Creating a New Breast with Abdominal Tissue: Natural and Permanent Reconstruction with the DIEP Flap Method

One of the breast reconstruction methods applied after surgical removal of the breast due to breast cancer is creating a new breast using abdominal tissue. Today, this is considered one of the techniques that offers the most natural and permanent results. In the plastic surgery literature, this method is called the DIEP flap (Deep Inferior Epigastric Perforator) and is now recognized worldwide as the gold standard.

In the DIEP flap technique, the tissue used is taken from the patient’s lower abdominal area, below the navel. This region is preferred because its soft structure, shapeability, and volume are quite similar to breast tissue. At the same time, patients not only gain a new breast but also experience a tummy tuck (abdominoplasty) effect through this procedure. Thus, it provides both aesthetic and functional benefits.

 

Preoperative Planning

Before the DIEP flap operation, a detailed planning process is carried out. In particular, computed tomography (CT) angiography is used to identify the most suitable blood vessels supplying the abdominal area. With this vascular mapping, maximum blood flow is ensured with minimal tissue damage during surgery.

 

Muscle-Sparing Approach

In this method, the rectus abdominis muscle in the abdominal area is preserved. In other words, without cutting or removing the muscle, only the blood vessels passing between the muscle fibers are carefully dissected for tissue transfer. This way, patients do not experience muscle function loss; walking, standing upright, and abdominal core strength are not affected.

 

Microvascular Anastomosis

The harvested tissue is connected by microsurgical techniques to the blood vessels located under the ribs in the chest area, which are prepared beforehand (anastomosis). This reconnection restores blood flow to the tissue, allowing the new breast to remain viable. If the other breast has also been removed or simultaneous reconstruction of both breasts is required, both sides can be reconstructed according to the preoperative drawings and planning.

 

Surgery and Recovery Process

The first 24 hours after surgery are critically important for monitoring the viability of the transferred tissue. Hourly checks are performed during this period. In the following days, monitoring continues with reduced frequency. Patients are usually kept under observation in the hospital for 7 to 10 days.

When patient selection is appropriate and the surgical technique is correctly applied, the risk of complications is very low. Tissue loss, infection, or vascular blockage are rarely seen. From an aesthetic perspective, the results are supported by scientific studies as being symmetrical, natural, and satisfactory.

 

Advantage in Radiotherapy Compatibility

For patients who require radiotherapy, the DIEP flap method is far more durable compared to silicone implant-based techniques. Negative effects of radiation such as hardening, thinning, and tissue damage are much less common with this approach. Therefore, it stands out as a long-lasting option that is highly compatible with oncological treatment.

 

Duration of Surgery

The operation usually takes 4–6 hours for a unilateral procedure and 8–10 hours for a bilateral procedure. In suitable cases, the surgery can also be performed simultaneously with the breast cancer operation (in the same session).

 

About the Author

Prof. Dr. Osman Kelahmetoğlu
Specialist in Plastic, Reconstructive, and Aesthetic Surgery

This article has been prepared by Prof. Dr. Osman Kelahmetoğlu based on scientific references and clinical experience. For more information or to schedule an appointment, please contact:

Email: iletisim@osmankelahmetoglu.com
Phone: +90 (533) 351 76 37