DIEP flap reconstruction with mastectomy

DIEP refers to deep inferior epigastric perforator blood vessels. A specialist microsurgical team moves the tissue and reconnects its blood supply in the chest. The mastectomy removes breast tissue; the DIEP procedure provides a new breast shape.

Reconstruction may be immediate, during the same operation as mastectomy, or delayed until a later date. Suitability depends on abdominal tissue, previous operations and scars, general health, smoking or nicotine use, planned cancer treatment, and personal priorities.

Unlike a flap that takes abdominal muscle, a DIEP flap aims to leave that muscle in place. It still involves surgery at both the chest and abdomen, a long scar across the lower abdomen, and careful monitoring of blood flow to the transferred tissue. Further procedures may refine shape or symmetry.

Tell the surgical team about medicines, supplements, previous abdominal surgery, clotting problems, and nicotine use. Follow their instructions on medicines, fasting, skin preparation, and activity. Arrange practical help because early recovery can limit lifting, driving, and standing fully upright.

After surgery, follow wound and drain instructions, take short walks as advised, and use the recommended support garments. Attend checks of the reconstructed breast and abdominal wound. If lymph nodes were treated, ask how to reduce swelling risk and recognise lymphoedema.

Contact the surgical team immediately if the flap becomes unusually pale, dark, cool, rapidly swollen, or increasingly painful. Urgent review is also needed for spreading redness, wound opening, pus, fever, persistent bleeding, or a sudden increase in drain fluid. Call emergency services for chest pain, severe breathlessness, collapse, or a painful swollen leg.

Ask whether immediate or delayed reconstruction fits your cancer treatment plan, whether abdominal blood-vessel imaging is needed, and what alternatives suit your body and preferences. Clarify likely scars, sensation changes, monitoring, rehabilitation, and what would happen if the transferred tissue developed a blood-flow problem.