DIEP flap surgery is an example of an abdominal wall flap procedure. The DIEP (deep inferior epigastric perforator) flap is named after the blood artery that goes through the abdominal muscle.

Surgeons must make a small incision in the layer covering the abdominal muscle to remove the blood vessels circulating within it.

This operation is classified as a muscle-preserving technique since surgeons do not remove any muscle, resulting in a quick recovery and a lesser chance of muscular weakening. The procedure is comparable to a free muscle-sparing TRAM (MS-TRAM) flap, with the exception that surgeons must employ a tiny portion of muscle during MS-TRAM surgeries.

What to expect with DIEP flap surgery 
During a DIEP flap procedure, surgeons use the same skin and fat as they would in a TRAM flap. Instead of removing the same muscle, doctors remove only the blood artery that supplies the skin and fat while leaving the muscle intact, which retains abdominal wall strength. Using microsurgery, surgeons join the flap's tiny blood vessels to the blood vessels in the chest. Surgeons use a separate incision to alter the navel.

DIEP flap surgery takes about six to eight hours. Following it, your abdomen appears flatter and feels tighter, as if you had a tummy tuck. The abdominal incision for DIEP flap surgery results in a horizontal scar that runs from one hip to the other and is about one-third of the way up between the top of your pubic hair and your navel, usually beneath your bikini line.

Sometimes the blood vessels that surgeons need to employ in DIEP flap surgeries are not all in the same line in the abdominal muscle. Surgeons may need to use many veins situated throughout the muscle. Rather than cutting through the muscle, doctors may separate one of the veins, loop it around the intervening muscle, and reattach it again. Some surgeons call this approach the APEX (abdominal perforator exchange) flap operation.

Not all breast reconstruction surgeons perform DIEP flap surgery, and the procedure is not routinely available in hospitals. Ask your cancer care team to refer you to plastic surgeons who specialize in DIEP flap repair, especially if your surgeon suggests TRAM flap surgery and you are concerned about the risk and potential complications.

By the way, if you are looking for a surgeon for DIEP flap surgery, you may try searching "DIEP flap surgeons near me".

Recovery from DIEP flap reconstruction
DIEP flap surgery necessitates a hospital stay of approximately five days. Recovery time might range from six to eight weeks.

Keep the area clean, dry, and safe, and follow your surgical team's recommendations for when to begin walking stretching exercises, and regular daily activities. As with any abdominal surgery, sitting or standing up from a sitting position at first may be difficult or unpleasant. It may also be difficult to get into and out of bed. Your doctor or physical therapist can demonstrate how to move as you heal.

Because you have had surgery on two separate sections of your body (your chest and your belly), you may feel worse than someone who has only had a mastectomy, and your recovery time may be longer. You'll have many incisions on your breast, lower abdomen, and around your belly button, as well as drains in your reconstructed breast and abdominal donor site. If you have axillary nodes removed during this procedure, you may have an additional incision under your arm.

If you are in significant pain, notify your surgical team and ask them what medications you can take.

DIEP flap risks and complications 
As with any surgical technique, DIEP flap reconstruction surgery carries the risk of necrosis, fat necrosis, hernia, and muscular weakening. DIEP flaps have a substantially lower risk of hernia than any other type of TRAM flap because they do not need surgeons to use any muscle to reconstruct the breast. However, any abdominal operation has the risk of a hernia.

DIEP flap surgery may not be right for you if: 
- you do not have enough stomach tissue.
- you've already undergone significant abdominal procedures, such as a colostomy (which connects the big intestine to a hole in the abdominal wall) or a tummy tuck (abdominoplasty).
- your abdominal blood arteries are too tiny or are not in the optimal location for a DIEP flap.

It may take a year or more for your tissue to fully recover and your scars to vanish.