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DIEP Flap Surgery Best for Natural Breast Reconstruction Results?

asked 3 years ago by anon
Latest answer by Raj S. Ambay, MD
Question viewed 7,213 times
Tags: DIEP, natural

There's a possibility I may need to have a mastectomy, so I have been looking into which breast reconstruction procedure would be best for giving me the most natural-looking new breasts. I read that the DIEP flap surgery is new and much more expensive than other breast reconstruction surgeries because it gives the best result. Is this true? I want to know which breast reconstruction procedure the doctors think is best?

18 answers to DIEP Flap Surgery Best for Natural Breast Reconstruction Results?

Best procedure for breast reconstruction really depends on each patient

The three basic types of breast reconstruction are 1) implant reconstruction, 2) pedicled flap reconstruction with or without implant, 3) free flap reconstruction. Implants are the fastest surgery with the easiest recovery, but can be difficult to match a natural breast, or can look very "implanty" if both sides are done. Pedicle flaps can look very natural but requires the sacrifice of a major muscle, such as the latissimus dorsi (back) or rectus abdominus (abdomen),... more

Leif Liu Rogers, MD
Beverly Hills Plastic Surgeon

www.leifrogersmd.com

DIEP flap Breast Reconstruction and Cost

First, breast reconstruction after mastectomy must be covered by your insurance thanks to a 1998 federal law. This is one procedure insurance companies can't successfully deny. So given the question regarding cost -- this should not be a self-pay cosmetic procedure. Now to address your question regarding the DIEP flap. The DIEP flap utilizes the excess skin and fat that is normally thrown away in a cosmetic tummy tuck. It is like its predecessor, the TRAM flap that harvested the excess... more

C. Bob Basu, MD
Houston Plastic Surgeon

www.basuplasticsurgery.com

Autologous tissue is most natural

In my San Francisco area practice I have been able to offer my patients a wide range of reconstructive options. I've had the opportunity to co-found a breast reconstruction program and found two microsurgical programs which primarily have focused on breast reconstruction. The two basic categories of breast reconstruction include implant reconstruction (typically tissue expander followed by a permanent implant) and autologous tissue (using your own body's tissue to reconstruct your breast)... more

Steven H. Williams, MD
San Francisco Plastic Surgeon

Natural Appearing Breasts with Added Benefits

You are absolutely right that a DIEP flap produces the closest tissue match to native breast tissue. Breast tissue primarily consists of skin and fat, as does the DIEP flap. As far as cost, breast cancer reconstruction is covered by law under health insurance. So please do not base your surgical decision on cost. Most breast reconstruction surgeons can work with your insurance company to obtain coverage. The primary benefit of the DIEP flap are the... more

Paul S. Gill, MD
Houston Plastic Surgeon

DIEP Flap Breast Reconstruction Surgery - Natural Breast Reconstruction

DIEP Flaps are when ONLY skin and fat from your lower abdomen are used to reconstruct your breast. No muscle is taken like in the TRAM operation. By avoiding taking muscles, you preserve your core strength. DIEP flaps should be performed by surgeons experience in microsurgical breast reconstruction. DIEP flap breast reconstruction do create natural breasts. The other advantages of DIEP flap breast reconstruction are that the flap will not rupture like implants and will change with you... more

Ankit Desai, MD
Jacksonville Plastic Surgeon

DIEP Flap breast reconstruction

A DIEP flap stands for Deep Inferior Epigastric Perforator flap. It is an evolution in technique from a traditional free TRAM flap. The main difference is the goal of sparing the muscle from the abdomen to decrease the likelihood of bulging or hernia in the abdomen after the procedure. DIEP flaps for breast reconstruction are typically covered by your insurance provider. The cost issue arises when a surgeon does not participate with your insurance provider. The higher cost is due to the... more

David Bogue, MD
Boca Raton Plastic Surgeon

www.drbogue.com

Your own tissue is better than an implant usually

In general, using your own tissue makes for a more natural looking and feeling breast but at the expense of more scars and a much longer recovery than from implant reconstructions. This is especially true in radiated patients and in one sided reconstructions. Bilateral reconstructions without radiation can be performed adequately with implants. The DIEP flap and the free TRAM flap are probably the "Cadilacs" of breast reconstruction both using the skin and fat of the lower abdomen that... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

DIEP FLAP SURGERY

A free flap breast reconstruction is more expensive than a pedicled TRAM or tissue expander- implant recosntruction. Some surgeons charge more for a perforator flap reconstruction than a free-Tram. I prefere autologous tissue reconstruction over a tissue expander and implant. I think it gives a more natural appearance and feel.

