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A deep inferior epigastric perforator (DIEP) flap is a type of free flap commonly used for breast reconstruction. Skin and fat from the lower abdomen are transferred with blood vessels called deep inferior epigastric perforators. The rectus abdominis muscle is preserved rather than transferred with the flap. Microsurgery reconnects the flap vessels to blood vessels in the chest.
read more about deep inferior epigastric perforator flap ...DIEP flap reconstruction is used to create a breast mound after mastectomy or to replace tissue damaged by prior surgery or radiation. It can be performed at the time of mastectomy or as a delayed reconstruction. Using the patient's own tissue can provide a soft, living reconstruction that changes with body weight and does not require a permanent breast implant. The procedure is suitable only when adequate abdominal tissue and appropriate blood vessels are available.
The surgeon maps and carefully dissects perforator vessels that pass through or around the abdominal muscle to reach the skin and fat. The lower abdominal tissue is removed while preserving as much rectus muscle and motor nerve function as possible. The flap is transferred to the chest, where its artery and vein are connected to recipient vessels under a microscope. The tissue is shaped into a breast, and the abdominal donor site is closed in a manner similar to an abdominoplasty incision.
Patients are monitored closely for flap circulation during the early postoperative period. Recovery involves care of both the reconstructed breast and the lower abdominal donor site. Walking, posture, lifting, abdominal strain, and exercise are increased gradually as wounds heal and strength returns. Later procedures can refine breast shape, improve symmetry, reconstruct a nipple, or revise scars when needed.
Risks include bleeding, infection, wound-healing problems, blood clots, seroma, fat necrosis, and partial or total flap loss. Abdominal complications can include weakness, numbness, bulging, or hernia even though the rectus muscle is preserved. Poor blood flow can require urgent microsurgical revision. Smoking, vascular disease, obesity, prior abdominal operations, and other health factors can influence surgical planning and complication risk.
The procedure is designed to preserve the rectus abdominis muscle. Small perforating blood vessels are dissected through or around the muscle to supply the transferred skin and fat.
Yes. The abdominal tissue is detached from its original circulation and its artery and vein are reconnected to recipient vessels in the chest.
Yes. Autologous tissue reconstruction is often considered after chest-wall radiation because healthy transferred tissue can replace damaged skin and soft tissue.
No. The transferred skin and fat do not regenerate at the donor site. The remaining abdominal tissues heal and are repositioned during closure.
Definition of DIEP flap. National Cancer Institute. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/diep-flap. Date Accessed August 12, 2026.
Breast Reconstruction After Mastectomy. National Cancer Institute. https://www.cancer.gov/types/breast/treatment/surgery/breast-reconstruction. Date Accessed August 12, 2026.
Breast Reconstruction Options. American Society of Plastic Surgeons. https://www.plasticsurgery.org/reconstructive-procedures/breast-reconstruction/techniques. Date Accessed August 12, 2026.
A systematic review of donor site aesthetic and complications after deep inferior epigastric perforator flap breast reconstruction. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC6722999/. Date Accessed August 12, 2026.
A 10-year retrospective review of 758 DIEP flaps for breast reconstruction. PubMed. https://pubmed.ncbi.nlm.nih.gov/15083015/. Date Accessed August 12, 2026.