DIEP Flap Breast Reconstruction Surgery | Breast Enhancement Surgeon | Breast Augmentation Surgery | Breast Reconstruction Surgery

Seattle and Bellevue Washington

Recent advances in surgical techniques have made it possible to reconstruct a breast mound using only the skin and fat from your abdomen (belly), without sacrificing your abdominal muscles. The Deep Inferior Epigastric Perforator (DIEP) flap allows for a natural breast reconstruction using only your own excess abdominal tissues, without the need for breast implants. Patients often have the added benefit of a tummy-tuck at the same time. And because your abdominal muscles are left intact, the post-operative pain you experience is less and the recovery time is often quicker than with a TRAM flap.

The DIEP flap requires teasing out very small blood vessels within the rectus muscle while leaving these small blood vessels attached to the belly skin and fat to be transferred. The muscles in your abdomen are left intact and functional. The reconstructed breast is shaped in the operating room for optimal aesthetics and the tissue transfer is completed using microsurgery.

Microsurgery establishes blood flow to the newly reconstructed breast. The 1-2 millimeter diameter arteries & veins that provide the blood supply to the reconstructed breast mound are anastomosed (hooked-up like the ends of a pipe) to similar sized arteries & veins in your chest using an operating room microscope. Because the DIEP is a more complex operation, slightly longer operating time is required than in a TRAM flap. However, the operation is very safe. Surgeons like Dr. Isik who are very experienced in DIEP flaps and microsurgery have a very high success rate, meaning the breast reconstruction surgery is safe and the result, aesthetically pleasing.

DIEP Benefits

The main benefit of the DIEP flap is that your abdominal muscles remain intact, muscles which help you do sit-ups or help with any motion that requires strength in your abdominal muscles. The DIEP flap allows active and athletic individuals to resume their favorite activities once recovered. Because the DIEP flap does not cut the muscle nor remove the abdominal fascia, the post-operative pain is less than a free or a pedicled TRAM flap and there is no hernia risk. Incisions will be made on your lower abdomen and around your belly button. These scars are the same as that from a TRAM flap and very similar to incisions from a tummy-tuck.

The DIEP flap for breast reconstruction is a complex operation but one that can result in a very natural breast mound shape that remains with you life-long. And because your tissues are used in the reconstruction and not breast implants, infection, leakage and capsular contracture are not a concern. This is the preferred method of breast reconstruction for patients who had chest wall radiation as part of their breast cancer treatment.

DIEP flap breast reconstruction is performed in Seattle Washington at Swedish Medical Center: 5.5 hours for one sided breast reconstruction and 7.5 hours for both (bilateral) breast reconstructions. You will be in the hospital for 3 days. Despite the length of time for this surgery, the DIEP flap for breast reconstruction is very safe and recovery quicker than a TRAM flap.

DIEP anatomy

rectus muscle

pre-op DIEP

DIEP free flap

post op DIEP

Dr. Isik is one of the few plastic surgeons in the Pacific Northwest who performs DIEP flaps for breast reconstruction on a weekly basis with very low complication rates. However, if you have pre-existing conditions that would complicate your breast reconstruction such as morbid obesity or smoking, your complication rates will be higher. For this reason, Dr. Isik may counsel you towards an alternative method of breast reconstruction if you are very obese or smoke. This is for your safety.

Download our information brochure on breast reconstruction.
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Actual patient photos are not shown on this web site. However, you can either follow the TV links below, download our brochure, or come in for a consultation to see actual patient photos. Also, we have many patients that have had a DIEP flap breast reconstruction from Dr. Isik who live in Seattle, Eastern Washington, Oregon, Montana and Alaska, that would be happy to share their experience and answer your personal questions. We also have a breast cancer and reconstruction support group that meets once a month in Seattle at The Polyclinic. This is an opportunity to meet and often, see other patients that have had a DIEP, TRAM, Latissimus, or Implant method of breast reconstruction. Please contact us to find out more.

Want to learn more?

Watch an online movie of Dr. Isik presenting on "Plastic Surgery: Reconstructive Success Stories", emphasizing the DIEP flap for breast reconstruction. Follow either of the links below:

Watch this movie on the Research Channel
Watch this movie on the UWTV site