DIEP stands for the Deep Inferior Epigastric Perforator flap. This block of tissue is based upon the main blood vessel which supplies vessels to the rectus abdominis muscle. This flap has become popular for breast reconstruction as the block of tissue that is transplanted to reconstruct the breast is the same tissue that is removed for a “tummy tuck.” The main advantage of this procedure is that it leaves the muscle mainly intact and only uses the tissue that is required for the reconstruction, mainly the skin and fat. In this procedure, extremely fine and delicate dissection is performed to preserve the very small blood vessels which connect the skin and fat through the muscle, then finally to the main blood vessel –the deep inferior epigastric artery and vein, which then connects to the external iliac artery.
Shown above is a DIEP flap that was harvested for a recent breast reconstruction case. The 3 photos show the Flap still connected to the rectus muscle, and then the flap detached and ready for transplantation. (Surgeons- Drs. C. Lee and S. Hansen, San Francisco)