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DIEP Flap
The DIEP (Deep Inferior Epigastric Perforator) flap is a free-flap reconstruction technique for mastectomy patients, using the skin and fat from the patient's abdominal area to form the reconstructed breast/s. A section of skin and fat from the abdominal area is fully detached from the body (making it a free flap), along with its blood vessels. It is then brought up to the chest where blood vessels and skin are reattached to the area. Microsurgery is required to reattach the fine blood vessels to the chest, so this is typically performed by a Plastic Surgeon in collaboration with a Breast Surgeon who performs the mastectomy.
DIEP reconstruction is well suited for the reconstruction of larger breasts, even in cases of bilateral mastectomies. It is also appropriate when a patient requires a mastectomy, but where the remaining skin is insufficient and unable to accommodate an implant.
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Fat and skin is fully detached from the abdomen and reattached to the chest to create a new breast shape. A nipple can be reconstructed using the skin in the area, or tattooed on
Reconstruction alternatives that use the patient's tissue for reconstruction (also known as autologous reconstruction) have advantages and disadvantages when compared to reconstruction using implants.
Advantages:
  1. Less affected by the effects of radiotherapy compared to implants
  2. Will evolve in shape and size (along with the rest of the body) as a person changes in body weight and ages
  3. Feels more natural than implants
  4. Does not require ongoing attention/maintenance
  5. Avoids risks specific to implants (e.g. rupture, capsular contracture)
  6. For DIEP reconstruction, some patients are pleased with the tummy tuck they receive as a natural consequence of having the reconstruction
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Disadvantages:
  1. Potentially longer recovery time
  2. Typically involves a longer surgery
  3. May require an additional scar, depending on where the tissue is obtained (scar fades over time)
  4. Not all patients have sufficient tissue for autologous reconstruction
  5. DIEP reconstruction is a much more complex procedure and may therefore be more costly than implant-based reconstruction
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