Muscle-sparing breast reconstruction with DIEP
If you’re in need of breast reconstruction surgery, you now have a new choice that offers quicker, less painful recovery. DIEP (deep inferior epigastric perforators) flap surgery is a cutting-edge breast reconstruction procedure using a flap of complete tissue – blood vessels, skin and fat – from your lower abdomen. A surgeon will then attach the flap and donor tissue blood vessels to the chest blood vessels and reconstruct the breast. When the tissue is obtained from your abdomen, no muscles are cut, making recovery quicker than other methods of reconstruction and also less painful. Many also think the result looks more natural than other options.
Are you a candidate?
Ideal patients for a DIEP flap reconstruction include: newly diagnosed breast cancer patients, patients with a BRCA mutation who are extremely high risk for the future development of breast cancer, patients who have had previous breast cancer and radiation, and patients who had a previous mastectomy and implant reconstruction with sub-optimal cosmetic results.
The ideal candidate for a DIEP reconstructive surgery has enough abdominal tissue for this surgery, but isn’t obese and doesn’t smoke. If you’ve had a previous abdominal surgery, you may not be a candidate for DIEP reconstructive surgery.
Be sure you discuss all possible risk factors with your doctor before proceeding.
When should you get DIEP reconstructive surgery?
Once your doctor has determined you’re a candidate, you may elect to have reconstructive surgery at the time of your mastectomy or at a later time – even years later.
In some cases, you may need to use a tissue expander to make room for the new tissue. A tissue expander is a medical device that is inserted to expand the surrounding tissue, helping to prepare the area for surgery by gradually expanding the muscles and breast skin to create room for the reconstructive tissue. If this process is needed, your reconstruction will need to be delayed and your surgeon will place the tissue expander during the mastectomy.
Chemotherapy and radiation could also affect the timing of DIEP reconstructive surgery. You will need to wait four to six weeks after chemotherapy and six to 12 months after radiation to have DIEP reconstructive surgery.
What should you expect post-surgery?
Your first 2-3 days are spent in the hospital to recover. Expect to be walking multiple times the day after surgery, and you can gradually increase walking time and distance as you feel comfortable. By day 3, most patients are ready to be discharged home.
If drains are used, they are removed once drain output is low enough. You can continue to increase cardio endurance and begin easing into range-of-motion arm exercises. By the end of the second week, you can switch from surgical garments to a bra and panty girdle once you get clearance from your doctor.
You should feel more comfortable doing things on your own. If you work a low-impact desk job, you should be able to return to work.
This is when you should be getting back to your normal routine. By week six there are no restrictions.
The Southern Breast Specialists team was the first multidisciplinary surgical team to offer DIEP flap reconstruction in the state of Mississippi in 2015. After six years, they remain the most experienced and capable breast cancer team in the state, attracting patients from North Mississippi, Louisiana and Alabama to the Mississippi Gulf Coast.
For a consultation regarding the most state-of-the-art breast cancer surgery and reconstruction available, please contact Dr. Paul Mace’s office in Gulfport at 228-822-6160 or Dr. Michael Diaz’s office in Biloxi at 228-396-2663.