Natural Breast Reconstruction

DIEP Flap
DIEP flap is the most advanced breast reconstruction technique available today.
• It is the preferred method used by Dr. Boonipat for reconstruction of the breast naturally, in Lubbock TX, with your own tissue and avoiding implants and foreign materials.
• The procedure uses the patient's own abdominal skin and fat, while preserving all abdominal muscles.
• The tissue is used to reconstruct a natural, warm, soft breast after mastectomy.
• Nerve reconstruction to restore sensation is possible with the technique.
• The tissue removal process is similar to a "tummy tuck."
• Preserving abdominal muscles leads to less pain, faster recovery, long-term core strength, and a lower risk of abdominal complications.
Dr. Boonipat also offers other natural ways to reconstruct the breast, avoiding implants long term. This might include other flaps from your body, 'Goldilocks' procedure (taking excess breast skin and using this to augments the volume) or fat grafting taken from liposuction from other areas of the body.
 
 
 
 
 
 
 
 
 
 


 
 
 
 
 
 
 
 
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DIEP Reconstruction (above), and Goldilocks procedure below. 
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Expected outcomes.
•  Patients with arm lymphedema from prior breast cancer surgery may be eligible for Vascularized Lymph Node Transfer.
• This procedure is often performed alongside DIEP flap reconstruction.
• Healthy lymph nodes are taken from the groin and transplanted to the underarm to help alleviate lymphedema symptoms.
• Patients dissatisfied with implant reconstruction results may be candidates for DIEP flap reconstruction.
• Implants can be removed through Explant Surgery, allowing the breast to be reconstructed using the patient's own tissue.

DIEP Flap Recovery Overview
• Week One:
o Hospital stay lasts 2-3 days.
o Patients are typically up and walking the day after surgery and can shower in the hospital.
o Recovery at home involves gradually increasing walking time.
o Out-of-state patients have a follow-up appointment scheduled for a week after surgery.
• Week Two:
o Local patients have a follow-up appointment within two weeks post-surgery; drains may be removed if output is low.
o Patients begin post-operative arm exercises and may switch to a wireless bra and panty girdle (with doctor's approval).
o Most patients feel comfortable driving if not on narcotics.
• Week Three:
o Patients generally start feeling more like themselves.
o At-home medications can typically be resumed with physician approval.
o Remaining surgical drains are removed.
o Those with low-impact or remote jobs can return to work.
• Week Four:
o Follow-up appointment with the surgeon is scheduled.
o Planning for stage 2 (revision) of reconstruction begins.
o Patients should continue to increase cardio endurance as tolerated.
• Week Five:
o New pains in the breast and abdomen may occur as activity increases; this is normal and will improve over time.
• Week Six:
o Most patients are released from all restrictions and can return to work.
o Healing rates vary, so it's important to listen to your body while resuming activities.


How is the surgery done?

DIEP Flap Surgery Overview
• The skin and fat below the belly button resemble breast tissue, making them a suitable option for replacing breast tissue removed during a mastectomy.
• Blood vessels, known as "perforators," keep the skin and fat alive and are located just beneath or within the abdominal muscle.
• A small incision is made in the abdominal muscle to access these vessels.
• The tissue is then disconnected and transplanted to the chest using microsurgery, where it is shaped to form a new breast.
• Patients also benefit from a flatter abdomen, similar to the results of a "tummy tuck," with reduced post-surgical pain and a very low risk of abdominal complications like bulging or hernia, especially compared to the TRAM flap, where a large portion of the abdomen muscle is taken.


What are the risks?

• Tissue Death (Necrosis): If the flap doesn’t receive enough blood, the tissue may die, leading to blackened, cold skin. In rare cases, the entire flap may need to be removed. Your surgeon will try to save the flap, and might need to return urgently to the operating room.
• Hernia: A portion of the abdominal contents can bulge through a weak spot in the abdominal muscles after surgery, but the risk is lower with DIEP flaps compared to other flap surgeries since no muscle is used in the breast reconstruction.
• Lumps: Firm scar tissue can form in the reconstructed breast, resembling a lump. This may resolve on its own or require removal by the surgeon.
• Asymmetry: This is expected to be relatively minimal if both sides are reconstructed in similar manner.
• Minor wound healing issues are relatively common in the abdomen, but usually resolve without consequences.
• Dog Ears: Small folds of skin and fat may develop at the ends of the abdominal scar. These usually go away over time but may require a minor procedure or liposuction to remove.
• Bleeding and blood clots, or infection