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The deep inferior epigastric perforator (DIEP) flap is used to rebuild one or both breasts with abdominal skin and fat. Unlike other flap procedures that involve the abdomen, the DIEP flap spares important muscle tissue. This leads to quicker recovery times and an increased ability to maintain abdominal wall strength.

DIEP flap reconstruction is typically performed by surgeons, operating room teams and hospitals that have significant experience with a technique called microsurgery. Surgeons use microscopes and other special tools to connect blood vessels and maintain blood flow in the tranferred tissue.

Candidates for DIEP flaps must have normal abdominal anatomy that has not been affected by previous surgery. Body weight, overall healthy and expectations for breast appearance also influence whether someone can or should undergo DIEP flap reconstruction. Microvascular surgery alternatives may include the free TRAM flapSIEA flap and TUG flap. When microsurgery is not an option, alternatives include the latissimus flap or pedicled TRAM flap.

DIEP flap reconstruction is performed under general anesthesia and takes four to seven hours to complete one breast and seven to 12 hours to complete both. Patients are hospitalized for four to eight days and can return to work in four to eight weeks.

Common side effects include bruising and swelling. Several temporary drain tubes remain in place after surgery. Surgeons monitor blood flow carefully. Return trips to the operating room may be necessary to restore blood flow. Delayed wound healing occasionally occurs. Flap failure is uncommon.

Listen to a physician explain differences between the DIEP flap and TRAM flaps.