Free DIEP flap
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.
If the reconstruction is performed in a second operation after the mastectomy, we call this a secondary breast reconstruction.
When both breasts need to be reconstructed, it can be done in a single operation using two DIEP flaps .
Secondary reconstruction of the left breast using a free DIEP flap.
Primary reconstruction of the right breast using a free DIEP flap (following a subcutaneous mastectomy). Mastopexy of the left breast.
Bilateral primary breast reconstruction using 2 free DIEP flaps (following a bilateral subcutaneous mastectomy).
Bilateral secondary breast reconstruction using 2 free DIEP flaps.
Bilateral primary breast reconstruction using two 2 DIEP flaps (following a bilateral subcutaneous mastectomy).