconstruction?
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DIEP Flap Frequently asked questions
Common myths and misconceptions about DIEP flaps
See patient photos
Read more about breast reconstruction
Read Dr. Granzow's articles from the leading Plastic Surgery Journals
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