Breast reconstruction using your own tissue without the use of implants is called autologous (referring to your own tissue) flap surgery. An autologous flap procedure uses a combination of skin, fat, and/or muscle that is moved from areas such as your abdomen, upper back, upper hip, or buttocks to the chest where it is shaped into a new breast. Not every woman is a candidate for this type of breast reconstruction, and it is best to discuss the pros and cons of these procedures with your surgeon.
DIEP (deep inferior epigastric perforators) flap surgery is a cutting-edge breast reconstruction procedure that uses a flap of complete tissue - blood vessels (perforators), skin and fat - from a woman’s lower abdomen as donor tissue. The flap is then transferred to the chest where the surgeon, aided by a microscope, will attach the donor tissue blood vessels to the chest blood vessels and reconstruct the breast. This delicate procedure provides significant benefits, such as a slimmer appearance, a natural-looking breast, maintained core strength and a quick recovery.
DIEP flap breast reconstruction surgery is relatively new to the world of plastic surgery, and few health care facilities have the expertise necessary to perform the surgery safely. Yet due to its significant benefits, DIEP is quickly becoming known as the state-of-the-art choice for breast cancer patients. That’s why Brigham and Women’s Hospital (BWH), as one of the select few hospitals nationwide that offers DIEP flap surgery, is committed to educating patients about the procedure and offering its benefits to more and more women.
DIEP flap procedure is similar to the traditional TRAM (transverse rectus abdominus muscle) flap procedure. The TRAM procedure is preferable in some cases, but for other patients, there are unique advantages to choosing the DIEP procedure.
Both procedures harvest abdominal tissue, thereby giving the patient the benefit of a slimmer appearance. However, there is a difference in how each procedure treats the rectus abdominus (“six pack”) muscle when removing the abdominal tissue. The DIEP procedure keeps the muscle in place on the abdomen so that it may continue to perform its intended functions. By maintaining the viability of the abdominal muscle, the DIEP procedure helps to preserve abdominal strength, lessen the likelihood of a hernia and shorten recovery time.
After the DIEP flap has been taken from the abdomen, the dissected blood vessels from the belly tissue are then connected to the patient's chest blood vessels. Studies have shown that this aspect of the DIEP procedure, which requires a long period of delicate microsurgery, can lead to a better blood supply for the transplanted tissue, and thus, less fat necrosis (tissue damage). In the TRAM procedure, the harvested flap’s blood vessels are not severed, thereby maintaining the tissue’s connection to the original (belly tissue) blood supply.
Once the vessels have been attached, the surgeon works on shaping the breast. By only using the body’s own tissue, a very natural shape can be attained. Visit our patient before-and-after photos page to see the results of DIEP flap surgery at BWH.
Summary of benefits of DIEP flap reconstruction:
If you have further questions or would like to schedule a breast reconstruction consult, please contact us.