DIEP Flap Reconstruction
DIEP Flap Breast Reconstruction in Houston and the Woodlands
DIEP flap breast reconstruction is the gold standard when it comes to breast reconstruction techniques that utilize your own body’s tissue to recreate the breast. It utilizes microsurgical techniques to move or transplant your own tissue, specifically the extra abdominal tissue on the abdomen below the belly button, from the abdomen to the breast. This portion of your own tissue is used in the same way as an implant, in the sense that it replaces the breast tissue that was removed during your mastectomy. Flaps are popular because there are no external or foreign body reactions, and they look, move, and feel completely natural.
What is Special?
DIEP flap reconstruction is today a very common procedure, but not all DIEP flap reconstructions are alike, and Dr. Linville utilizes several new techniques to get the best aesthetic result from your reconstruction. Getting the absolute best result requires a very careful planning process from the very beginning, even if you are electing to delay your reconstruction or if you will be needing adjuvant radiation therapy. Additionally, Dr. Linville and his staff treat you like family, with an unmatched personal concierge service that will make you feel comfortable and assured you are with someone who truly cares.
A reconstructive surgeon is also only as good as the breast oncologic surgeon with whom he or she works, and Dr. Linville is grateful to work with some of the best in the country.
- Delayed-Immediate – Plastic surgeons do not like to radiate flaps because it can shrink or alter the flap itself. Thus, almost all flaps in the past were delayed, and if a patient was expected to undergo radiation, no reconstruction was done at the time of mastectomy. However, a new technique is to place a tissue expander at the time of mastectomy, even if the patient is going to get radiation, and follow this at a later time with a DIEP flap. The expander acts to preserve the normal breast skin envelope, which gives a superior cosmetic result once the final DIEP reconstruction is done. It helps keep the flap up in a good position, helps to shape it, and helps to minimize scar.
- Immediate – Reconstruction is done at the same time as the mastectomy, and you wake up with a fully reconstructed breast. This helps minimize an already traumatizing event and diagnosis, and helps minimize the total number of surgeries. Several other important things can be done during surgery to contour and shape the flap to look just like a breast.
- Nipple-sparing mastectomy – if you are a candidate for nipple sparing mastectomy, then you can also still be a great candidate for DIEP flap reconstruction. Nothing looks more natural than your own tissue, and the same holds true for the nipple. Whenever we can save the nipple and areola, we will do so.
- Ptosis correction – A very new technique aims at correcting ptosis or sagging of the nipple or breast before the final reconstruction. Typically, a lumpectomy and a lift are done together, also known as an oncoplastic breast reconstruction. This serves to help shape and raise the breast first. Three to six months later, you then undergo a completion mastectomy, but the nipple is spared, and your reconstruction is performed, but with an unmatched aesthetic result.
- Fat transfer – autologous fat transfer is utilized in nearly every breast reconstructive procedure nowadays because of its unmatched ability to add volume, shape the breast, and conceal underlying implants or flaps. This is also a great way to add volume to the flap as a secondary procedure (once you’ve healed).
- Using flaps for augmentation – Occasionally, the amount of tissue from your abdomen isn’t enough to replace all the volume from your breast. There are several other flaps that can be used, from the buttock, back of the thigh, or the back, and they go by the acronyms SGAP, IGAP, PAP, TAP, and Lat flap.
- Delayed – If you have deferred reconstruction due to medical conditions, radiation, or simply because that was your choice, but you are now considering reconstruction, Dr. Linville will work with you to come up with the safest and best option available to get you feeling whole again. DIEP flaps can be a great means to limit your risk and limit your number of surgeries. Shaping the flaps to look like a breast in this technique requires special training and attention to detail to get right.
Breast Reconstruction Revisions
Occasionally, revision procedures are necessary to get everything situated exactly how you and Dr. Linville want it to be. If you have had reconstruction elsewhere and simply want to know your options, or you are in need of a revision, Dr. Linville will see you in consultation and discuss your options, and implement the latest techniques as described above to help deal with any reconstructive challenges.
Patients should expect a minimum of two weeks to recover from DIEP flap reconstruction, and that would be the minimum in order to feel good enough to return to work. No lifting or strenuous activity is allowed for 4-6 weeks, and this is mostly to make sure you heal without complications.
Enhanced Recovery Techniques
New knowledge and medications are allowing for shorter recovery times and enhanced recovery. Special medications are used, even before surgery, to help decrease the need for narcotics and decrease the pain you experience during and after surgery. Further, long-acting injectable medications are utilized to decrease your pain level even further, which allows the patient to have less nausea, less pain, and get home quicker.
All it takes is an initial consultation and Dr. Linville and his staff will take it from there. His expert team will help make this an easy process for you.