DIEP flap breast reconstruction is commonly used to reconstruct the breasts following mastectomy. When performing DIEP flap breast reconstruction, the lower abdominal tissue is used to replace the breast tissue and/or skin that have been removed.
In patients who have ptotic breasts, or breasts in which there is a long sternal notch to nipple distance then the mastectomy may be performed using a Wise pattern similar to a breast reduction, or the mastectomy may be performed through the areola and then the remaining skin is tailored into a Wise pattern to make the breasts appear more youthful.
During the procedure, a small piece of cartilage is removed from the third rib to expose the internal mammary artery and vein. The lower abdominal tissue is harvested and the blood supply to the skin and fat is traced through the fascia, through the rectus muscle, and then down to the deep inferior epigastric artery and vein.
The abdominal tissue is then transferred to the chest and the blood supply is connected from the internal mammary artery and vein to the deep inferior epigastric artery and vein of the flap. The abdominal donor site is then closed in a manner similar to an abdominoplasty.