Breast reconstruction with the DIEP technique
This procedure consists in using a skin sample and some fat from the abdomen to reconstruct the breast.
The DIEP technique can be applied when the quality of the chest skin is not good enough to support an implant alone, if the morphology of the abdomen lends itself to the procedure (small round belly), and the patient does not smoke.
The volume of the breast is recreated without using implants.
The flap used is free: the tissues are vascularized through their own vessels (inferior deep epigastric vein and artery) and cut at their point of origin before being sutured (anastomosed) to the receptor vessels (axillary vein and artery or internal mammary vein or artery) through microsurgery.
Before the procedure
An angiography scan will be performed in order to map out the blood vessels that will be used for the abdominal flap. It will not be possible to use the DIEP technique if the vessels were dissected during a previous procedure such as liposuction or caesarian section.
The procedure
The surgery is performed under general anesthesia and lasts between 4 and 8 hours. In order to optimize the stages of the procedure and to limit potential complications, it is carried out by 2 surgeons with extensive experience.
The first surgeon removes fat and skin paddles from the abdomen, as they would do for classic abdominal surgery. While the first surgeon proceeds, the second one identifies and dissects the receptor vessels in the axilla (armpit or behind ribs). The flap is placed and the team uses a microscope to perform the reconnecting of blood vessels in the flap. Then the flap is shaped in a semi sitting position in order to preview the result in a standing position.
After the procedure
The drains placed during the operation will be removed between the 3rd and the 5th day after surgery. On the 2nd day, the garment is replaced with a medical bra which will be worn for at least 1 month. An abdominal shaping girdle will be worn day and night for 2 months.
The reconstructed breast is supple and more or less voluminous. Over time, its evolution will be the same as the natural evolution of the contra lateral breast.
This procedure has the advantage of treating the abdominal area and giving the breasts a natural shape. If a modification is necessary, it will be performed during the areola and nipple reconstruction procedure.
The first shower is permitted the day after the surgery but baths should be avoided during the first month. The scars need to be protected from the sun for a 1 year period after surgery!