DIEP Flap Reconstruction

DIEP flap surgery has a longer recovery time compared to implant breast reconstruction. It usually takes 6-8 weeks to fully heal and be able to resume normal exercise activity.

Recovery after DIEP flap surgery can take anywhere from six to eight weeks. Abdominal swelling usually subsides by 2-3 months after surgery.

The best way to reduce swelling is to follow your post operative instructions. You will have activity restrictions for the first few weeks, as well as drains during this time. Abdominal tissue swelling is normal and wearing a light compression garment can help minimize swelling. Lymphatic massage is also very effective to reduce swelling after surgery, as it helps recirculate the lymphatic fluid within the tissue. We recommend patients get a weekly treatment for the first 4-6 weeks after surgery, and longer if possible.

The DIEP flap is an excellent approach to breast reconstruction but its not 100% effective in every case. In very rare instances, the tissue transfer does not succeed do to blood flow issues. In these instances, silicone gel breast implants may be an alternative reconstructive option, or using another body site for donor tissue such as the thighs or buttocks may be used.

For a few weeks following DIEP surgery, youll be instructed to wear a compression undergarments to help minimize swelling and protect the surgical sites. After that, we typically recommend patients wear a tight Spanx to help minimize swelling.

Sensation typically does not return after DIEP flap surgery. When DIEP flap surgery is performed, only the artery and vein are transferred to the chest area. Although there have been numerous studies on the success of nerve transfer during time of DIEP flap surgery, the results have been poor. That being said, even without nerve transfer, a small fraction patients do report return of some breast sensation, which may be similar to \u201cphantom\u201d sensations.

Preparing for DIEP surgery involves detailed discussions with your plastic surgeon and potentially your oncologist for how best to go about your unique surgical plan. We will review all the details about the surgery, your hospital stay, and post operative recovery with you at your pre-operative appointment. We recommend you bring the family member who will be helping you in the weeks after surgery to this pre-operative appointment. We suggest you take a least 4-5 weeks off from work and strenuous activity so you can heal properly.

DIEP breast reconstruction is covered by health insurance. Patients should review their benefits, and expect that they will need to undergo an approval process prior to surgery.

Mesh has been increasing used in breast reconstruction to support the new tissue mound. Your surgeon will determine if mesh is necessary in your treatment plan, but know that most often it can be avoided in DIEP flap breast reconstruction.

A TRAM flap takes the entire rectus muscle with the skin and fat, whereas a DIEP flap takes only the skin and blood vessels and preserves rectus muscle function. The benefit of a DIEP flap is that by preserving the recuts muscle, abdominal wall strength is maintained.

DIEP stands for deep inferior epigastric perforator artery, which is the main artery and blood supply to the specific area of lower abdominal tissue skin and fat.

DIEP surgery usually results in manageable discomfort which can be alleviated with over-the-counter or prescription medicine as needed. By implementing enhanced recovery after surgery protocols, we performed nerve blocks along the abdominal wall in surgery using a long acting anesthetic called Exparel which helps numb the surgical site for several days, and minimizes the need for narcotics after surgery. We also prescribe muscle relaxers and recommend Tylenol and anti-inflammatory medications for discomfort.

Most patients require 1-2 night stay in the hospital to monitor the abdominal tissue that was transferred and to make sure patients their meet milestones for safe discharge home with their caregiver.

DIEP flap surgery takes four to six hours but can take longer depending on if it is performed in conjunction with another procedure, like a mastectomy.

DIEP flap surgery is not typically performed after a tummy tuck, as the lower abdominal tissue that would be used for the DIEP flap has been removed with the tummy tuck procedure.

Both the breast and abdominal incision sites will have drains that will need to be emptied and recorded twice daily. Based on how well you’re healing and the recorded results from the drain contents, the drains can be removed one to three weeks after surgery.