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The Deep Inferior Epigastric Perforator Flap or the DIEP breast reconstruction technique is an advanced technique and is a refined version of TRAM flap surgery. In both these procedures the skin and tissue removed during mastectomy is replaced by soft, warm, living tissue from the abdomen of the patient herself. This is an advanced autologous (own tissue) transfer. TRAM uses the muscle but in the DIEP method, the rectus abdominal muscle is preserved, thus allowing the abdominal strength and integrity. It uses only the blood vessels, fat and skin from the abdomen. Also DIEP can be performed at any time, even many years after the mastectomy though generally patients prefer to do it immediately after the mastectomy.
The most modern techniques of mastectomy involve performing ‘skin sparing’ mastectomies where the breast tissue is completely removed but the outer breast skin ‘envelope’ is left intact. This can be filled with the transferred tissue from the abdomen, making the new breast very similar to the original one. This is very much preferred as there is no fear of the breasts being asymmetrical or different from each other. Also the skin texture will remain the same, as the skin is the same. As compared to the TRAM procedure DIEP is an improved version and the patient will have less restrictions. TRAM may make the abdominal muscle strength weak as a whole muscle is removed but in the DIEP method only the blood vessels and fatty tissues are removed to make the breast, hence restrictions may be less. Sometimes women have hernia problems after TRAM, which is not the case with DIEP.
DIEP is a more complex surgery and requires an experienced surgeon who is highly skilled in microsurgery. Hence one has to be careful as to who handles the procedure. Research has to be done regarding the experience and case studies of the surgeon. A patient who has undergone the C –section delivery or has had multiple surgical procedures on the abdomen will have to seek the doctor’s guidance before deciding on DIEP or TRAM method as the area may not have adequate tissues to be transferred to the breast area.
Patients who have undergone the DIEP method generally have less pain, earlier recoveries and less potential for complications. The surgery may take the same time as TRAM. Research shows that DIEP generally has fewer complications, less pain and is less invasive than TRAM or LAT flaps or any other type of breast reconstruction methods, if done by a surgeon who is highly skilled in the procedure. |
