Place your health and well-being in the hands of an expert

Dr. Christopher J. Micallef is a double-board-certified plastic and reconstructive surgeon whose precision, artistry, and dedication to excellence make him the ideal choice to perform the complex and demanding DIEP flap procedure. In addition to his expertise and consummate skill, Dr. Micallef is a compassionate provider who practices active listening to fully understand your goals and wishes, translating them into a personalized treatment plan for success.

What is risk-reducing DIEP flap reconstruction?

Breast reconstruction using the patient’s own autologous materials (soft tissue, fat, and skin) produces a highly authentic look and feel, enhancing confidence and quality of life. One of the most common options is the Deep Inferior Epigastric Perforator (DIEP) flap surgery, which relies on tissue harvested from the abdomen to create new breast mounds. 

What are the Benefits of DIEP Flap Reconstruction?

Reduces risks associated with implants – DIEP flap surgery can eradicate the risk of complications that comes with conventional reconstruction, including capsular contracture, rupture, BII (Breast Implant Illness), and the need for revision surgery down the line.

Creates natural-looking contours – DIEP flap breast reconstruction provides soft, rounded, and symmetrical breasts that look and feel authentic. The DIEP flap’s strong blood supply and safeguarded abdominal nerves translate to enhanced sensation in the transferred materials. 

Preserves the stomach muscles – DIEP flap surgery typically does not interfere with the patient’s stomach muscles. Tiny blood vessels are detached with the DIEP approach to support the transplanted skin and fat, but the muscle remains intact. This muscle-sparing technique also lowers the risk of hernias after surgery, promoting a quicker, less painful recovery.

Enhances self-esteem and a positive body image – Undergoing a mastectomy can be a deeply distressing experience. DIEP flap breast reconstruction helps women to regain their sense of femininity, beauty, and confidence and feel more at ease in their old clothes. It can make them feel whole again knowing their breasts are made from their own body tissue rather than a synthetic substance. 

Well-placed incisions and scars – Scarring with the DIEP flap is more favorable than with most other types of flaps, as the incision marks can be concealed with clothing or the bikini line after surgery. 

Long-lasting results – Implant reconstruction usually requires that the implants be replaced every 10-15 years and that patients undergo regular screenings. DIEP flap surgery uses the patient’s own tissue to recreate the breast mounds, so there is no need for additional surgeries or maintenance.

Who is a good candidate for DIEP flap breast reconstruction?

An in-depth consultation with Dr. Micallef and his team is required before moving forward with DIEP flap reconstruction. This time is reserved for you to ask questions, gather more information, and gain a better understanding of the entire treatment process. You may be eligible for DIEP breast reconstruction if you:

  • Have excess abdominal tissue to spare
  • Desire natural-looking breasts that feel authentic to the touch
  • Are undergoing a primary reconstruction surgery
  • Wish to replace your previous implants
  • Are free from any medical concerns that might interfere with the healing process
  • Have not had previous abdominal surgeries
  • Have realistic expectations for your results

Note that patients can only undergo DIEP flap breast reconstruction a single time. This means that if you undergo the procedure on one breast and then later decide to undergo it on the second breast, at that point you will need to harvest flap materials from a different part of the body, such as the back or thighs, or choose implant-based reconstruction.

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Risk factors and genetics

As the second most common form of cancer among women in the United States, breast cancer does not have a single cause. However, there are risk factors to be aware of. Women with a family history of breast cancer can get genetic testing to assess whether they carry the BRCA 1 or BRCA 2 gene mutation. If these markers are found, it means a 70% lifetime risk of getting breast cancer. Many patients with the BRCA 1 or BRCA 2 mutations will opt to have elective mastectomy followed by DIEP flap reconstruction, lowering their risk without compromising the femininity of their figure. 

    What can I expect from the procedure?

    DIEP flap breast reconstruction usually takes 6-8 hours to perform. The treatment steps are as follows:

    Prior to surgery – Before surgery, you will receive detailed instructions to follow from Dr. Micallef. Be exacting in your adherence to these requests so that your surgery is seamless. On the day of your appointment, you will receive general anesthesia that will keep you asleep and unconscious throughout the surgery. Your vital signs will be closely monitored to keep you safe. 

    Harvesting the donor tissue – The next step is for Dr. Micallef to create a precise incision in the lower belly. A carefully chosen portion of tissue, fat, and skin along with its blood vessels is then extracted and readied for transfer. 

    Closure of the abdominal incisions – Once tissue extraction has been completed, Dr. Micallef then closes the incisions using advanced suturing techniques. He will work to create smooth stomach contours and may reposition the belly button to enhance the overall abdominal shape.

    Transferring the autologous tissue – At this stage of the process, Dr. Micallef will transfer the skin, tissue, fat, nerves, and vital blood vessels to the chest region, sculpting a new breast mound with meticulous artistry.

    Connecting the blood vessels – Next, Dr. Micallef will use microsurgery to connect the flap’s blood vessels to those in the chest, which ensures the long-term viability and vitality of the new breast mound. 

    Closing the chest incisions – Once the flap is expertly placed and secured, Dr. Micallef will close the incisions with fine sutures, being careful to optimize wound healing and reduce the appearance of postoperative scarring as much as possible. 

    Postoperative monitoring – Once the procedure is complete, the patient is placed in the recovery suite where they are carefully monitored as they awake from a deep slumber. 

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    Recovery after DIEP flap surgery

    Patients may need to stay in the hospital for 2-5 days after surgery, at which point they can resume the healing process at home. Dr. Micallef will provide detailed aftercare instructions, prescriptions for pain medications, and compression garments to help reduce swelling. 

    Because DIEP flap surgery requires healing in two areas of the body, the recovery process will typically take twice as long as it would with implant-based reconstruction. It’s important to allow your body to recuperate at its own pace and not place too many requirements on your healing timeline.

    Patients will need to abstain from heavy lifting, strenuous exercise, and intercourse for around 4-6 weeks after surgery. However, gentle walks and stretching exercises are encouraged. Dr. Micallef will schedule you for regular follow-up appointments to ensure your recovery remains on track.

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