New techniques offer great results in breast reconstruction surgery
The acronym DIEP stands for "deep inferior epigastric perforator," the name of a blood vessel that supplies blood to fat tissue in the lower belly area. The DIEP flap includes the blood vessels, fat tissue, and skin around it. In breast reconstruction surgery after mastectomy, doctors can use the DIEP flap to make a new breast very close in appearance and texture to a natural breast.
Breast Cancer Basics
According to statistics published by on BreastCancer.org, breast cancer affects about one in eight women who reach the age of 80. Some risk factors for developing breast cancer: being a woman (yes, men can get breast cancer, too, but rarely), getting older, and a family history of breast cancer. Other risk factors, similar to the risk factors for cancer in general, include poor diet, lack of exercise, excessive alcohol consumption, and more. Regular mammograms can detect cancer early and provide the best chance for complete recovery.
Mastectomy
Breast cancer can be treated with chemotherapy, radiation therapy, hormonal therapy, and surgery. Surgery includes "lumpectomy," which seeks to remove the cancerous tumor while preserving the rest of the breast, and mastectomy, which requires complete removal of the breast. Mastectomy, though it can save a life, leaves a woman disfigured. In addition to physical recovery, emotional recovery can be difficult.
DIEP Benefits
DIEP flap surgery offers women undergoing a mastectomy a more acceptable breast reconstruction than artificial implants. Using the patient's own tissues minimizes rejection and results in a new breast similar in texture and look as the natural breast. Removing excess belly fat and tightening up the skin offers many women an additional cosmetic benefit. DIEP flap surgery can accompany a mastectomy, or a woman with a healed mastectomy can have it later. Doctors can also combine DIEP flap surgery with conventional breast implants. Women without sufficient belly fat and those with certain kinds of circulation problems should not have this kind of surgery.
The Procedure
Doctors performing the mastectomy can spare the skin of the breast and in many cases also the nipples. They then make an incision in the abdomen, remove the DIEP flap and surrounding tissues, and rebuild a new breast. They connect the DIEP flap blood vessels to the existing blood vessels that supplied the natural breast and cover the new breast with the original skin. If the mastectomy did not allow for sparing the nipples, doctors can reconstruct the nipples and tattoo natural looking areolas at a later date.
DIEP Flap Versus TRAM Flap Surgery
TRAM stands for "transverse rectus abdominis muscle" a vertical abdominal muscle. In TRAM flap surgery, doctors reposition this muscle and surrounding fat and skin tissue to rebuild a breast. The natural blood vessels supplying the TRAM flap remain in place. Compared to TRAM flap surgery, patients undergoing DIEP flap surgery recover more quickly and maintain their abdominal muscle strength. However, DIEP flap surgery requires more time since it requires blood vessel microsurgery.
Clinical Study
A study published in the journal Plastic & Reconstructive Surgery in 2009 found that patients undergoing DIEP or TRAM surgery both had good results. Those undergoing DIEP had twice the risk of fat tissue loss called necrosis due to complexity of the microsurgery on the blood vessels; however, very few patients experienced this problem. Patients receiving DIEP had less complications and problems in the abdominal area compared with those having TRAM.
Tags: flap surgery, blood vessels, DIEP flap, DIEP flap surgery, DIEP flap
