DIEP Flap Reconstruction is a microsurgical reconstructive technique that can restore the breasts after a mastectomy due to breast cancer or other factors. Your reconstructive surgeon uses your own abdominal tissue to create new reconstructed breasts with a completely natural look and feel.

DIEP flap breast reconstruction involves using the skin, fat, and blood vessels of the lower abdominal region to rebuild a soft, warm, living reconstructed breast mound on the chest.  This method of breast reconstruction is also known as “autologous” or natural tissue reconstruction because it uses the patient’s own tissue without any implants. It can be an excellent option for women who develop radiation damage or implant-related complications.

What is DIEP Flap Breast Reconstruction?

“DIEP” stands for deep inferior epigastric perforator, which is the name of the primary blood supply to the specific region of skin and fat in the lower abdominal region. A DIEP flap is a modern version of the more traditional muscle-sparing free TRAM flap; however, the difference is that in a DIEP flap, no muscle is used to create the breast.

During DIEP flap surgery, only the skin, fat, and blood vessels from the lower abdominal region (similar to the tissue removed in a “tummy tuck”) are taken and used to rebuild a breast mound on the chest. Using specialized microvascular surgical techniques, your surgeon will carefully reattach the vessels from the DIEP flap tissue to the vessels in the chest. Essentially, these breast reconstruction procedures are soft tissue transplants. The result is a soft, warm, living breast mound that will last a lifetime and age naturally with the patient.

By sparing the abdominal muscles, abdominal wall strength is better preserved using the modern DIEP flap technique compared to traditional TRAM flaps, which take the rectus muscles.

Feel Whole Again

Who is a good candidate for DIEP Flap Breast Reconstruction?

Ideal candidates for DIEP flap reconstruction are medically healthy and have enough lower abdominal skin and fat volume for donor tissue. Patients who have had extensive abdominal wall surgery or a previous tummy tuck/abdominoplasty may not be good candidates for DIEP flap breast reconstruction surgery and can consider other donor sites, such as the thigh or gluteal regions. To determine if you are a good candidate, we recommend you come in for a consultation with one of our board-certified plastic and reconstructive surgeons to discuss your goals and determine a customized reconstructive treatment plan.

Before + After

Patient Results

Breast reconstruction surgery is often a life-changing experience for our patients. Our goal is to help our patients feel whole again after undergoing breast cancer treatment. View our gallery to learn more about the various reconstructive surgeries performed by our board-certified plastic surgeons at Tucson Plastic Surgery.


Patient Reviews

My surgeon is Dr Mahabar and this is about my experience having D Flap reconstructive surgery. First l need to say he's an amazing surgeon. He turned my radiation scars and horrible mastectomy scars into…
- JU
Words cannot express how much I appreciate the entire team at Tucson Plastic Surgery. Being diagnosed with breast cancer has led me down a road I never intended to go. The care and compassion that…
- MM
From start to finish not only was this the best customer service experience I’ve ever had but they also listened to my concerns, put me at ease, and truly only do what’s best for your…
- JH

DIEP Flap Breast Reconstruction Procedure

DIEP flap surgery is performed under general anesthesia, and the entire breast reconstruction process takes about 6-8 hours. In the pre-operative area, your reconstructive surgeon will mark the lower abdominal tissue in a pattern similar to a tummy tuck procedure, with the goal that your final scar remains hidden within an undergarment or bikini bottom. The lower abdominal skin, fat, and DIEP blood vessels are carefully removed, and the abdominal rectus muscles are spared. The DIEP tissue flap is then carefully transferred to the chest and used to create a new breast mound. Using specialized microvascular surgical techniques, your surgeon will reattach the vessels from the DIEP flap tissue to the vessels in the chest to restore a warm, living, natural breast mound.

As part of our Enhanced Recovery After Surgery (ERAS) protocol, the nerves along the abdominal wall and chest are injected with Exparel, a long-acting local anesthetic and nerve-blocking agent. This helps block pain for up to 3-4 days and minimizes the need for narcotic use after surgery. Once the surgery is complete, you will recover in the hospital for 1-2 days.

Recovery Process

DIEP Flap Breast Reconstruction Recovery

6-8 Weeks

Most patients are ready to go home after a 1-2 night stay in the hospital. It is important that you follow instructions and avoid being overly active too early. You will have drains and be given detailed instructions on how to care for them at home. They are usually removed within 1- 2 weeks after surgery. We recommend a family member or close friend stay with you for a few weeks while you recover, as you will not be allowed to do chores or engage in heavy lifting. In general, we recommend sleeping in a reclined beach chair position for 2 weeks and no lifting greater than 5 lbs for 6 weeks. At around 6-8 weeks, you will be allowed to resume normal activity and vigorous unrestricted exercise after 2-3 months.

Frequently Asked Questions

How long does it take to recover from DIEP flap surgery?

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.

How long does abdominal swelling last after DIEP flap?

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

How do you reduce swelling after DIEP flap?

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.

What happens if DIEP flap fails?

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.

What should I wear after DIEP surgery?

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.

Do you have feeling in your breast after DIEP flap surgery?

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.

How do you prepare for a DIEP surgery?

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.

Is DIEP flap surgery covered by insurance?

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.

Is mesh used in DIEP flap 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.

Is DIEP surgery safe?

DIEP flap surgery is safe when performed by experienced, fellowship trained, and board-certified plastic surgeons like Dr. Mahabir and Dr. Kurtovic. Collectively they have performed over 1500 DIEP flap surgeries, and prioritize your safety during the procedure. The surgery is performed under general anesthesia in a hospital, and uses enhanced recovery after surgery protocols to improve patient outcomes. You will be monitored in the hospital for 1-2 nights to ensure your meet milestones for safe discharge home with your caregiver.

What is the difference between a TRAM flap and DIEP flap?

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.

What does DIEP stand for?

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.

How long does pain last after DIEP flap surgery?

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.

How long is hospital stay after DIEP flap surgery?

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.

Will I have drains after DIEP flap surgery?

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.

Silvia Kurtovic, MD & Raman Mahabir, MD

Board Certified Plastic Surgeons

At Tucson Plastic Surgery, we have a patient-centric approach that sets us apart from the rest. We take the time to really get to know you and your aesthetic goals during one-on-one conversations which help us to fully understand your motivations.

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