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DIEP Flap Reconstruction Surgery Houston

The loss of your breast or breasts due to cancer or a mastectomy can be overwhelmingly challenging. It is a significant change that can have a massive impact on your self-image. Fortunately, modern medical techniques allow for experts to reconstruct the breast. One powerful method is the DIEP flap breast reconstruction.

DIEP stands for Deep Inferior Epigastric Perforator. What this means is we take a section of tissue and form it into a new breast for you. This tissue includes skin, fat, and blood vessels from your abdomen. It is quite an intensive surgery and demands the hand of an experienced surgeon to be a success.

Breast Reconstruction Overview

Breast reconstruction is the process of restoring breasts to women who may have had part or all of the breast removed. Patients seeking this procedure have often lost their breasts because of breast cancer. For others, they have had an elective mastectomy after identifying certain genetic markers. Both situations are incredibly emotionally painful and mark massive changes in your daily life.

Our goal at Linville Plastic Surgery is to help you reach your goals and restore your confidence.

Why You Need a Top-Quality Surgeon

The complexity of this procedure requires a surgeon specially trained in microsurgery. They must be able to effectively transplant tissue to a new location and re-establish blood supply.

Much of this procedure is done under a microscope to reattach blood vessels in their new location. So you can imagine how precise your surgeon must need to be. The abdominal muscles remain intact, and only the tissue covering them is used.

Dr. Linville performs DIEP Flap Breast Reconstruction regularly. He has a long list of very pleased patients, and you can view before-and-after photos. This method is the gold standard in breast reconstruction techniques today.

Candidates for DIEP Flap Breast Reconstruction Surgery:

  • Patients with a breast cancer diagnosis
  • Patients with a positive genetic screen indicating a high likelihood of developing breast cancer during their lifetime
  • Patients who have already had a mastectomy or partial mastectomy
  • Patients who have sufficient skin and fat around their abdomen to form a new breast
  • Patients who want to avoid using an implant to form a new breast

During your consultation, Dr. Linville will work with you to form a personalized plan. By listening to your goals and needs, he can match you with the right procedure to help you meet them.

Breast Reconstruction Surgery before and after picture front view
Breast Reconstruction Surgery Patient before and after picture 3/4 right side View
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The Process

The first step is a consultation with Dr. Linville. During your meeting, he will take a complete medical history and discuss your options with you. He will also assess whether you have enough tissue to repurpose for this method.

Dr. Linville routinely involves your breast surgeon when deciding to pursue DIEP flap surgery. The reason is that this can be done at the same time as a mastectomy, or sometime later. In some cases, a patient may have an implant or fat grafting to enhance the final result.

You are given all the information ahead of time so that you can make an informed decision. Our goal is that you are fully aware of what to expect as far as surgery, recovery, and outcome. We advise patients to view before-and-after photos of previous DIEP flap patients. Doing so will help you get an idea of what your results may look like. Also, we encourage you to ask questions so you can go into this process confidently.


Beyond DIEP Flap, What Are My Options?

Nipple-Sparing Mastectomy with direct-to-implant or free flap:

Although this technique is not safe for everyone, it preserves the nipple during a mastectomy. It can provide the best cosmetic outcome possible. Implants or DIEP flap can be placed under the breast skin to restore the breast shape and volume. It can also be combined with fat grafting to yield an unmatched aesthetic result.

Oncoplastic Surgery:

Oncoplastic Surgery is done at the time of lumpectomy. It utilizes breast reduction principles to help shape and restore the breast around the site without leaving a divot or deformity.

Partial Breast Reconstruction for Lumpectomy Defects:

If you need a larger lumpectomy or segmental mastectomy, this technique can help preserve some parts of the breast without requiring a full mastectomy. It restores the lost skin and breast volume with skin and fat from the side or back, usually within the bra line.

