A DIEP flap rebuilds a breast using skin and fat from the lower abdomen, the same area removed in a tummy tightening operation. Tissue travels with its own blood vessels, and the abdominal muscle underneath is left in place.
A DIEP flap moves skin and fat from below the navel to the chest to rebuild a breast. Surgeons trace the small vessel supplying that tissue through the abdominal muscle, tease it free without cutting the muscle, then join it to vessels near the breastbone or armpit under a microscope.
Skin and fat across the lower abdomen are supplied by vessels that rise from a deeper artery, pass through the straight abdominal muscle and fan out beneath the skin. In a DIEP flap the surgeon opens the sheath, follows one or two of those vessels through the muscle fibres and frees them without removing muscle. The whole apron of tissue below the navel can then travel on that single supply.
At the chest the tissue is shaped into a breast mound and its artery and vein are joined to vessels near the breastbone. Since it is living fat and skin rather than an implant, the rebuilt breast is soft, changes with weight and ages alongside the other side. No implant is needed, so there is nothing to replace later.
The abdomen is closed like a tummy tightening operation. A long low scar remains, the navel is brought out through a new opening, and the area below the scar stays numb for a long period. Women who have had extensive previous abdominal surgery, or who have little spare tissue, may be better served by another donor site.
It suits women who want a reconstruction built from their own tissue and who have enough spare skin and fat below the navel.
Breast size, abdominal tissue and previous scars are assessed, and a scan often maps the perforating vessels. Marks are drawn while standing so the abdominal scar sits low and level.
Mastectomy is completed, or an old scar is reopened in delayed cases, and the pocket is prepared. Recipient vessels near the breastbone are exposed and checked for good flow.
The abdominal apron is lifted and the chosen perforator is followed through the muscle. Fibres are separated rather than cut, and the vessel is freed down to its origin.
Tissue is moved to the chest and the artery and vein are joined under a microscope. Only when flow is steady is the flap shaped into a breast mound and stitched in.
The abdomen is closed with the navel brought through a new opening, drains are placed, and the position is checked so the scar sits evenly on both sides.
Flap colour and warmth are checked repeatedly. You are nursed slightly bent at the hips to protect the abdominal closure, and gentle leg movement starts early to reduce clot risk.
Drains come out as they settle. Walking becomes easier and more upright, though the abdomen feels tight, and lifting anything heavy is not allowed.
Most women are back to light routine and driving, guided by comfort. Swelling in the breast mound falls, and the abdominal scar is red but flattening.
Shape and softness settle. Nipple reconstruction, tattooing or small adjustments to symmetry can be planned, and numbness below the abdominal scar slowly improves for many.
A rebuilt breast can look natural in clothing and feel soft to touch, yet it is not the same as the breast that was removed. Sensation is usually reduced, the shape is created rather than restored, and matching the other side often takes a second smaller operation. Scars remain on the breast and low across the abdomen. Many women feel more at ease in clothes, which is often the outcome that matters most.
This is major surgery on two areas at once, and both carry their own risks.
The abdomen sets the pace of early recovery, while the breast needs protection rather than effort.
The abdominal improvement is a side effect. This is major reconstructive surgery planned around blood vessels, not a cosmetic contouring operation.
Sensation is usually reduced long term. Some feeling may return at the edges, but the rebuilt breast rarely feels as it did before.
Follow up examinations and imaging continue as planned by the cancer team, and reconstruction does not stop recurrence being detected.
Most women have a smaller second stage for symmetry, nipple reconstruction or minor shaping, planned once swelling has settled.
Elegance Clinic in Surat discusses implant and tissue options side by side, including what each one asks of a woman in the years afterwards. Nothing is booked until the whole sequence, timing and cost are clear.
This page explains a technique, so it does not carry a price of its own. What a reconstruction costs depends on the treatment it belongs to, on whether it happens with mastectomy or later, on theatre time, hospital stay and any second stage for symmetry.
A written estimate follows assessment, and the related treatment page lists the usual band.
These are the questions that come up most often in consultation. If yours is not here, send it on WhatsApp and the team will reply, usually the same day.
Ask your question →Cost follows the treatment rather than the technique. Theatre time, hospital stay, dressings, garments and a possible second stage for symmetry all count. A written estimate is issued after assessment so the whole path is clear beforehand.
It is widely used alongside or after mastectomy. Risks include bleeding, infection, clots and failure of the joined vessels, so fitness, tobacco use and timing with chemotherapy or radiotherapy are all reviewed before surgery is offered.
Recovery can vary. Early days are spent under flap monitoring with limited movement, then walking and daily activity build up over weeks. Lifting restrictions last longer because the abdominal repair needs time to hold.
It usually looks natural in clothing and feels soft, since it is living tissue. Sensation is reduced and the shape is created rather than restored, so symmetry often needs a smaller adjustment later.
Women with little lower abdominal tissue, those who continue to smoke, and those whose earlier abdominal surgery has divided the vessels may need another option. Significant heart or lung disease can also make long surgery unwise.
Sometimes yes, which avoids a second major operation. In other cases it is delayed until radiotherapy is finished and tissues have settled. The cancer team and reconstructive surgeon decide this together with you.
Your examination, tissue availability, previous scars, medicines and tobacco use are reviewed, and vessel imaging may be arranged. Implant alternatives, risks, scars, recovery limits and the written estimate are explained before any decision is made.
Seeing patients from across the city and beyond: read about the practice on the plastic surgeon in Surat page, or check what a written estimate covers on the costs and insurance page.
