A large flap of fat and skin is usually taken from the tummy area, without damaging the rectus abdominal muscles (the ‘abs’). The transposed tissue receives its blood supply via perforator blood vessels traversing through the muscle. This free DIEP flap (Deep Inferior Epigastric artery Perforator flap) is completely detached from the abdomen (tummy). Micro-surgery is then performed to reconnect the blood vessels of the flap to the existing blood vessels at the side of the sternum. A new breast is constructed from the transposed flap . The abdomen is then stitched in the same way as a tummy tuck.
If the reconstruction is performed at the same time as the mastectomy, it is called a primary or immediate reconstruction . In this case, the skin on the breast can be saved (subcutaneous mastectomy), which leaves fewer visible scars.
When both breasts need to be reconstructed, it can be done in a single operation using two DIEP flaps .