Breast Reconstruction after Mastectomy with DIEP Flap

Abstract

The transverse rectus abdominis musculocutaneous (TRAM) flap has become the procedure of choice for autologous breast reconstruction after mastectomy in the past decade. Despite the numerous advantages of the free TRAM flap, abdominal wall complications are the major concerns for plastic surgeons performing breast reconstruction with TRAM flaps. Since the report of successful breast reconstruction with the free deep inferior epigastric perforator (DIEP) flap by Allen and Treece in 1994, there has been increasing use of the free DIEP flap for breast reconstruction in recent years. The reported results of the free DIEP flaps were comparable to those of the free TRAM flaps, though there might be slightly increases of rates of partial flap loss and fat necrosis. However, the abdominal wall complications could be eliminated. After the experiences of breast reconstructions with free TRAM flaps, we chose the free DIEP flap as our procedure for the breast reconstruction after mastectomy for recent 10 cases. There was no total or partial flap loss. The results were cosmetically acceptable, though the dissections of perforators were tedious. We believe the free DIEP flap is an excellent technique that can obtain a successful, autologous tissue breast reconstruction with minimal donor-site morbidity.