DIEP Flap Breast Reconstruction After Mastectomy

Advantages of Microsurgical Breast Reconstruction with Perforator Flaps

DIEP Flap Breast Reconstruction, which stands for Deep Inferior Epigastric Perforator, is the preferred method of breast reconstruction after mastectomy. Unfortunately, there are not many plastic surgeons trained in the microsurgical skills necessary to perform complex perforator flap procedures like the DIEP Flap. For this reason, the less optimal TRAM Flap continues to be the standard of care in many practices across the nation when it comes to breast reconstruction after mastectomy.

In the hands of a specialized surgeon who performs microsurgical procedures on a regular basis however, the DIEP Flap procedure proves to be more advantageous to women facing breast reconstruction after mastectomy. The more advanced DIEP surgery is a complex procedure and ultimately more technically demanding of the surgeon, with reconstruction on one breast lasting anywhere from four to six hours and eight to ten hours for both breasts. Nevertheless, the results provide patients with a significantly more elegant solution in terms of utilizing abdominal tissue. Unlike the TRAM Flap, which requires the removal of abdominal muscle and fascia, DIEP surgery lessens the surgical burden on the donor tissue site by harvesting only abdominal skin and fat without the need to remove any of the rectus abdominis muscle. As a result of using this sophisticated muscle-preserving technique as opposed to the TRAM Flap, patients experience less postoperative pain and retain abdominal wall strength, which is important for reducing the risk of post-surgical complications such as hernias or bulges.

Both the TRAM and DIEP Flap breast reconstruction procedures are successful at creating a softer, more natural-looking breast than that of an artificial implant, as these techniques utilize the patient’s own natural tissue. However, the preservation of abdominal muscle and shorter hospital stays associated with the DIEP Flap ultimately make this technique more favorable for women seeking breast reconstruction after mastectomy. It is Dr. Spiegel’s philosophy that almost all patients who qualify for the TRAM Flap are candidates for the improved DIEP surgery as well. She strongly believes in the value of preserving the abdominal muscle to maintain trunk flexion function and reduce the risk of hernia formation. In addition she is committed to doing her best to ensure the recovery phase for her patients is as painless and unproblematic as possible. For this reason, she does not perform the secondary TRAM Flap procedure in her practice, focusing her clinical expertise instead on advanced microsurgery and more sophisticated muscle-preserving perforator flaps.

At the Center for Breast Restoration, we understand the emotional and physical toll that battling breast cancer can take on our patients. It is our priority to make breast reconstruction after mastectomy as comfortable and complication-free as possible. With a multidisciplinary team made up of oncologists, general surgeons specializing in breast surgery, radiologists, radiation oncologists, pathologists, and psychologists, we are equipped to help guide you through the journey of completing successful rehabilitation from breast cancer and other breast related problems. Dr. Spiegel is dedicated to continually improving upon new, less invasive treatments and procedures to improve the quality of life for all of her patients.