Steven Wallach, MD
Manhattan Plastic Surgeon

DIEP flap and insurance coverage

Diep flaps are the state of the art in breast reconstruction. Insurance will cover it because it is the law. Regarding the issue of a natural look; Diep flaps use tissue that would be discarded in a cosmetic tummy tuck. It also does not use your abdominal muscle in most cases like the TRAM that has been used for 50 years. I would visit with a plastic surgeon who is experienced in this procedure. Depending on where you live in the country, there are not many surgeons who do this... more

Raj S. Ambay, MD
Tampa Plastic Surgeon

Diep flap breast reconstruction

Breast reconstruction may be performed with either the women's own tissue (often from the abdomen-ie, diep flap), or with tissue expanders and implants. Diep flaps involve transfer of the skin and fat from the abdomen while sparing the muscles of the abdominal wall (rectus abdominus muscles). Surgeons who perform this procedure often have specialized training in reconstructive microsurgery.

Loren Schechter, MD
Chicago Plastic Surgeon

Understanding DIEP Flap Surgery

There is no one best form of breast reconstruction for all patients. Although a DIEP flap can be a wonderful reconstruction option, it is suited primarily to patients with an adequate amount of lower abdominal skin and fat. In addition, if a patient may have radiation therapy after mastectomy-- which is sometimes only determined after the mastectomy-- then I do not usually recommend a DIEP flap, because the radiation can damage the flap. If I believe the patient is at significant risk of... more

James Romanelli, MD
Long Island City Plastic Surgeon

DIEP Flap Surgery - Natural Breast Reconstruction

DIEP FLAP SURGERY: Women who choose to undergo breast reconstruction with a DIEP flap have skin and fatty tissue removed from the lower abdominal area through an incision similar to that used for what’s known as a “tummy-tuck.” The skin and fatty tissue transferred with a DIEP flap is essentially identical to that which is transferred with a TRAM flap--but, importantly, no muscle is removed from the abdomen with a DIEP flap. As a general rule, women who are good... more

David Greenspun, MD, MSc
New York Plastic Surgeon

www.davidgreenspunmd.com

Your own tissues allow for the most natural breast reconstruction

\Plastic surgeons have devoted countless hours in honing new and better techniques to reconstruct the breast to make a woman feel whole again, fulfilling the need for form and function. There are several ways to recreate the breast. There is Implant Reconstruction and Autologous Tissue (your own body tissues) Reconstruction. There are advantages and disadvantages with either technique; however, I believe that using your own tissues without an implant creates the most natural,... more

Charles K. Lee, MD
San Francisco Plastic Surgeon

www.lplasticsurgery.com

DIEP flap breast reconstruction

For patients undergoing mastectomy, there are two general methods of breast reconstruction : 1) Implant-based breast reconstruction, and 2) Autologous reconstruction using your own body tissues. Which one is better depends on each individual situation and what the patient is interested in. If you are considering autologous reconstruction using your own tissues, there are several options. The most commonly used tissue is tha abdominal area. There are other... more

Peter Ashjian, MD
Bakersfield Plastic Surgeon

Diep flap for breast reconstruction

Each women has the ability to have natural results depending on her body type. Each type of reconstruction has its isks and benfits that have to be evaluated by each patient. As someone who has perfromed all the procedures and performs DEIP flaps, it is clearly the patients choice after consultation with their Plastic Surgeon. The procedures are covered for the side with cancer and the normal side. Please do not let the cost of any given procedure dictate what is ultimately done for... more

Robert Whitfield, MD
Milwaukee Plastic Surgeon

What type of breast reconstruction gives best result

There is a lot of options available for breast reconstruction, which can make it difficult to decide what is best for you. Let's break it down a little. First, there is implant versus using your own (autologous) reconstruction. Each has pros and cons, some of which I Iist here. Implant reconstruction has shorter operating times, quicker recovery and can be less expensive. The downside: multiple procedures, lifetime issues with implants requiring revisions... more

Tracy Pfeifer, MD
Manhattan Plastic Surgeon

The "Natural" breast resconstruction

In my opinion the goal of all breast surgery is a natural result. Traditionally, breast reconstruction differs from aesthetic breast enhancement because the goal is a natural result in clothing only with breast reconstruction. In my hands I can achieve a natural result close to aesthetic enhancement with tissue expanders and implants. This does not mean an "natural" result can not be achieve with flaps (DIEP, TRAM, etc) especially the hands of a surgeon that performs these... more

Earl Stephenson Jr., MD, DDS
Atlanta Plastic Surgeon

Advantages of a DEIP flap for breast reconstruction

TRAM flaps are commonly used for breast reconstruction. TRAM stands for 'Transverse Rectus Abdominis Muscle,' wherein the abdominal muscle and overlying fat to reconstruct the breast. A more advanced technique is to preserve the muscle and use only the overlying fat of the abdomen using a DIEP flap (Deep Inferior Epigastric Artery Perforator). The most important advantage is that it minimizes the morbidity or muscle loss of the abdomen. It can provide a very natural appearing breast, but... more