A Diep flap is a type of breast reconstruction where a blood vessel called deep inferior epigastric perforators (DIEP), as well as the skin and fat linked to it, is removed from the lower abdomen and transferred to the chest to reconstruct the breast after a mastectomy without sacrificing any of the abdominal muscles.
The DIEP flap reconstruction procedure is similar to a muscle-free TRAM flap procedure, but requires only removal of the skin and fat. Unlike in the TRAM procedure, however, no muscle is sacrificed. The DIEP flap - like a TRAM flap - requires an incision to the abdominal muscles (rectus), such as a blood vessel, or perforator, necessary to keep the tissue alive just below or within this muscle. Therefore, small incisions are made in the abdominal muscles to access the vessels.
After the skin, tissue and perforator (collectively known as "flap") have been dissected, the flap is transplanted and connected to the patient's chest using microsurgery. The plastic surgeon then forms the cover to make the new breasts. Because no abdominal muscle is lifted or transferred to the breast, the patient usually sees a lower risk of losing abdominal muscle strength and may experience faster recovery compared to TRAM flap patients. Studies comparing abdominal results with muscle-free TRAM and DIEP show that abdominal wall hernia is less common in DIEP patients, although the level of abdominal wall protrusion is the same for both procedures.
Many women who undergo this form of reconstruction enjoy the added benefit of a flat stomach, with results that resemble a "tummy tuck" procedure. However, one risk of this procedure is the potential for abdominal muscle denervation after DIEP dissection. In addition, because of all types of breast reconstruction, two or three stages performed several months are often necessary to complete the reconstruction process and to get the best cosmetic results.
Due to the complexity of the operation, only a few breast centers offer DIEP flap breast reconstruction. Operation times may be twice as long as muscle free TRAMs, and blood flow to the DIEP cover may not be as good as TRAM surgery that avoids muscle - something to be taken seriously before choosing this. method. However, with better preoperative imaging of blood vessels in the abdomen (using a CT scan), surgery time and complication rates may be further reduced in DIEP diap breast reconstruction. Despite the claimed benefits, little data exists to support DIEP flame exclusion claims over TRAM flap breast reconstruction.
Video DIEP flap
In non-medical terms
DIEP flap surgery is a reconstruction of the breast after a mastectomy of one or both breasts using natural fat from the patient's own body.
Natural Breast Tissue
Natural fatty tissue is taken from the stomach and used to replace malignant breast tissue. Because the breast is rebuilt with natural body fat, the breast will feel and move like a natural breast. Breasts will also gain weight and lose weight along with the rest of the body so that both breasts will maintain the symmetry of size. Usually no follow-up surgery is needed in the future as is the case with silicone implants.
Reconstruction time
Surgery may be performed at the time of mastectomy (immediate breast reconstruction) or later in time (delayed breast reconstruction). Most women choose their breast reconstruction at the time of mastectomy, due to the amount of time and the number of operations that are reduced to complete the reconstruction. The reasons for delaying surgery may be due to patient preference, advanced tumors requiring radiation, or due to complications with immediate breast reconstruction. The DIEP flap, as it can restore both surface area and breast volume is ideal for immediate and delayed breast reconstruction.
Recovery
The recovery from the DIEP chip happens gradually. Most patients leave the hospital within 5 to 6 days, feeling healthy after 2-3 weeks, and can return to normal activity within 3 - 4 months.
Tummy Tuck
During the harvest of belly fat and abdominal skin, "tummy tuck" is done as an automatic benefit. However unlike the standard "tummy tuck" in which the excessive flabby abdominal skin is removed and excess fat is removed, the DIEP flap procedure involves a longer recovery time as significant surgery is performed for 2 vertical abdominal Rectus muscles in the process of "scratching" carefully and finding small blood vessels or "perforator" needed to provide blood supply to fat tissue. These are the "sit up" muscles or also known as the six-pack muscles. They are important abdominal core muscles and take time to heal. In cases where complications occur (5%) these muscles are very weak and will impact mobility or result in abdominal bulges. In this case the strengthening mesh can overcome the weakening but in rare cases the muscles weaken permanently. The belly button is reconnected in this process.
Lift Breast
Another benefit of this surgery is that both breasts are given breast lift. This will leave permanent scarring. The width and placement of incisions and scars vary according to the preferences and skills of the surgeon. Lifting is done by replacing the nipple higher to the breast and lifting the excess skin. The amount of abdominal fat that usually allows the surgeon to give the patient increased breast size for women with smaller breasts.
After shutdown
This operation can be done only once. In the case of a single mastectomy, the second breast can not be rebuilt at a later date with a fatty tissue flap from the abdomen. For this reason some patients may choose to perform a mastectomy in non-cancerous breasts to reduce the likelihood of further cancer development.
Areolae and nipple
Unless a nipple release mastectomy is performed, the areola and breast nipple are removed in this surgery and the new areola is formed using abdominal skin plates. If the patient chooses a new nipple and areola is formed as a follow-up procedure through surgery and tattooing process. Some women are satisfied without nipples and others choose to have a celebratory tattoo applied.
Loss of sensation
The sensation in the nipple, most of the breasts and the area around the abdominal tension scar is significantly less after this operation, because microsurgical surgery is routinely focused on the vascular supply causing the nerves to be unkempt. Although technically more challenging, skin sensation can be recovered by identifying and connecting the intercostal nerve branches.
Maps DIEP flap
References
External links
- DIEP flap entry in the public domain NCI Dictionary of Cancer Terms
Ã, This article incorporates public domain material from the document of the US National Cancer Institute "Cancer Dictionary Dictionary".
Source of the article : Wikipedia
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