Immediate Deep Inferior Epigastric Perforator or DIEP Flap is the breast reconstruction surgery which is performed just after mastectomy or removal of breast tissue to treat and prevent breast cancer. The term flap means taking healthy tissues from other parts of the body for the reconstruction of the breast. The common part is the abdomen from where tissues are sourced to reconstruct the breast and give it a firmer and natural look. Deep Inferior Epigastric Perforator or Immediate DIEP Flap Reconstruction involves taking excessive tissues and fat from the abdomen area and using it for the reconstruction of the new breast after removal of the breast through a mastectomy. It is the complex surgery which is performed by plastic surgeons just after the mastectomy has been performed by breast surgeons. The surgeons may prescribe the two-stage procedure, of which the first stage is to place implant expander and the second stage is to complete the tissue reconstruction.
Prior to the breast removal surgery, the patient is asked to consult their plastic surgeon. The plastic surgeon and breast surgeon would work together to create the best treatment and breast reconstruction strategy for better cosmetic results. Your plastic surgeons would show you the available surgical options along with some example pictures of before and after. The type of reconstruction surgery required depends on certain factors including your health, body type, and cancer treatment opted for and this helps in selecting the best treatment for best cosmetic results.
Plastic surgeons will also let you know the pros and cons of the Immediate DIEP Flap Reconstruction and also the alternatives if available any for your condition. Moreover, you will also learn the aftercare processes and the complications that may arise post surgery. If you have any medical conditions it is necessary that you inform about it to the surgeon. You also are required to stop using anti-inflammatory drugs or blood thinning drugs prior to the surgical procedure.
Immediate DIEP Flap Reconstruction is performed under general anesthesia and in most of the cases patients are discharged on the same day after a few hours of observation. The procedure involves making of incisions in the abdominal area, right from one hipbone to the other. The scar from the incisions would be below the bikini line. For left side reconstruction procedure, the surgeon would source abdomen tissues from the left side and for the right side, they would take tissues from the right side of the abdomen. When the surgeon is required to perform reconstruction for both the breasts, then they use tissues from both the sides of the abdomen.
After removing the required amount of tissues from the abdomen area, the surgeon would remove lower abdominal tissues along with vein and artery and close the remaining skin in abdomen tightly than before. The tissues extracted from the abdomen go into reconstructing the new breast. In most of the cases, a small amount of the rib close to the middle of the chest is removed so that the tissues can be connected easily to the vein and artery in the chest. In some cases, the tissues are safely connected to the blood vessels of your armpit. Surgeons don’t reconstruct the areola and nipple portion during Immediate DIEP Flap Reconstruction surgery. They may go for revised breast surgery for reshaping of the breast and this can only be done after fully healed reconstructed breast.
Recovery is faster as compared to other surgical procedures and women who undergo the surgical procedure need to stay in hospital post-surgery for at least 4-5 days. Some women may also require a longer time for recovery depending upon the type of reconstruction, health, and age. You can resume to the normal routine on the second day of the surgery, but you are not asked to perform any rigors exercises or physical activities until it is fully healed. To recover fully you may wait for 1-2 months.
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