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Center for Breast Reconstruction


DIEP flap is a type of breast reconstruction surgery.

What is DIEP Flap?

DIEP (deep inferior epigastric perforator) flap is a type of breast reconstruction surgery, which involves use of the skin and fat tissue from the lower abdomen to rebuild the breast.

The entire breast mound can be recreated without the use of an implant. The DIEP flap procedure is a completely muscle-sparing operation and does not move the core strength muscles of the abdomen (the rectus abdomnimus). Therefore, abdominal wall/core strength is preserved.

DIEP is a free flap procedure, during which the skin and fat of the lower abdomen are detached from their main blood supply and reattach to blood vessels in the chest using a microscope.

This complex flap procedure requires a 3-4-day hospital stay during which the circulation to the flap is closely monitored. You will be placed on mild blood thinning medications while you recover.

Diagram of DIEP flap procedure

Who Can Have This Procedure?

DIEP may be right for you if you:

  • Have enough lower abdominal tissue.
  • Have not had previous surgery on your abdomen.
  • Wish to retain strength in your core.
  • Have had radiation to the chest wall in the past.

Things to Consider

  • Not all breast reconstructive surgeons have the expertise to perform this complex procedure. ChristianaCare’s Stephanie Caterson, M.D. is very experienced in flap procedures and has performed more than 1500 DIEP flaps.
  • DIEP flaps do not remove the rectus muscle, therefor maintain abdominal strength.
  • DIEP flaps do not require the use of synthetic mesh to support the area where the abdominal tissue was removed. This lowers the risk for abdominal hernias or bulges, compared to TRAM flaps.
  • DIEP flap leaves a long scar in the lower abdomen above the pubic line.
  • DIEP requires a longer hospital stay and recovery time compared to implant-based reconstruction.
  • For more information, please visit the American Society of Plastic Surgeons website.

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