Reconstruction methods
A DIEP flap rebuilds the breast using lower-abdominal tissue.
A deep inferior epigastric perforator (DIEP) flap uses skin and fat from the lower abdomen to reconstruct the breast, while attempting to preserve the abdominal muscle.
It is a form of autologous reconstruction and involves microsurgery to reconnect small blood vessels at the chest.
What a DIEP flap involves
Skin and fat are transferred from the lower abdomen to the chest, where small blood vessels are reconnected under a microscope to supply the tissue.
Because it uses the patient's own tissue, there is no permanent breast implant. The reconstructed breast may change in shape and softness more naturally over time.
The donor site
A DIEP flap attempts to preserve the abdominal muscle, but muscle preservation does not eliminate all donor-site risks.
- A lower-abdominal scar
- Abdominal weakness or bulging
- Hernia
- Wound-healing problems
- Changes in abdominal contour or sensation
Microsurgical monitoring
After surgery, the transferred tissue is monitored closely because its blood supply depends on the reconnected vessels. Early problems require urgent specialist assessment.
Radiotherapy and timing
Radiation can affect transferred tissue, causing firmness, volume change, fat necrosis or asymmetry. Some teams prefer delayed reconstruction after radiotherapy; others may recommend a different sequence. There is no single sequence that is best for every patient.
What a DIEP flap cannot guarantee
International follow-up
Early microsurgical complications require urgent care. Patients should not plan to leave Korea until the surgical team considers travel appropriate, and should understand which clinical team will follow the reconstruction after they return home.
Questions for your reconstructive surgeon
- Am I a suitable candidate for a DIEP flap?
- What are the donor-site risks in my case?
- How is the flap monitored after surgery?
- How could radiotherapy affect the result?
- How many operations are likely in total?
- Who will manage complications after I return home?