Introduction
Another kind of breast reconstruction is DIEP (deep inferior epigastric perforator) flap surgery. This procedure involves the stomach's deep inferior epigastric perforator artery, a blood vessel. During the treatment, a surgeon reconstructs the breast using blood arteries, fat, and skin from the lower belly.
Since no abdominal muscles are removed during deep inferior epigastric perforator flap surgery, this is one of the key advantages. The recovery period is lengthened in other treatments, such as TRAM (transverse rectus abdominis muscle) flap surgery, which removes muscle from the abdomen or other body parts.
Who Should Have DIEP Flap Surgery?
After breast cancer surgery, one can have deep inferior epigastric perforator flap surgery to reconstruct their breasts. Following a lumpectomy or mastectomy, they may elect to have breast reconstruction (partial breast removal), depending on whether they choose immediate reconstruction following their breast cancer surgery or DIEP flap surgery (delayed reconstruction).
Some women decide on breast reconstruction for the following reasons:
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Give their chests a more symmetrical appearance.
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Improve the fit of clothing.
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Boost their sense of self-worth.
Who Should Not Undergo a DIEP Flap Operation?
The operation for DIEP flap reconstruction is not appropriate for everyone. This technique might not apply to everyone for the following reasons:
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Individuals who have already undergone TRAM or a DIEP flap procedure to reconstruct other breasts.
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Surgeons can only remove fat, skin, and blood arteries from the belly once.
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If there is a lack of excess tissue and fat in the abdomen.
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Skinny individuals.
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Individuals who had liposuction or abdominoplasty in the past. A stacked DIEP procedure (which uses tissue from both sides of the belly rather than the center) may be an option in certain circumstances.
How Is a DIEP Flap Procedure Done?
The process differs depending on whether a patient needs urgent or delayed repair. A tissue expander may have been inserted under the skin of the chest of some patients undergoing delayed reconstruction. During the flap operation, if there is a tissue expander, it will be taken out.
Anesthesia:
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At least six hours before the surgery, patients should refrain from eating or drinking.
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General anesthesia is preferred for the procedure; the patient is encouraged to accompany someone to take care of them.
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Depending on the method, the time required to complete the operation ranges from six to eight hours.
Surgical Procedure:
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Incision: The surgeon will slice the lower tummy with a lengthy incision. The incision starts from one side of the hip bone to the other side of the hip bone gap beneath the belly button and above the pubic hair.
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Removal of Tissue: The tissue on the abdomen is removed in one piece, along with a flap of skin that includes blood arteries and fat. There is no muscle removal by the surgeon.
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Transfer of Tissue: The surgeon creates an incision in the chest to transfer tissue similar to the incision line in a mastectomy or lumpectomy. They move the flap to the breast location and delicately join the flap's blood arteries to those in the patient's chest.
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Breast Shaping: Following the attachment of the blood vessels, the surgeon will shape the tissue to mimic the normal contour of a breast.
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Insertion of Drains: The wounds on the chest and abdomen will likely receive drains from the surgeon. Drains assist in fluid removal, edema reduction, and the healing process. They will be taken out a few weeks following the procedure.
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Closure of Wounds: The surgeon uses stitches or staples to close the incisions in the chest and belly. They adjust the belly skin, so the navel remains in its natural position.
What Are Post-Operative Instructions for the Patient?
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After a DIEP flap procedure, recovery can take six to eight weeks.
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For several weeks, the surgeon might instruct patients to wear a compression garment across their chest or abdomen.
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One must refrain from exerting themselves physically, lifting hefty objects, or moving a lot.
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The surgeon might advise starting modest exercises or arm motions by the second week.
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Numbness may be present in the tummy and breast after reconstruction that could last up to a year.
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After about two weeks, discomfort and soreness in the chest and belly will subside.
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Swelling occurs for a few weeks around the repaired breasts, underarms, and tummy.
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Patients may experience stiffness in the stomach's skin and the area surrounding the breast reconstruction.
What Advantages Do DIEP Flap Operations Have?
The following advantages of DIEP flap surgery:
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Gives Natural Appearance: Compared to implants, many people believe that using their own tissue provides new breasts a much more natural shape and feel.
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Preserves the Muscle: This procedure retains abdominal strength since the surgeon does not cut or extract muscle from the abdomen. Additionally, recovery time is quicker than with other flap operations.
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Gives Permanent Results: Permanent outcomes are provided through DIEP flap surgery. If individuals put on or lose weight, implants could shift, harden, rupture, or require adjustment.
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Preservation of Sensation: Breast sensation may be preserved. The restored breast may retain some feeling. Inquire with the surgeon if it is possible to move sensory nerves from the flap to the chest.
What Are the Complications of DIEP flap surgery?
Although they are uncommon, complications following DIEP flap surgery can include the following:
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Hernia: Following this surgery, a portion of the intestine can push through a weak place from the abdominal muscles.
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Lumps: Firm scar tissue that feels like a lump may develop in the reconstructed breast. The lump might disappear on its own or be removed by the surgeon.
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Necrosis: Some tissue may perish if the transferred flap does not receive enough blood. The skin may become cold to the touch and turn black. The surgeon must remove the dead tissue. Only very rarely does the entire flap become necrotic and require removal.
Conclusion
Another kind of breast reconstruction is DIEP flap surgery. After a mastectomy or lumpectomy for breast cancer, patients may decide to undergo this operation. During this treatment, a surgeon takes a layer of skin, fat, and blood arteries from the lower abdomen and moves it to the chest. Patients do not lose any muscle in their abdomen because this is a muscle-sparing procedure. Compared to implant reconstruction, DIEP reconstruction involves more work and has a more extended recovery period, but the outcomes are more aesthetically pleasing.