Staged Breast Reduction:

This begins with reducing and raising the breast and nipple before mastectomy via breast reduction. Its advantages are:

  • The breast envelope is optimized for a cosmetic result
  • It often spares the nipple
  • It can prevent the need for radiation once the mastectomy is completed at a later stage

Breast Reduction is optimal for women with very large breasts where the nipple is too low to be raised during a mastectomy. It allows the chance to still perform a nipple-sparing mastectomy. This can be followed by implant or flap reconstruction.

Immediate Nipple Reconstruction:

Sometimes the nipple must be taken during a mastectomy. In this case, it is occasionally beneficial to build a new nipple at the same time as the initial reconstruction. It works instead of waiting for later and necessitating another surgery. Nipple Reconstruction is most commonly done in bilateral cases when using free flaps to maximize symmetry.

3-D Tattooing:

3-D Tattooing is the absolute latest in techniques. And for it, Dr. Linville has teamed up with Houston’s best. He works with experts who specialize in creating and restoring the subtle nuances of the nipple and areola.


Following your surgery, you will receive specific instructions about how to care for yourself. This will have information about medications to take and not to take. You will see be seen a few days following your discharge from the hospital to make sure your recovery is on the right path.

You will continue to be seen regularly for several months following surgery. Dr. Linville will let you know, based on your specific procedure, how long to abstain from exercise and when to resume full normal activities. Dr. Linville is always reachable if you have any concerns or questions. The best thing you can do for yourself is to follow the post-operative instructions carefully.

What questions should I ask my plastic surgeon, and how does Dr. Linville answer these?

Picking a plastic surgeon for your reconstruction is an immensely personal decision. They will be the person working with you even longer than your original breast surgeon. As you select this surgeon, there are a few important considerations.

Are you board certified in plastic surgery and do you have specialized training in microsurgery?

I’m board certified in both plastic surgery and general surgery. I have extensive training in all the most advanced breast reconstruction techniques. Among these is microsurgery, which is necessary for flap reconstruction. I have been invited to speak on breast reconstruction for other physicians and pride myself on my aesthetic outcomes.

Will I look the same after my mastectomy and reconstruction as I do before? Can I see before and after photos of your previous patients?

My goal is for my reconstruction patients to look as good or better than they do before their surgical procedures. I focus on giving reconstruction patients the same aesthetic attention that my cosmetic patients get. That being said, there are variations in what to expect based on the procedure and treatments for each patient. I am happy to share many photos of prior patients so you can learn more. I have a few on my website that you can see here.

How many surgeries will be involved, and what kind of time am I looking at as far as healing and recovery?

This varies according to a few factors. The type of mastectomy, the breast surgeon, and the type of reconstruction. There is usually a minimum of 2-3 surgeries in 12 months. Also, there is the potential for 1-2 more later. These are for fine-tuning your aesthetic outcome. It is not a quick process. Careful attention to detail and dedication to the best possible result takes time.

What kinds of breast reconstruction do you perform regularly?

While I am trained in many different kinds of reconstruction, I focus primarily on two procedures. These are implant-based reconstruction and DIEP flap reconstruction. I believe these two give the best aesthetic outcome to my patients.

Is this billable to my insurance?

Absolutely, and we have experts on staff to help navigate this. These procedures are covered because they are diagnosis-driven. Therefore, insurance companies are obligated to pay for treatment after a cancer diagnosis is received. We’ve worked with nearly every insurance company and type of plan out there and can help you understand the complexities involved.

Is there anything I can do, as a patient, to enhance my results?

Yes, yes, and yes. It is absolutely imperative that you follow the post-op orders after this procedure. This is major surgery. Your body will need time, nutrition, and rest to heal adequately. Breast reconstruction is a physically and emotionally exhausting process. So, the better you take care of yourself on both of those fronts, the better you will recover.

What makes you different from other reconstructive surgeons?

My goal is to have the prettiest results out there. There are many capable surgeons, particularly in Houston. But, the goal of many is only an adequate result. Their goal is that, with clothes on, patients resemble their former selves. I believe my reconstructive patients deserve results as aesthetically pleasing as my breast augmentation patients. In some cases, you have to look really closely to tell which is which!