DIEP Flap Breast Reconstruction: Using Your Own Tissues Instead of a Breast Implant
If you are considering breast reconstruction after a mastectomy, you may have come across the term DIEP flap reconstruction. DIEP flap surgery is considered one of the most advanced forms of autologous breast reconstruction, using your own tissue to create a breast without the need for implants.
This guide explains what DIEP flap reconstruction involves, who may be suitable, and what to expect during recovery.
What Is DIEP Flap Reconstruction?
DIEP (Deep Inferior Epigastric Perforator) flap reconstruction is a microsurgical procedure that uses skin and fat from the tummy to create a new breast after mastectomy.
Unlike older techniques, the abdominal muscles are preserved.
The tissue is transferred to the chest, and the tiny blood vessels are reconnected using microsurgery to establish a new blood supply.
The result is a breast reconstructed entirely from your own tissue that can look and feel more natural than an implant-based reconstruction.
What Are the Benefits of DIEP Flap Reconstruction?
Many women choose DIEP flap reconstruction because it offers several advantages:
Natural look and feel: The reconstructed breast is made from your own tissue rather than a silicone implant, which results in a softer and more natural fee.
Long-lasting results: Unlike implants, DIEP flaps do not need routine replacement. Once healed, the reconstructed breast becomes a permanent part of your body.
No implant-related complications: Because no implant is used, there is no risk of implant rupture, capsular contracture, implant malposition, or the need for future implant exchange.
Improved Body Mid-Section Contour: The tissue is taken from the lower abdomen, producing a contouring effect similar to a tummy tuck, with a scar placed low on the abdomen.
A Good Reconstruction Option Following Radiotherapy: It is an excellent breast reconstruction option for patients who have undergone radiotherapy, as implants can be associated with higher complication rates when placed in previously irradiated tissue.
Who Is a Candidate for DIEP Flap Reconstruction?
You may be suitable for DIEP flap reconstruction if you:
Have undergone or are planning a mastectomy
Have sufficient lower abdominal tissue
Are in reasonable overall health
Prefer a reconstruction without implants
Have previously received radiotherapy
Wish to avoid future implant replacement surgery
Previous abdominal surgery, including Caesarean sections, does not necessarily prevent DIEP flap reconstruction, although additional assessment may be required.
When Can DIEP Flap Reconstruction Be Performed?
Immediate Reconstruction
The breast reconstruction is performed at the same time as the mastectomy.
Delayed Reconstruction
The reconstruction is performed months or even years after mastectomy.
Both approaches can achieve excellent outcomes, and the best timing depends on your cancer treatment plan and personal preferences.
What Happens During DIEP Surgery?
DIEP flap reconstruction is a highly specialised microsurgical procedure.
The operation involves:
Harvesting skin and fat from the lower abdomen.
Preserving the abdominal muscles.
Transferring the tissue to the chest.
Connecting blood vessels under a microscope.
Shaping the tissue into a natural breast mound.
The procedure may take several hours, particularly for bilateral reconstruction.
What Is Recovery Like After DIEP Flap Reconstruction?
Recovery varies between patients, but most women can expect:
A hospital stay of approximately 5-7 days
Walking within the first few days after surgery
Several weeks of reduced activity
Return to light daily activities within a few weeks
Return to work within 4–8 weeks, depending on occupation
The reconstructed breast and abdomen will continue to settle over several months.
Will My Reconstructed Breast Have Sensation?
Following mastectomy, breast sensation is often reduced regardless of the reconstruction method used.
Some patients experience gradual return of sensation over time. In selected cases, specialised nerve reconstruction techniques (neurotisation) may be performed to potentially improve sensory recovery.
However, no reconstruction technique can guarantee normal breast sensation.
What Are the Risks of DIEP Flap Reconstruction?
As with any major operation, DIEP flap reconstruction carries potential risks, including:
Bleeding
Infection
Wound healing problems
Fat necrosis
Abdominal bulging or weakness
Blood clots
Partial or complete flap loss
Although flap failure is uncommon in experienced microsurgical centres, it remains a recognised risk of the procedure.
Frequently Asked Questions
How long does a DIEP flap last?
A DIEP flap is living tissue and is intended to last for life. Unlike implants, it does not require routine replacement.
Can I have DIEP flap reconstruction after radiotherapy?
Yes. Many women who have received radiotherapy are excellent candidates for DIEP flap reconstruction.
Will I have a tummy tuck after DIEP flap surgery?
Although DIEP flap surgery is undertaken for breast reconstruction rather than cosmetic purposes, the abdominal scar and contour often resemble those of a tummy tuck, with the added benefit of a flatter, more contoured abdomen.
Can I have reconstruction years after my mastectomy?
Yes. Delayed DIEP flap reconstruction can be successfully performed many years after breast cancer treatment.
Dr Law’s Credentials
AHPRA Specialist Plastic and Reconstructive Surgeon. MED 0001775113.
FRACS (Plastic Surgery). Fellow of the Royal Australasian College of Surgeons.
MSc (Plastic Surgery). Master of Surgery (with Merit), University of Edinburgh.
MSc (Res). Master of Surgical Science in Plastic and Reconstructive Surgery, University of Oxford.
MBBS(Hons), BSc(Med)Hons 1. Double degreem, Bachelor of Medicine and Bachelor of Surgery, Bachelor of Science (Medicine) Honours.
Next Steps if You’re Considering Breast Reconstruction Surgery in Sydney
DIEP flap reconstruction offers a natural, durable solution for women seeking breast reconstruction after mastectomy. By using your own tissue and preserving the abdominal muscles, it can provide excellent long-term outcomes while avoiding many of the limitations associated with implants.
If you are considering DIEP flap breast reconstruction in Sydney, consultation with a specialist plastic and reconstructive surgeon fellowship trained in microsurgery can help determine whether this procedure is right for you.
To learn more, you’re welcome to book a consultation with Dr Law at our Darlinghurst, St Leonards or Bankstown locations.
This article was written by:
Dr. Jenaleen Law
Specialist Plastic and Reconstructive Surgeon
MBBS(Hons), BSc(Med)Hons, MSc(Res), MSc, FRACS(Plast)
AHPRA Registration: MED0001775113
