DIEP Flap Reconstruction The Woodlands

As a means of reconstructing a breast following breast cancer treatment and a mastectomy, the DIEP Flap breast reconstruction technique performed by Houston plastic surgeon Dr. Paul Gill is one of a few procedures that recreates the breast using your own tissues.

picture of microsurgical breast reconstruction, houston surgeon
During DIEP breast reconstruction, tissue is moved from the abdomen to the new breast.

During his training, Dr. Gill completed a research fellowship with Dr. Robert Allen, M.D., the founder of the DIEP (Deep Inferior Epiastric Perforator) flap for breast reconstruction. This involved the publishing of many landmark research publications in the field of breast reconstruction. One of their papers was selected by the prestigious American Association of Plastic Surgeons for the James Barrett Brown Award. This award is given to the author of the single best plastic surgery publication in the country for that year. Through this enormous honor, Dr. Gill was able to present his work on the DIEP flap for breast reconstruction to many world leaders in the field of plastic surgery at only 28 years of age.

Among plastic surgeons in the Houston area, as well as nationwide, Dr. Gill stands out as a recognized leader in DIEP breast reconstruction.

If You’re Considering DIEP Flap Breast Reconstruction in Houston

The DIEP Flap Breast Reconstruction technique uses tissue from your abdomen to recreate the breast mound. It is like the TRAM Flap Breast Reconstruction technique in that it uses tissue from the abdomen, but unlike TRAM – no muscle is relocated in DIEP. This reduces discomfort and weakness in your midsection following surgery and decreases the risk of bulging or the formation of hernias.

DIEP is ideally performed on women who have lost one or both breasts in a mastectomy, do not wish to undergo implant-based reconstruction and exhibit adequate tissues in the abdomen for this type of reconstruction. It can be performed after a mastectomy as soon as the patient is comfortable. Prospective patients should be otherwise healthy, free of cancer and be non-smokers, which will aid in proper healing.

What to Expect from Surgery

For this breast reconstruction in Houston, which can take four to six hours to complete, you will be under a general anesthetic. When beginning, Dr. Gill will isolate the tissue and blood vessels in your lower stomach, below the bellybutton. Using careful incisions, he will remove an appropriate amount of tissue, including the underlying blood vessels. Using microsurgery, he will reattach the tissues and their corresponding blood vessels in the chest wall to recreate the breast.

Once aesthetic goals are met and the recreated breast approximately matches the opposite breast, Dr. Gill will close the incisions with sutures and apply a dressing. Given that tissue is removed from the lower abdomen, closing this incision has an aesthetic result similar to a tummy tuck.

Recovering from DIEP Flap Breast Reconstruction

This procedure is extensive and you may stay in the hospital for up to four days after surgery. During this time, you will be given medication to manage pain and may be expected to walk one day after your surgery. You may require further operations, including nipple reconstruction, which will take place up to two months later.

What is a Stacked DIEP Flap Breast Reconstruction?

A stacked DIEP flap breast reconstruction is a new cutting edge technique to reconstruct the breast of women who have either had previous abdominal surgery or require full use of the abdominal tissue to reconstruct one breast. In comparison to a unilateral or single DIEP flap breast reconstruction this technique utilizes both sides of the abdomen to reconstruct the breast mound.

How Long Does a Stacked DIEP Flap Breast Reconstruction Take to Perform?

This procedure takes anywhere from 4-6 hours to perform simply because it is two separate micro vascular anastomoses and two separate DIEP flaps used to reconstruct the breast mound compared to the traditional flap.

How do you Perform a Stacked DIEP Flap Breast Reconstruction?

We perform a stacked DIEP flap breast reconstruction at Gill Plastic Surgery in the Houston and Woodland, Texas by elevating two separate DIEP flaps, one from the left hemi abdomen, one from the right, and depending on the breast we are reconstructing we will bury or remove the superficial layer of skin on one flap and bury this flap under the dominant more superficial flap. This provides for a substantial breast mound with excellent projection and shape and allows candidates, who would traditionally not be offered a DIEP flap due to their previous abdominal surgery, or patients who did not have enough substantial tissue for a unilateral reconstruction to now undergo this procedure.

Who is a Good Candidate for a Stacked DIEP Flap Breast Reconstruction?

An excellent candidate for a stacked DIEP flap breast reconstruction is a moderately sized patient who would require full use of the abdomen to recreate one breast,or patients who have a midline scar, either from a hysterectomy, C-section, or previous bowel surgery that prohibits use of the full abdomen without raising two separate DIEP flaps. Therefore the stacked DIEP flap breast reconstruction is utilized in patients who have had midline scars and require full use of the abdominal tissue and the procedure entails elevation of both hemi abdomen DIEP flaps and utilizing them in a stacked fashion to reconstruct a single breast. It typically takes patients approximately 2 weeks to recover from a stacked DIEP flap. They are usually able to return to desk activities, drive, and do basic activities of daily living by 2 weeks and return to full, unrestricted activity by 6 weeks. At Gill Plastic Surgery in Houston and Woodlands, Texas we perform over 150 breast reconstructions annually. We take great pride in our attention to detail and team center approach. We utilize an experienced mircorsurgical team approach in all DIEP breast reconstruction procedures.

In addition, we communicate frequently with your medical oncologists and breast surgeon to determine the optimal treatment plan and safest method to reconstruct the breast, ensuring the reconstruction does not interfere with any necessary cancer treatment.

To learn more about the advanced breast reconstruction techniques Dr. Paul Gill uses in his Houston plastic surgery practice, we encourage you to call his office to set up a consultation. Use our online email form to contact us or call 281-853-5308.