Deep Inferior Epigastric Perforator (DIEP) Flap

In deep inferior epigastric perforator (DIEP) flap breast reconstruction, Mass General plastic surgeons use skin and fat from the lower abdomen to create a new breast after mastectomy.

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Mass General offers many options for breast reconstruction, including:

DIEP Flap Breast ReconstructionIf you have a mastectomy to treat or prevent cancer, breast reconstruction can surgically recreate a natural-looking breast. One option for breast reconstruction is a deep inferior epigastric perforator (DIEP) flap procedure.

In a DIEP flap, the surgeon first excises skin and fat from the lower abdomen. This process does not require removing any of the rectus abdominus muscle, which houses the artery and vein that serve as the primary blood supply to skin and fat of the lower abdomen.

The excised abdominal tissue, or "flap," is then transferred to the mastectomy area. There, blood flow is restored by reconnecting the artery and vein to a set of vessels in the chest wall. The surgeon then shapes the flap to form a new breast.

Unlike the TRAM flap, the DIEP flap avoids using abdominal muscle. DIEP flaps thus take longer to complete. However, they may involve less postoperative pain and may reduce the risk of hernia formation.

Please note: A DIEP flap leaves a scar that extends along the lower abdomen, from one hip to the other. As a result, the recovery period may be longer than with breast construction with implants or tissue expanders.

Why Choose Mass General for Your Procedure

  • Harvard affiliated
  • 500+ breast reconstruction procedures per year
  • Coordinated care with your entire cancer team
  • Highly experienced in the latest procedures

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Are You a Candidate for DIEP Flap Breast Reconstruction?You may be a good candidate for DIEP flap reconstruction if you:

  • Prefer to reconstruct one or both breasts using your own tissue
  • Have sufficient tissues in your lower abdomen to create one or both breasts
  • Have never had surgery on your abdomen
  • Are not a candidate for implant reconstruction
  • Have had radiation administered to your chest wall
  • Have had failed reconstruction using a breast implant

You may not be a good candidate for DIEP flap reconstruction if you:

  • Lack sufficient lower abdominal tissue to create acceptable breast volume
  • Have had abdominal surgery (e.g. an abdominoplasty)
  • Smoke (or quit smoking only recently)
  • Have diabetes
  • Are obese
  • Have an overly large abdominal pannus (hanging flap of tissue)
  • Cannot tolerate anesthesia over long stretches
  • Do not want a lower abdominal scar

Other Flap OptionsDepending on your particular situation, other flap options to create the new breast may include:

The TUG flap and SGAP/IGAP flaps are generally used with patients who lack enough abdominal tissue for the DIEP or SIEA flap.Breast Reconstruction at Mass GeneralOur plastic surgeons have extensive experience in all types of breast reconstructive techniques, including the newest and most innovative procedures. When appropriate, we combine techniques, using flaps, implants and nipple tattooing to achieve the most natural-looking outcome.

All forms of breast reconstruction after mastectomy have inherent risks, which will be fully discussed during your consultation.