DIEP & Other Abdominal Flaps

DIEP & Other Abdonimal Flaps 

A variety of flaps can be created when using the abdomen as a donor site based on the blood vessels that will be used to provide vascularity to the transplanted tissue.

The DIEP (deep inferior epigastric perforator) flap is certainly the gold standard and preserves the musculature of the abdominal wall.

The SIEA (superficial inferior epigastric) flap is another flap that is transplanted from the abdomen. It uses blood vessels that do not travel through the abdominal musculature. Unfortunately, only a small percentage of patients are a candidate for this type of flap. Between 10-15% of patients have adequate SIEA that can support adequate vascularity to enough skin and fat from the lower abdomen to provide a successful reconstruction. This is determined pre-operatively using CT scan imaging.

We also offer a variation of those flaps in the form of the extended abdominal flap and the APEX flap. The latter is performed when the perforators are not in an ideal position in relation to the umbilicus and will allow recruiting more volume while maintaining the incision lower to provide a more esthetic result.

We treat the abdomen in a similar fashion as an abdominoplasty or tummy tuck. The incision is kept low so that it can be hidden in the panty line area. In addition, repair of diastasis will be performed when needed.

What to expect after an abdominal based flap:

A hospital stay of 2 nights for unilateral (one breast) and 3 nights for bilateral (two breasts) procedures is the norm. Patients should refrain from strenuous activities for 4-6 weeks. Discomfort is well controlled by the use of long-acting local anesthetic and nerve blocks. Patients can typically resume driving at 2 weeks and return to work at 3 weeks post-operatively.