What to Expect With DIEP Flap Reconstruction Surgery

Medically Reviewed by Jennifer Robinson, MD on March 17, 2023
Written by Mary Jo DiLonardo
3 min read

After a mastectomy, you may want to have breast reconstruction surgery. In some cases, you can use your own tissue instead of implants to rebuild your breast. That’s called flap surgery.

For DIEP flap surgery, doctors take tissues from your belly to remake a breast. Using your own tissue usually creates more natural results because the new breast ages the same way your original breast would. And you don’t risk the problems that can come with implants.

Your surgeon will take skin, fat, and blood vessels -- but no muscles -- from your lower belly above your pubic bone. That’s sometimes called the “tummy tuck” area. DIEP stands for deep inferior epigastric perforator. It’s named for the artery that runs through your abdomen, or lower belly. The procedure is designed to have fewer side effects and more natural results.

You’ll likely have DIEP surgery at the same time as your mastectomy. That means you won’t have to have two separate operations. You’ll heal more quickly and get back to normal life faster.

But if you’ve already had a mastectomy and decide on breast reconstruction later, DIEP could still be an option.

You may not be able to get DIEP if you don’t have enough belly tissue or if you have already had certain abdominal surgeries. The doctor can help you decide if it’s right for you.

During DIEP surgery, the doctor will make a cut along your bikini line from hip to hip. They’ll remove some skin, fat, and blood vessels from your lower belly and move them up to your chest where you had the mastectomy. They’ll form these tissues into the shape of a breast. Your surgeon will use a microscope to help them see as they connect blood vessels to the blood vessels in your chest. This allows the new breast tissue to grow and thrive.

You’ll stay in the hospital for about 3 to 5 days so your surgeon can make sure everything is OK. It may take 6 weeks or more to completely recover. You’ll have several cuts to take care of. You’ll probably have to wear elastic bandages or support bras to help keep swelling down while you heal.

Like all surgeries, there are some risks with DIEP.

It’s rare, but sometimes the tissue moved to your chest doesn’t get enough blood flow and dies. If it’s a small area, your surgeon can trim away the dead tissue. If it’s most of the tissue, they’ll have to replace the whole flap.

Or the blood supply could get cut off in spots, causing scar tissue. These areas might feel like lumps in your breast. They may or may not go away on their own.

There’s also a chance you could get a hernia or muscle weakness around the spot in your lower belly when the surgeon removed the tissue. You usually need surgery to fix a hernia.

Unlike some other flap surgeries, DIEP doesn’t require the surgeon to cut muscles from your abdomen and move them to your chest. That means you won’t lose strength in your belly. And your recovery should be less painful than some other flap surgeries.

Because DIEP surgery uses natural tissue, your new breast should change with your body. If you gain or lose weight, for example, you’ll see those changes in the breast, too.

You’ll have a scar across your lower abdomen, around the belly button, and on your newly built breast. Your abdomen should be tighter and flatter, as if you had a tummy tuck.