Common DIEP Flap Breast Reconstruction Misconceptions

Many misconceptions lead patients to believe the DIEP flap is too risky or painful. Some women choose to go with implant reconstruction, believing the journey will be easier. However, many of these patients will go on to experience common implant-related complications (such as pain, capsular contracture, rippling, cold-feeling breasts, etc.) and will require multiple revision surgeries.

As you may gather, many women who experience these complications go on to have their implants removed and undergo DIEP flap reconstruction. We see this regularly at our San Antonio plastic surgery clinic.

What Are Common DIEP Flap Breast Reconstruction Misconceptions?

If you’re considering breast reconstruction, it’s essential to separate fact from fiction. While DIEP flap surgery isn’t the right choice for every woman, it’s necessary to understand the truth about this option so you can make the best decision for your body and your future.

Many people think DIEP flap surgery is too complex or that it requires a lot of abdominal tissue, but in reality, it’s a natural and long-lasting solution that uses your own body to create beautiful, personalized results. Understanding the benefits and limitations of DIEP flap reconstruction is key to choosing what aligns with your unique goals and lifestyle.

At PRMA, we’re committed to giving you the facts and the support you need so you can make an informed decision with confidence. We’re here to guide you every step of the way as you navigate your breast reconstruction journey.

Let’s explore your breast reconstruction options together and find the right path for you!

Misconception #1: DIEP Flap Is More Painful Than Implant Reconstruction

Many patients believe DIEP flap breast reconstruction is more painful than implant surgery. While every patient’s experience is different, studies show patients report more pain following sub-pectoral tissue expander/implant surgery compared to DIEP flap. The DIEP flap reduces muscle trauma and preserves all patient abdominal and chest muscles. Most implant-based reconstruction procedures involve placing an implant under the chest muscle.

This requires releasing and lifting the muscle off of the chest wall to create a pocket for the implant, which is painful and adds to patient recovery. For patients needing tissue expanders, the overlying breast tissue will be stretched over a period of time, causing discomfort.

At PRMA, our patients experience minimal pain after DIEP flap surgery thanks to our Enhanced Recovery After Surgery (ERAS) protocol. In fact, most patients can control their post-operative discomfort without the use of narcotics!

Misconception #2: DIEP Flap Has a Higher Complication Rate

Any surgery carries a risk of complications. In the hands of experienced surgeons, DIEP flap breast reconstruction is safe. At PRMA, our DIEP flap success rate is over 99%. I feel it is important to note here that when radiation therapy is a part of cancer treatment, about 1 in 3 implant reconstructions fail. The DIEP flap provides a safe and natural alternative.

Misconception #3: DIEP Flap Has a Longer Hospital Time

Again, thanks to the implementation of our ERAS protocol, patients are recovering faster after DIEP flap surgery. Patients can expect to be up and walking the day after surgery and back home after 2-3 days. There is no extended stay period in the hospital following DIEP flap surgery.

Misconception #4: Any Plastic Surgeon Can Perform DIEP Flap

This is a dangerous misconception! Most plastic surgeons do not routinely (if at all) perform advanced perforator flap procedures like the DIEP flap. Experience matters for a successful outcome!

Seek out a board-certified plastic surgeon who performs at least 100 DIEP flaps yearly with a very high success rate. At PRMA, we perform over 700 perforator flap procedures a year with a success rate of over 99%! Because of the few surgeons routinely performing this procedure, many women may have to travel for surgery. Although travel may seem overwhelming, it’s worth it! 

Other Common Concerns About DIEP Flap Surgery

Let’s clear up some other common misconceptions to help you make a more informed decision.

• Impact on Abdominal Strength: Many women find that, over time, they regain their core strength and even feel stronger in the long run. With the right guidance and patience, most patients can return to their normal activities and exercise routines through a structured rehabilitation program.
• Scars after DIEP Breast Reconstruction: Scars from DIEP flap breast reconstruction are typically low on the abdomen, similar to a tummy tuck, and can be concealed under clothing. With proper care and scar-reducing treatments, they often fade over time, leaving a reminder of your strength and resilience.
• Sensitivity and Sensation: After DIEP flap breast reconstruction, some women may experience changes in breast sensitivity or sensation due to nerve involvement during surgery. While sensation can partially return over time, it varies by individual and depends on the extent of nerve healing.
• Aesthetic Outcomes: DIEP flap breast reconstruction provides soft, natural-looking results by using your own tissue, closely mimicking the feel of a natural breast. The procedure also allows for precise shaping and symmetry, offering a highly personalized and aesthetically pleasing outcome.
• Insurance Coverage: DIEP flap breast reconstruction is typically covered by insurance, as federal law requires most plans to cover breast reconstruction after mastectomy. This includes procedures to restore symmetry and address both breasts, ensuring access to comprehensive care.

Benefits of DIEP Flap Breast Reconstruction

The DIEP flap procedure offers a range of benefits that make it a popular choice for women seeking natural, long-lasting results. Here’s why so many women are turning to this advanced technique for their reconstruction journey.

• Natural Results: The DIEP flap uses your own tissue, creating soft, natural-looking breasts that feel like your own body.
• Muscle Preservation: Unlike other procedures, the DIEP flap preserves all abdominal muscles, reducing recovery time and maintaining core strength.
• Long-Lasting Outcomes: Since it uses your own tissue, the reconstruction ages naturally with your body and eliminates concerns about implant-related complications.