- DIEP (deep inferior epigastric artery perforator) flap is a technique in which skin and fat (no muscle) are used to reconstruct a breast.
- The breast is reconstructed entirely with your own tissue, so you don’t have to deal with implants. Your breasts look and feel natural and I’ll make them as symmetric as possible.
- DIEP flap reconstruction involves taking skin and fat from the lower abdomen. Patients like the “tummy tuck” it provides.
- DIEP flap revision is a second surgery performed to achieve the final breast contour.
- During this stage of the reconstruction, we can address any issues you have with your new breast and improve the aesthetic appearance compared to your initial operation.
Revision of a DIEP flap reconstruction involves tightening and adjusting the skin and contouring the underlying fat. There are two maneuvers that I generally do to achieve these goals. When it comes to tightening up and adjusting the skin envelope, that involves removing scars, cutting out extra skin, and tightening up the skin. Essentially, I’m tailoring your skin to improve the overall shape of the reconstructed breast. And this tailoring is generally done along the existing scars that you already have.
As far as improving the overall volume and contour of the breasts themselves, that involves a combination of removing fat with liposuction and adding fat where you need it, so fat grafting.
To summarize, at the revision of a DIEP flap reconstruction, we’re sucking out fat from areas where you don’t want it, adding fat to areas where you need it, cutting out extra skin, and tightening up the skin on your breasts, your abdomen, your armpits, wherever there’s all that loose skin. We get rid of that extra loose skin and we also suck out some extra unwanted fat and use it to further contour and improve the overall shape of your reconstructed breast.
Revision of DIEP Flap – Recovery
Recovery after revision of a DIEP flap breast reconstruction is much easier than recovery after the initial DIEP flap operation.
Drains: There are no drains – under most circumstances, I do not need to put drains in. All we’re doing is shifting fat and tightening skin. There’s really no need for drains in that situation.
Showering: If that’s all you had done – shifting fat, sucking out fat, injecting fat, and tightening up skin, you can shower after 24 hours
Exercise: You can exercise after 1 week in a supportive bra and a compression garment. You can go swimming after 3 weeks.
Compression garments: I do want you to wear a compression garment such as Spanx or a spandex garment to compress the area where we sucked out fat. So, if we sucked out fat from your flanks and love handles and your abdomen, I want you to wear Spanx that will compress that area.
Supportive bra: I also want you to wear a supportive bra to help support the shape of the breasts while they’re healing. Don’t wear a sports bra that has a tendency to pancake and flatten the breasts. Instead wear a bra that has a more cupping shape, such as a foam bra with or without an underwire that has, I guess, a more normal breast shape. The shape of the bra will help shape your breasts as they’re healing.
Length of recovery: The length of the recovery from DIEP flap revision really depends upon the amount of liposuction that we did. The more areas and the more aggressive liposuction that was performed, it means you’re going to be sore longer and have to wear compression longer. So, it’s highly variable regarding the duration of recovery following revision of DIEP flaps. Most patients only take a long weekend off work after revision of a DIEP flap.
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