For women facing mastectomy, breast reconstruction is a deeply personal decision. The DIEP flap (Deep Inferior Epigastric Perforator flap) has emerged as one of the most sophisticated and highly regarded options in autologous breast reconstruction. Dr. Bram Kaufman, a board-certified plastic surgeon with specialized microsurgery training at MetroHealth Medical Center in Cleveland, is experienced in DIEP flap reconstruction and helps patients understand whether this technique is the right choice for them.
What Is the DIEP Flap?
The DIEP flap is a microsurgical breast reconstruction technique that uses the patient’s own skin and fat from the lower abdomen to create a new breast mound, without sacrificing the underlying abdominal muscle. The name refers to the blood vessels that supply the tissue: the Deep Inferior Epigastric Perforators, which are the arteries and veins that perforate through the abdominal muscle to supply the overlying skin and fat.
The surgeon dissects the skin and fat from the abdomen along with these perforating blood vessels, disconnects the tissue from the abdomen, and reconnects it to blood vessels in the chest using microsurgical techniques under an operating microscope.
How Is the DIEP Flap Different From the TRAM Flap?
- TRAM flap: Harvests all or part of the rectus abdominis muscle along with the skin and fat. This muscle sacrifice can result in abdominal weakness, bulging, or hernia.
- DIEP flap: Harvests only the skin and fat, threading the blood vessels through, not sacrificing, the muscle. The rectus abdominis is preserved, maintaining abdominal strength and integrity.
Why Is the DIEP Flap Considered the Gold Standard?
- Uses the patient’s own tissue, no implant, no foreign material
- Results feel and behave like natural breast tissue, warmth, softness, natural weight
- Ages naturally alongside the rest of the body
- Preserves the abdominal muscle, maintaining core strength
- Generally preferred for patients who have received or will receive radiation therapy
- Long-lasting results, the reconstructed breast remains stable over decades
Who Is a Good Candidate for DIEP Flap Reconstruction?
- Women undergoing mastectomy who prefer autologous reconstruction over implants
- Patients with sufficient lower abdominal skin and fat to create an appropriately sized breast mound
- Those who have received or will receive chest radiation
- Patients who have had previous failed implant reconstruction
The Technical Demands: Why Surgeon Experience Matters
DIEP flap reconstruction is among the most technically demanding procedures in plastic surgery. The microsurgical connection of blood vessels requires specialized training, advanced equipment, and a high volume of experience. Dr. Kaufman’s fellowship training in microsurgery and his experience at MetroHealth Medical Center make him well qualified to offer this technique to Cleveland-area patients.
Dr. Kaufman provides DIEP flap and all forms of breast reconstruction to patients in Cleveland, Beachwood, and surrounding Northeast Ohio. To discuss your reconstruction options, contact Dr. Kaufman’s office directly.
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