We know how difficult it is for a woman to undergo a mastectomy, a surgery to remove a breast due to cancer. It is a great burden on the body as well as the mind. After that journey, you may need to have breast reconstruction. There are several methods for this. Today we are talking about a special surgery that uses your own body parts to give a very natural look.
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So, what is DIEP Flap surgery?
Simply put, a DIEP Flap is a surgical procedure that uses your own tissue to reconstruct a breast. Instead of external implants, a part of your own body is used.
The name DIEP comes from the words 'Deep Inferior Epigastric Perforator'. This refers to the name of a blood vessel (artery) in our lower abdomen. Here's what happens during the surgery:
Your surgeon will take some skin, fat, and blood vessels from your lower abdomen, specifically from the area above your pubic bone, which is called the 'tummy tuck'. But no muscle is removed . This is one of the biggest advantages of this surgery.
Then, this tissue is brought to the chest area and shaped into a breast. The most important thing happens next. Through Microsurgery performed under a very fine microscope, the tiny blood vessels in the tissue taken from the stomach are connected to the blood vessels in the chest. This gives the newly created breast a good blood supply and it grows as if it were a part of your own body.
Because you use your own tissue, the results are very natural. It also avoids some of the complications that can come with external implants.
When is this surgery performed? Who is not suitable for this?
There are two cases where this surgery can be performed.
1. Immediate Reconstruction: This DIEP Flap surgery can be done at the same time as your mastectomy. Then you don't have to go through the surgery twice. Some people think that they can recover immediately and return to normal life quickly.
2. Delayed Reconstruction: If you have already had your breast removed and are considering reconstruction at a later date, then DIEP Flap surgery is still a good option.
The most important thing is to talk to your doctor to make the best decision about this.
But this surgery is not for everyone. Let's look at the table below to see which cases are not suitable for this surgery.
| Reason for incompatibility | A simple explanation |
|---|---|
| Insufficient tissue in the abdomen | If you are very thin, or have previously had abdominal fat removed through surgery such as liposuction, you may not have enough tissue in your abdomen to create a breast. |
| Having had previous flap surgery | If abdominal tissue has already been used to reconstruct the other breast, there may not be enough tissue left for another surgery. |
| Some previous abdominal surgeries | This surgery may be possible if you have had a C-section or hysterectomy. However, it may not be possible if you have had surgery that changes the way your stool comes out, such as a colostomy. |
| Problems with blood vessels in the lower abdomen | Sometimes the blood vessels needed for surgery may be too small, or the location may not be suitable for surgery. |
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Check Availability →What happens before and during the surgery?
After scheduling your surgery, your doctor will give you some instructions like:
- Get some lab tests done: You may be asked to do something like a blood test to see if you are healthy enough for surgery.
- Stop smoking completely: If you use tobacco (cigarettes, beedis), it can affect anesthesia and delay healing.
- Stop taking certain medications:You should definitely tell your doctor about all the medications you take (including vitamins and supplements).
On the day of surgery, you will be given an intravenous (IV) anesthetic . You will then be put to sleep. You will not feel any pain or anything during the surgery.
During the surgery, the doctor makes an incision along your bikini line in your lower abdomen. From there, a flap of skin, fat, and blood vessels is carefully removed. Then, another incision is made along the scar from the previous breast surgery, and the tissue from the abdomen is brought in and shaped into a breast shape. Then, the blood vessels are connected using the microsurgery'' we talked about earlier.
Finally, several very small tubes (drains) are placed in the incisions in the breast and abdomen. These need to be left in place for several weeks. These are used to drain excess fluid from the surgical site, reduce swelling, and speed up healing. The incisions are then closed with stitches or staples.
Remember, this is not a minor surgery that can be done in a few hours and you can go home. It is a complex surgery that takes about 6-8 hours to reconstruct one breast, and about 10-14 hours if you are reconstructing both breasts.
You will have to stay in the hospital for two to three days after the surgery. It will take about 6 weeks to fully recover.
Aren't there risks and complications?
Like any surgery, this one has some risks.
For example, if the blood supply to the newly created breast is cut off or insufficient, there is a small chance that the flap will die (flap failure). This is very rare. If a small area dies, the doctor can cut it out and remove it. But if a large area dies, the entire flap will have to be replaced.
At other times, blood flow to certain areas is reduced, and scar tissue may form in those areas, which may feel like lumps. These may disappear over time.
Also, there is a small chance that the muscles will weaken and a hernia will form where the tissue was taken from the stomach. If a hernia does form, it usually requires another surgery to repair it.
If you have these symptoms after surgery, call your doctor immediately.
- Abnormal bleeding
- If something like pus comes out of a cut (signs of infection)
- Unbearable severe pain
- Difficulty breathing
- Fever
If this happens, inform your doctor immediately. If it is an emergency, go to the Emergency Department (ETU) of the nearest hospital.
How should I take care of myself during the recovery period and at home?
You will have to wait a few weeks after the surgery.You will be asked to wear a special compression bra . You will also be asked to wear a special compression wrap around your abdomen. These will help reduce pain, control swelling, and aid in healing.
These things are normal after surgery:
- Bruising
- Soreness and Pain
- Swelling
- Tightness in the incisions
- Numbness in the abdomen or chest: This numbness can last for up to a year.
Although many of these things will subside in a few weeks, if you have any symptoms that are bothering you, don't be afraid to talk to your doctor.
After the surgery, you will have a scar along your bikini line. This will fade to a large extent in about 12-18 months. You will also have a scar on your breast. If you wish, you can have another surgery to reconstruct your nipple after you have fully recovered from this surgery.
💡 Take-Home Message
- DIEP Flap is a surgery to reconstruct a breast using your own abdominal tissue (skin and fat) after removing a breast.
- The results obtained with this method are very natural-looking and the risks associated with external implants are minimal.
- This is a complex surgery that takes many hours. It also takes about 6 weeks to heal.
- This surgery is not suitable for everyone. It depends on your body type and previous surgeries.
- Talk openly with your surgeon about the pros and cons of this surgery, and whether it's right for you.
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