The DIEP flap is a state of the art tissue transplantation procedure designed for breast reconstruction. The great thing about the DIEP flap is that it utilizes the excess skin and fat in your lower abdominal wall. Essentially, the excess skin and fat that would be normally thrown away in a cosmetic tummy tuck.

In the DIEP flap we harvest the tissue, we save the abdominal wall muscles and we microsurgically dissect out the blood vessels that feed this excess skin and fat. We remove the excess skin and fat and its associated blood vessels, and we remove it completely from the body, and we actually transplant this tissue, the skin and fat, and the blood vessels to the chest wall, and we hook it up to new vessels coming from your chest wall.

Now, this is very delicate tissue transplantation surgery because the vessels that we're hooking up are essentially two millimeters in diameter each and we use sutures that are usually half the diameter of a human hair, very delicate work, but fortunately we perform these on a weekly basis, on a regular basis with excellent outcomes. Now, the DIEP flap surgery is not right for everyone. Clearly, it's more involved surgery as this is very delicate tissue transplantation microsurgery, but the DIEP flap has a lot of advantages.

Number one, you're restoring your breast using your own tissue. Number two, you're saving your abdominal wall muscles, decreasing the risks of abdominal wall weakness, hernia, or bulging. Number three, you get the fringe benefit advantage of the tummy tuck closure of your donor site and of course for your reconstruction, you're using your own tissue to restore your own breast. Once your tissue has healed it's yours to keep for life, it doesn't reject, it doesn't form scar tissue, it's yours to keep for life and it provides a very nice, natural soft supple result for your reconstructive breast.

The disadvantage of DIEP flap surgery, well, it's clearly more involved surgery, a longer operative time, a unilateral DIEP flap, in other words, reconstructing one side takes us between five to seven hours. A bilateral breast reconstruction with bilateral DIEP flaps can take anywhere between 8 to 12 hours of surgery time, so you have to be healthy enough to be a candidate for this surgery, in addition, it's a longer recovery course.

Initially, you'll be in the hospital for about four days after surgery and the recovery once you go home is really consistent with that of the cosmetic tummy tuck with a little bit more recovery, and of course, anytime we perform autologous breast reconstruction where we're using your own tissue and we're moving or transplanting the tissue, there's always a very small chance that part or all of that tissue may not work. The national statistics for flap loss or tissue loss is less than 3%. Our experience in the Institute of Advanced Breast Reconstruction is less than 1%. So, overwhelmingly the majority of patients do very, very well with a nice soft supple natural result.

What is the DIEP Free Flap Breast Reconstruction Procedure?

Doctor Bob Basu discusses the DIEP Free Flap Breast Reconstruction procedure.