DIEP Flap - Deep Inferior Epigastric Perforator Flap

Perforator flaps represent the state of the art in breast reconstruction, replacing the skin and breast tissue removed at the mastectomy site with soft, warm, living tissue.  This can be accomplished by using excess skin and fat from the abdomen.

A slim incision along the bikini line is made, much like that used for a tummy tuck. The necessary skin, soft tissue, and small nutrient blood vessels are removed.  This excess tissue, called the "flap", is then transferred up to the mastectomy site to reconstruct the breast.  Using a microscope, these small blood vessels are attached to vessels in the chest to re-establish blood flow into the flap, allowing it to survive in its new location.

Unlike conventional TRAM flap reconstructions, use of refined perforator flap techniques allow for collection of this tissue without sacrifice of underlying abdominal muscles. This tissue is then surgically transformed into a new breast mound. The abdomen is the most common donor site, since excess fat and skin are usually found in this area.  In addition to reconstructing the breast, the contour of the abdomen is often improved much like a tummy tuck.

Restoration of the nipple and areola follow several months later. Scars fade substantially with time. For many women, the reconstructed breast may have a more youthful appearance than their natural breast.