DIEP Flap Surgery: What To Expect

DIEP Flap Surgery: What To Expect

For women who have gone through breast cancer and treatment, breast reconstruction surgery can be an option

There are several different methods of breast reconstruction that can depend on a number of factors, such as personal preference, the surgery you’ve had, and the size and shape of breasts. One of these options is DIEP flap surgery, also known as DIEP reconstruction.  

In this article, we’ll be taking a closer look at the DIEP flap surgery process, recovery time and tips, and any long-term effects or complications of this surgery. If you are thinking about having DIEP flap surgery, continue reading to find out more about the procedure.

What is DIEP flap surgery?

Treatment for breast cancer can be quite invasive and may result in partial or full removal of the breast.

DIEP flap surgery is a type of breast reconstruction that uses a woman’s own body tissue to make a new breast after a mastectomy or double mastectomy. It can rebuild your breast and match it as closely as possible to the original, natural breast, with a similar shape and size.

In a DIEP reconstruction, skin and fat are taken from the abdomen to form the shape of the breast. Unlike other types of flap surgery (such as TRAM flap procedures), no muscle is taken or used to rebuild the breast.

DIEP stands for ‘deep inferior epigastric perforators’, which are the blood vessels used in the reconstruction. These blood vessels are taken out from the abdomen along with the fat and skin and joined up to blood vessels in the breast area.

Whether you decide to have reconstructive surgery or not is a personal choice. For many, DIEP flap reconstruction or other types of breast reconstructive surgery signals a new beginning.

The DIEP flap surgery process

During DIEP flap surgery, the surgeon will make an incision along your bikini line. A portion (known as a flap) of skin, fat, and blood vessels is then taken from the wall of the lower belly.

This tissue is then moved up to the chest area to rebuild the breast.

The tiny blood vessels in this piece of tissue are matched to the blood vessels in your chest and carefully reattached by the surgeon under a microscope, which is known as microsurgery.

DIEP flap surgery doesn’t cut or remove any muscle from the abdomen. Your surgeon will leave the abdominal muscle in place as they remove the skin, fat, and blood vessels. Because of this, most women tend to recover more quickly and are less likely to lose abdominal muscle strength with this type of procedure.

DIEP flap reconstruction surgery takes around six to eight hours to carry out and should always be carried out by a qualified and experienced surgeon.

DIEP flap recovery

The length of time that DIEP flap recovery takes can vary from person to person. Generally speaking, it takes around three months for you to resume normal activities, although this will depend on a few different factors, such as your general health at the time of your surgery.

After surgery, a patient will typically be moved to a room where staff can monitor things like your heart rate, blood pressure, and body temperature to keep an eye on how you’re getting on. You may also be given medication if you are in any pain or discomfort after surgery. to ensure you are well enough to go home.

Our specialist breast reconstruction surgeons can discuss any details, including timelines, of the DIEP flap recovery process with you in a consultation if you’d like to know more.

DIEP flap recovery tips

Upon leaving the hospital, you will be given specific instructions on how to aid recovery and look after yourself by your surgeon or healthcare team.

This will include guidance on how to look after both surgery sites (on your chest and abdomen), including advice on how to care for stitches and dressings.

Your surgeon may suggest that you wear a compression girdle for up to eight weeks after DIEP flap surgery, as well as a supportive sports bra (non-wired) to give you comfort and support.

They will also give you other DIEP flap recovery tips, such as stretching exercises and breathing exercises to carry out, and advice on when to resume your normal activities.

Because DIEP flap reconstruction involves abdominal surgery, you will probably find that it is painful and hard to sit down or get back up again. Getting in and out of bed may also be difficult. Your surgeon or healthcare team will show you how to move to be as comfortable and pain-free as possible.

You should avoid heavy lifting, strenuous activities (such as sports) and sexual activity for at least six weeks after surgery.

Breast Reconstruction after breast cancer

Two-and-a-half years after being diagnosed with breast cancer, Josephine Mitchell was referred to Consultant Plastic Surgeon Miss Anita Hazari at The McIndoe Centre where she underwent removal of her right breast prosthesis and replacement with a Diep reconstruction.

Long term effects of DIEP flap reconstruction

An advantage of this type of reconstruction is that it doesn’t cut into or use any muscle. Because of this, most people tend to recover more quickly. They also have a lower risk of long-term effects, such as loss of abdominal muscle strength or hernia — particularly compared to TRAM flap reconstruction.

DIEP flap reconstruction will leave noticeable, permanent scars where the incisions were made, around your breasts and lower abdomen (below the bikini line). These typically fade and become less obvious in time, but the horizontal scar below the bikini line is quite long, stretching from hip to hip.

DIEP flap reconstruction complications

As with all surgical procedures, there can be some risks with DIEP flap reconstruction.

One possible DIEP flap reconstruction complication is clotting. In some rare cases, the blood supply to the breast can become blocked off by blood clots. In these situations, the patient would need to go back into surgery to improve the blood flow and remove clots.

At The McIndoe Centre, we do everything we can to minimise the risk of any complications. Your surgeon will talk you through any possible risks before you decide to have your operation.

DIEP flap vs implants

Deciding between types of breast reconstructive surgery — such as DIEP flap vs implants — is a personal choice that can depend on a few different factors.

While implants are relatively simple (compared to other breast reconstruction), they do need to be replaced every 10 to 15 years. Whereas once the incision sites and tissue transfer heals in a DIEP flap reconstruction, additional surgeries are no longer needed.

If you’re deliberating between the two, you can speak to one of our specialist breast reconstruction surgeons for personalised advice and guidance.

DIEP flap surgery at The McIndoe Centre

At The McIndoe Centre, we offer DIEP flap surgery tailored to your personal requirements.

If you are considering DIEP flap surgery, you can arrange a consultation with one of our specialist breast reconstruction surgeons to discuss your options further.

You can make a breast reconstruction enquiry on our website to arrange a consultation or call our free helpline on 01342 488054 for more information and professional advice.

Our friendly team is always happy to answer any questions you may have regarding our treatments and services.

East Grinstead, UK. 5, July, 2019.
The McIndoe Centre - images to go with a then and now comparison set of images.