Our signature procedure is the DIEP flap (Tummy Tuck Breast Reconstruction). This is a highly specialized and advanced method of breast reconstruction performed by less than 2% of all plastic surgeons in the country on a regular basis. In this method, we perform a tummy tuck like procedure. Rather than discarding the excess skin and fat from the abdomen like a cosmetic tummy tuck, we meticulously dissect the blood vessels which are normally cut. These tiny vessels (also known as perforators), are the size of a tip of a pencil, and provide blood flow to the skin and fat. We then carefully remove the tissue and transplant it in the exact same location of the breast that was previously removed by a mastectomy. Under the microscope we hand sew the artery and the vein of the tummy tuck tissue into the vessels of the chest that were cut when the mastectomy was performed. The breast is then shaped to mimic the breasts that were lost through the mastectomy.
• No muscle is removed and therefore the pain after surgery is minimal. In fact, 98% of our patients only take Tylenol for pain the day after surgery and require no narcotic or pain medications.
• Patient receives a tummy tuck. The tissue harvested is the same as a cosmetic tummy tuck. This tissue is used to recreate a breast.
• Quick recovery. 3 day hospital stay. The overwhelming majority of our patients are discharged from the hospital on the third day. Most are driving after 1 week and return to all their normal activities without restrictions after 2 weeks.
• Nothing artificial is placed. In other methods of breast reconstruction, including techniques that some may call a DIEP flap, an artificial mesh is placed in the abdomen because a section of muscle is taken along with fascia (cover over muscle). Since we do not take any muscle or fascia, there is no defect and all incisions are closed simply with sutures. A second benefit in not placing artificial mesh is the infection rate is also much lower than any traditional method of breast reconstruction including TRAM flap and implants.
• Sensation of the breast skin after mastectomy. In selected cases, when we are involved with the reconstruction at the time of mastectomy, we take great care to preserve the nerves that allow the breast skin to have sensation. Our nerve sparing technique is a significant advantage to the traditional mastectomy that has been performed nearly the same way for almost 80 years.
• Simultaneous transplant of lymph nodes. At the time of the DIEP flap, we can also incorporate lymph nodes that are removed by an axillary lymph node dissection. This may lower the risk of a permanent complication such as lymphedema (swollen arm).