Breast Reconstruction (DIEP)

DIEP Flap Breast Reconstruction

What is a DIEP Flap?

A DIEP flap involves the removal of skin, fat, and blood vessels from the lower abdomen (below the belly button), which are then transplanted to the chest using microsurgical techniques.

This procedure is designed to preserve the abdominal muscles and maintain abdominal strength. The approach and techniques used are tailored to each patient’s individual needs and anatomy.

The Procedure

During the reconstruction, tissue is taken from an area such as the abdomen and transplanted to the chest, where it is shaped to form the breast. Breast reconstruction may also include optional procedures, such as reconstruction of the nipple or adjustments to nipple size and position, depending on the patient’s anatomy. In some cases, implants may be used in combination with tissue reconstruction to achieve the desired shape and volume.

The exact surgical techniques and steps are determined based on each patient’s unique circumstances, and these will be discussed thoroughly during the consultation.

For more information about DIEP flap reconstruction, recovery, or related procedures, consult your surgeon or access additional resources available on this website.

Aftercare

After your DIEP breast reconstruction surgery, your incisions will be bandaged, and some swelling, bruising, and tenderness are expected as part of the healing process. Your healthcare provider may prescribe pain medication to assist with managing discomfort during recovery.

Most patients stay in the hospital for a few days following the procedure to ensure close monitoring during the initial recovery phase. Once at home, it is important to follow the personalised aftercare instructions provided by Dr Bish Soliman. These may include recommendations such as avoiding smoking and alcohol, limiting certain movements, and wearing compression garments to support healing. You may also need assistance with daily tasks during the early stages of recovery, depending on your mobility and overall condition.

For further guidance and support, Dr Bish Soliman will provide specific advice tailored to your individual circumstances and recovery needs.

Potential Complications of DIEP Flap Surgery

All surgical procedures carry some degree of risk. Below are some potential complications specific to DIEP flap breast reconstruction surgery:

• Tissue Compromise: In rare cases, the blood supply to the transplanted tissue may be insufficient, potentially leading to tissue failure. Approximately 1 in 100 patients may need to return to the operating theatre for further assessment or intervention. Very rarely, alternative reconstruction methods may be required if the tissue fails.
• Haematoma: A haematoma, or collection of blood, may occur in about 2% of cases. If this develops, it may require surgical evacuation in the operating theatre.
• Infection: Although rare, infections can occur. Antibiotics are administered during the procedure to reduce this risk.
• Seroma (Fluid Build-up): Fluid accumulation in the abdominal or breast areas may occur after the drains are removed, affecting approximately 1 in 20 patients. This is typically managed by needle drainage and usually resolves within a few weeks. In rare cases, steroid injections may be necessary.
• Fat Necrosis: If the blood supply to some of the transplanted fat is inadequate, it may lead to fat necrosis, resulting in lumps within the reconstructed breast. These lumps may be managed with massage or, in some cases, surgical removal if they persist.
• Asymmetry: Natural differences between breasts are common, and achieving perfect symmetry is rare. Over time, changes due to aging or gravity may also affect symmetry. Secondary procedures may occasionally be needed to address significant asymmetry.
• Abdominal Bulge or Hernia: While rare, weakness in the abdominal wall can result in a bulge, and in very rare cases, hernia formation may occur. This complication may require additional surgery for correction. The DIEP technique minimizes this risk as the abdominal muscle and its nerves are preserved.
• Hypertrophic or Keloid Scarring: Some individuals may develop abnormal scarring. Your surgeon will provide post-operative advice to help manage scarring, and meticulous wound closure is performed to minimize this risk.

These risks will be discussed in detail during your consultation, allowing you to make an informed decision about your surgery. Individual outcomes may vary, and careful post-operative care can help minimize complications.