DIEP Flap Reconstruction in New York

When you think of reconstruction options after a mastectomy, you probably think of breast implants. However, there’s another option that only sources tissue from your own body and doesn’t require foreign material to remain in your body for life. 

A reconstruction via DIEP flap, short for Deep Inferior Epigastric Perforator flap, uses a flap of tissue from your lower abdomen to remake the breast mound. A DIEP flap reconstruction enables your new breasts to have a more natural look and feel than other options because, like your original breasts, they’re made out of your own skin and fatty tissue.

Due to the delicate nature of the surgery required to reconnect all the blood vessels, it’s essential that you include a plastic surgeon on your healthcare team. Plastic surgeons have advanced training and expertise in performing microsurgeries like DIEP flap reconstructions and can provide you with the best treatment and surgical outcomes.

At Harris Plastic Surgery, we pride ourselves on caring for our patients throughout the whole breast reconstruction process. If you are interested in a DIEP flap breast reconstruction in Long Island or New York or have questions regarding the procedure, contact our office.

What Is a DIEP Flap Reconstruction?

A DIEP flap reconstruction is a surgical procedure that uses a patient’s own skin and fat tissues from the lower abdominal wall to reconstruct the shape and volume of breasts after a mastectomy.

The surgery itself consists of four stages:

Tissue Transfer: Tissue is taken from the patient’s lower abdominal area. This surgery uses abdominal skin and fat but does not remove any of the abdominal muscles.

Blood Vessel Microsurgery: Blood vessels from the abdominal tissue are connected to blood vessels in the patient’s chest near the mastectomy site to provide proper blood flow and oxygen to the transplanted tissue.

Shaping the Breasts: Once the tissue is reconnected to the patient’s blood supply, the main volume of fatty tissue can be shaped into an aesthetically pleasing breast mound for a natural look and feel.

Closing the Incision: After the tissue has been successfully transplanted and the breasts are reconstructed, all incisions on the abdomen and breasts will be closed and covered to begin healing. Because excess tissue has been removed from the abdominal wall to create the breast volume, closing the abdominal wall after DIEP flap harvest will produce a tighter contour, like a tummy tuck.

After the DIEP flap reconstruction is fully healed, the patient and plastic surgeon can discuss options for nipple and areola reconstruction to finalize the look of the new breasts – unless a nipple-sparing mastectomy has been performed and no reconstruction is needed.

DIEP Flap Reconstruction Long Island New York

Benefits of a DIEP Flap Reconstruction

When considering breast reconstruction, there are several options to choose from. One of the most common techniques is to use breast implants or tissue expanders. However, a growing number of surgical methods transfer skin and tissue from the patient’s own body instead of relying on mechanical devices for reconstruction. In addition to the DIEP flap, some other reconstructive procedures include:

While each surgical technique comes with its own list of pros and cons, the table below lists the benefits and risks of a DIEP flap surgery for breast reconstruction.

DIEP Flap Reconstruction Benefits and Risks

Benefits

Risks

  • Natural look and feel
  • Long-lasting results
  • No risk of implant-related complications
  • Enhanced abdominal contour
  • Restored self-esteem
  • Flap failure (from inadequate blood supply to the transferred tissue)
  • Necrosis
  • Scar formation
  • Occasional need for revision surgery within the first year to obtain the best appearance

Frequently Asked Questions About DIEP Flap Reconstruction

DIEP (Deep Inferior Epigastric Perforator) flap surgery is a breast reconstruction procedure that uses skin, fat, and blood vessels from your lower abdomen to reconstruct the breast after a mastectomy. Unlike other flap surgeries, DIEP does not use the abdominal muscles, so recovery is faster and easier, and you’ll have fewer risks of complications.

DIEP flap surgery uses your own tissues instead of implants to rebuild the breast mound. Between flap surgery options, the key difference is that the DIEP flap uses only fat and skin from your abdomen, not any of the abdominal muscles. This means less postoperative pain, a quicker recovery, and a lower risk of abdominal weakness compared to other flap surgeries.

