Creating a New Breast with Abdominal Tissue: Permanent Reconstruction with the DIEP Flap Method
One of the breast reconstruction methods applied after the surgical removal of the breast due to breast cancer, creating a new breast with abdominal tissue, is one of the techniques offering the most natural and permanent results today. This method is referred to as the DIEP flap (Deep Inferior Epigastric Perforator) in plastic surgery literature and is now accepted as the gold standard worldwide.
The tissue used in the DIEP flap technique is the patient's abdominal tissue from the area below the navel. This region is preferred because of its soft structure, moldability, and significant similarity to the breast in terms of volume. At the same time, thanks to this operation, patients not only gain a new breast but also obtain a tummy tuck (abdominoplasty) effect. This provides both aesthetic and functional gains.
Pre-operative Planning
A detailed planning process is conducted before the DIEP flap operation. In particular, the most suitable vessels supplying the abdominal region are identified in advance using CT angiography. Thanks to this vessel mapping, maximum blood supply is achieved with minimum tissue damage during surgery.
Muscle-Sparing Approach
In this method, the rectus abdominis muscle in the abdominal region is preserved. That is, the tissue transfer is ensured by carefully dissecting only the vessel structures passing through the muscle without cutting or removing the muscle itself. In this way, patients do not experience loss of muscle function; activities such as walking, standing upright, or intra-abdominal muscle strength are not affected.
Vascular Anastomosis with Microsurgery
The harvested tissue is connected to the vascular structures previously prepared in the chest area, located under the ribs, using microsurgical techniques (anastomosis). Thanks to this connection, blood flow to the tissue is restored, and the new breast tissue can maintain its vitality. If the other breast has also been removed or if simultaneous reconstruction is required for both breasts, reconstruction can be performed on both breasts according to the drawings made before the planning.
Surgery Process and Aftermath
The first 24 hours after surgery are of critical importance in terms of monitoring the vitality of the transplanted tissue. Patients are usually kept under observation in the hospital for 7 to 10 days.
When appropriate patient selection and correct surgical techniques are applied, the risk of complications is quite low. From an aesthetic perspective, scientific studies have supported that the results are symmetrical, natural, and satisfying.
Advantage of Compatibility with Radiotherapy
In patients who need to receive radiotherapy, the DIEP flap method is much more durable compared to methods using silicone implants. Negative effects such as hardening, thinning, and tissue damage caused by radiation are less common in this technique. Therefore, it stands out as a long-lasting option compatible with oncological treatment.
Surgery Duration
The operation duration generally varies between 4–6 hours for unilateral applications and 8–10 hours for bilateral applications. It can also be performed simultaneously with the breast cancer operation.