The DIEP flap method is a breast reconstruction method that uses the patient's own tissue. The breast is reconstructed using a flap of sub-abdominal fat tissue. Breast reconstruction with such a DIEP flap is a technically very demanding procedure. The advantage is a particularly natural reconstruction result.
Here you will find the most important information and qualified DIEP flap specialists.
Every year, 45,000 women in Germany are diagnosed with breast cancer. Of these women, around 70 percent can undergo breast-conserving surgery and treatment.
However, in around 30 percent of cases, the mammary gland has to be removed completely. The removal of the breast is a great loss for many of those affected, as their breasts are an important part of their self-image as a woman.
For them, the decision to undergo breast reconstruction is also a decisive step towards a new quality of life.
After losing a breast due to breast cancer, many sufferers want breast reconstruction © Akarat Phasura | AdobeStock
The aim of breast reconstruction is to achieve a permanently natural shape and soft consistency of the breast. Various procedures are available for this purpose. Breast reconstruction is best achieved with the patient's own tissue.
In the past, either the large back muscle or the straight abdominal muscle was used for this. Today, however, no muscle has to be sacrificed at specialized centers. Instead, a sub-abdominal fat flap is used - the so-called DIEP flap (Deep Inferior Epigastric artery Perforator flap).
Treatment of the cancer should be completed before DIEP flap surgery (except for hormone therapy).
The DIEP flap method is a lengthy and technically demanding operation. Therefore, patients must not have any significant cardiovascular or pulmonary limitations. If necessary, they should be specially examined again and treated with medication before the DIEP flap operation.
Nicotine impairs blood circulation. It is therefore advisable to give up smoking at least 3 months before the DIEP flap operation. Certain medications should not be taken before the operation - after consultation with the attending physician.
Patients should inform their doctor of any allergies and all known secondary illnesses and previous operations on the abdomen (e.g. liposuction).
Surgery using the DIEP flap method is performed under general anesthesia. The breast is reconstructed from sub-abdominal fatty tissue while sparing the abdominal wall muscles.
Blood vessels 1 to 2 mm in diameter are responsible for the blood supply to the sub-abdominal fat tissue. These small blood vessels are dissected and exposed using microsurgery. They also give this flap its name: DIEP flap - Deep Inferior Epigastric artery Perforator flap.
This flap of lower abdominal fat is completely detached from the abdominal wall during DIEP flap surgery. The breast is then formed from it. The surgeon connects the small blood vessels to the vessels in the chest wall under the microscope.
The DIEP flap operation creates a defect in the lower abdomen. This is closed by tightening the upper abdominal skin - as in an abdominoplasty. The abdominal muscles are no longer involved in this modern DIEP flap method. The navel is repositioned in the tightened skin.
The nipple is reconstructed at a later date.
Autologous blood donation is offered 4 and 8 weeks before the operation. Patients then also practice special isometric muscle exercises.
Before the operation, the patient has a detailed consultation with the surgeon. This includes a thorough explanation of the possible surgical risks of the DIEP flap method.
On the day before the DIEP flap operation, the necessary preliminary examinations are carried out at the clinic. This often includes an ultrasound examination of
is planned. The doctors use duplex sonography to mark the perforator vessels and mark them accordingly.
After the DIEP flap operation, the patient must remain in bed for 5 days. Patients are given medication to improve circulation. They should continue to carry out their isometric muscle exercises during bed rest.
The drains are removed after an average of 3 to 5 days. 10 to 14 days after the DIEP flap operation, you can be discharged home if everything goes normally.
The time required for full recovery after DIEP flap surgery depends on the individual case. Patients should take it easy physically for 8 to 12 weeks. After that, sporting activities can be slowly increased.
Most skin sutures are made of absorbable suture material that is absorbed by the body. Only the stitches around the navel are removed after about 2 to 3 weeks. Scar care and massage with fatty ointments, e.g. panthenol, is recommended. The fresh scars should be protected from UV light.
Breast reconstruction with the DIEP flap is a technically very demanding procedure. The advantages are the natural reconstruction results and the usually uncomplicated long-term course.
Tumor follow-up can be carried out without any problems using sonography or, in special cases, magnetic resonance imaging.
The main risk associated with surgery using the DIEP flap method is insufficient blood supply to the DIEP flap. In this case, a loss of the lower abdominal fat flap is to be expected. This complication occurs in 1 to 2 percent of patients.
Otherwise, as with other operations, general surgical risks such as
Corrective surgery is often necessary after DIEP flap surgery in order to achieve an optimal aesthetic end result.
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