Ideal candidates are women who have enough abdominal tissue for the reconstruction and are in good overall health. If you’ve had previous abdominal surgeries, such as a tummy tuck, or have certain medical conditions, your surgeon may suggest an alternative approach. Women who have significant medical co-morbidities, such as being an active smoker, morbid obesity, or other active medical problems, may not be ideal candidates for flap surgery.

Recovery from DIEP flap surgery typically takes 6 to 8 weeks. You’ll likely stay in the hospital for 2 to 5 days before going home, and most people can resume light activities after a few weeks. Full recovery, including resuming normal exercise, may take several months, but your surgeon will provide detailed post-op care instructions tailored to your unique needs and surgery.

Unfortunately, all breast reconstruction techniques available do come with scarring, but skilled plastic surgeons can typically hide these scars around your natural contours so they are less visible. For the DIEP Flap surgery, scars will be present on your lower abdomen, similar to a tummy tuck scar, and on the reconstructed breast. More good news is that reconstruction scars tend to fade over time and become less noticeable.

Yes, DIEP flap surgery can be performed either immediately after your mastectomy (an immediate reconstruction) or months/years later (delayed reconstruction), depending on your treatment plan, health concerns, and personal preferences.

As with any surgery, there are risks, including infection, bleeding, flap failure, fat necrosis, or complications related to anesthesia. DIEP flap surgery also carries a risk of abdominal weakness or hernia, though this is less common with the DIEP flap technique compared to other flap procedures.

Most health insurance plans, like NYSHIP in New York, cover breast reconstruction after a mastectomy, including DIEP flap surgery. However, coverage can vary depending on your provider and plan. It’s a good idea to check with your insurance company beforehand to make sure they cover the procedure that will work best for your unique needs.

DIEP flap surgery is a complex procedure that can take anywhere from 4 to 10 hours, depending on your anatomy, if you are having the mastectomy immediately before, and whether you are having one or both breasts reconstructed.

Many women need follow-up procedures after the initial reconstruction. These can refine the shape of the breast, adjust symmetry, or address complications. Some women also opt for nipple and/or areola reconstructions, which take place after the initial reconstruction has had time to heal. These additional aesthetic procedures are usually minor and can be done as outpatient surgeries.

Why Choose Harris Plastic Surgery for DIEP Flap Reconstruction?

There are so many decisions to make when you are considering breast reconstruction surgery in Long Island, either as a delayed option once you’ve already healed from a mastectomy or as a prophylactic mastectomy with immediate reconstruction. One of the best ways to set yourself up for a successful surgery is to surround yourself with a team of patient-centered experts. 

From the moment you set up your consultation appointment, our billing expert, Joanne Parrinello, can answer all your questions about logistics, finances, and the winding maze that is health insurance. She is dedicated to ensuring you have the most stress-free experience possible.

Your treatment plan will begin with a thorough patient evaluation and consultation, where you and Dr. Harris will meet and discuss your needs, medical history, what you want from your breast reconstruction, and how you can reach those goals together. Dr. Harris has advanced microsurgical training from the Massachusetts General Hospital/Harvard Medical School with extensive experience in microsurgical breast reconstruction.

If you’re ready to schedule your DIEP flap reconstruction surgery in Long Island, or you have more questions
about other treatment options, contact us online or by phone/text today.

Stephen U. Harris, MD FACS

Dr. Stephen U. Harris is a board-certified cosmetic surgeon and recognized expert in breast reduction and reconstruction surgeries, having performed thousands in his career. When it comes to patient care, his philosophy is that every surgery should improve his patient’s overall quality of life, not just their appearance. Dr. Harris stays up-to-date on all the latest advancements in breast augmentation, reconstruction, and reduction and is a recognized innovator in the field. In fact, he was the first surgeon at Good Samaritan Hospital to offer primary prepectoral implant breast reconstruction, as well as secondary prepectoral revision surgery.

Dr. Harris also serves as Chief of Plastic Surgery at Good Samaritan Hospital in West Islip, New York and is an active staff surgeon (and former Chief of Plastic Surgery) at South Shore University Hospital in Bay Shore, New York.