DIEP flap

The deep inferior epigastric perforator is a flap of tissue that is typically used in plastic surgery for reconstruction of the female breast. Also in the German literature as alternative name DIEP Flap ( Deep Inferior Epigastric Perforator engl. ) familiar. Was first described this reconstruction technique in 1989 by Koshima and Soeda.

This method is used tissue from the lower abdomen area, consisting of skin and subcutaneous fat, as a donor for breast reconstruction. Unlike the TRAM flap no abdominal muscle tissue is integrated into the graft when lifting the DIEP. There are dissected blood vessels emanating from the deep epigastric vessels ( vasa epigastric profunda ) and perforate the rectus abdominis muscle.

When the flap transplantation of skin and subcutaneous fatty tissue is removed from the lower abdomen. The blood vessels of the graft are micro- surgically connected to blood vessels in the chest area ( thoracic artery and vein or internal mammary ). So that the circulation of the natural tissue is ensured. A natural breast shape is modeled from the transplanted tissue.

In further steps can be performed ( by full-thickness skin graft from the upper eyelid blepharoplasty for example ) the plastic reconstruction of the nipple (eg star -flap ) and areola. This is done after completion of the healing process. The breast reconstruction with autologous tissue allows a cosmetically optimal result. Patients is the implantation of silicone prostheses saves, which must be replaced after 10 to 15 years. Due to the demanding surgical technique, this method is performed, despite its advantages, only a few is trained plastic surgeon.