Introducing the DIEP Flap Procedure
Autologous tissue reconstruction is the most common form of breast reconstruction surgery, and there are several methods that can be used, all of which involve the use of tissue that comes from a part of the body other than the breast. The newest and most advanced form of breast reconstruction available today is the DIEP (deep inferior epigastric artery perforator flap). It is the preferred technique performed at PRMA in San Antonio, Texas. PRMA specializes in the most advanced breast reconstruction techniques available including DIEP flap, SIEA flap, GAP flap, TUG flap, fat grafting, Alloderm one-step, and nipple-sparing mastectomy. To date PRMA's plastic surgeons have performed over 5,000 breast reconstructions making PRMA one of the busiest breast reconstruction centers in the world.
As board-certified PRMA plastic surgeon Dr. Peter Ledoux explains, "The surgery uses the patient's own abdominal skin and fat to reconstruct a natural, warm, soft breast after mastectomy. Unlike the TRAM flap, the DIEP flap preserves all the abdominal muscles. Only abdominal skin and fat are removed similar to a ‘tummy tuck.' Patients experience less pain after surgery because of this, enjoy a faster recovery and maintain their abdominal strength long-term."
Understanding the DIEP Flap Procedure
The skin and fat below the belly button feels very similar to breast tissue. It is the perfect choice to replace the breast tissue removed by the mastectomy. The blood vessels ("perforators") that keep this skin and fat alive lie just beneath or within the abdominal muscle. A small incision is made in the abdominal muscle to access these vessels. The prepared tissue ("flap") is then disconnected from the body and transplanted to the chest using microsurgery. Most patients are also candidates for sensory nerve reconstruction that allows for improved long term sensation in the reconstructed breast. The surgeons then shape the tissue to create the new breast.
Dr. Ledoux states that, "Patients also enjoy the added benefit of a flatter abdomen. The risk of abdominal complications such as bulging and hernia is also very small, much smaller than with the TRAM flap. Sometimes all the lower abdominal tissue is needed to reconstruct one breast. Occasionally this cannot be performed as a single flap. For example, the patient may have a previous midline abdominal scar or may be too thin. In these cases, the lower abdominal tissue can be transplanted as 2 separate flaps, which are then reconnected on the chest using microsurgery to create one breast. This technique is known as the stacked DIEP flap procedure."
There are many reconstructive breast surgeons in the United States, however only about 40 routinely perform the DIEP procedure due to the technical difficulty of the surgery. A team of two microsurgeons performs every DIEP flap procedure. This ensures that patients benefit from the expertise of two specially trained surgeons and also significantly decreases the length of the surgery and anesthesia time.
PRMA Plastic Surgery is the only center in San Antonio, Texas and one of only a handful of centers worldwide to provide breast reconstruction on such a large scale. Their surgeons have treated patients from all over the US as well as from several countries across the world and have built tremendous reputations for breast reconstruction excellence.
How long will my DIEP Flap surgery last?
Breast reconstruction surgery can take from 3-6 hours (not including mastectomy) depending on the type of procedure performed. For instance, a unilateral (one-sided) breast reconstruction will take less time than a bilateral (two-sided) breast reconstruction.
How closely will the reconstructed breast match my opposite healthy breast?
There will be aesthetic differences between your natural breast and your reconstructed breast, particularly at first. However, patients should not worry about this initially. Almost always revision surgery will be performed a few months after the reconstruction to ensure that your breasts are as aesthetically pleasing and matching as possible. Please also remember that most women are not 100% symmetric to begin with. Please visit our gallery to see our patients' before and after breast reconstruction pictures.
How long will the recovery be?
Recovery from DIEP flap breast reconstruction is a gradual process which usually takes 4-6 weeks.
How long will my DIEP Flap surgery last?
Breast reconstruction surgery can take from 3-6 hours (not including mastectomy) depending on the type of procedure performed. For instance, a unilateral (one-sided) breast reconstruction will take less time than a bilateral (two-sided) http://prma-enhance.com/
About PRMA Center for Advanced Breast Reconstruction
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