AAMC: DIEP flap is an innovative breast reconstruction technique
By Devinder Singh and Tripp Holton
Nov 22, 2019 | 3:49 PM
DIEP flap is a breast reconstruction procedure that uses tissue from the lower abdomen to make a new breast mound. The delicate blood vessels called deep inferior epigastric perforators (DIEP) are re-connected under a microscope.
Essentially, this makes a living breast implant from skin and fat from the lower abdomen — the same tissue a plastic surgeon would discard during a tummy tuck.
Anne Arundel Medical Center is the only hospital in Anne Arundel County that offers this procedure. DIEP flap combines breast reconstruction with a tummy tuck, making it a popular choice for breast cancer patients who get a mastectomy.
Most patients choose an implant because it’s quick and easy. However, these can come with some potential problems, including possible infection and scarring around the implant. Although it is a more intense operating room experience and recovery takes longer, when patients choose their own tissue there is almost no downstream maintenance.
The DIEP flap procedure is highly intricate, requiring surgeons to reconnect vessels in order to make the tissue live and using tools so small they can’t be seen with the naked eye. Even the most skilled microvascular surgeon can’t do this alone.
At AAMC, for example, we work with the operating room nursing team to build a dedicated operating room and team specifically focused on microsurgical breast reconstruction. It’s essential to use a team-based approach coupled with innovative technologies for success.
We use a 3D computerized tomography of the abdomen and pelvis — or CT scan of the belly — as a ‘roadmap’ that informs them of what to expect as they dissect the flap (or belly skin that will create a new breast). Our team also uses Xact, an alternative energy source technology that’s less damaging to the muscle when making cuts to access tissue, as well as SPY fluorescence imaging to better visualize microvascular blood flow.
After beating breast cancer, the focus should be on rebuilding emotionally and physically. A really good breast reconstruction is also an aesthetic reconstruction. That’s the new standard of breast reconstruction.