Deep Inferior Epigastric Perforator Flap, or DIEP Flap, is the gold standard for autologous reconstruction, and is the most commonly performed procedure at the New York Center for the Advancement of Breast Reconstruction.

The DIEP flap procedure replaces the skin and soft tissue removed during mastectomy with skin and fatty tissue from the abdomen using sophisticated microsurgical techniques. Because the DIEP flap procedure requires special surgical training as well as expertise in microsurgery, not all surgeons can offer DIEP, and it is not available at all hospitals.

An incision is made in the lower abdomen, and the necessary skin and soft tissue are removed—without touching the abdominal muscles. As a muscle-sparing type of breast reconstruction, DIEP flap has tremendous advantage over other procedures, like the TRAM, which sacrifice major abdominal muscles during surgery. Tiny feeding blood vessels from the donor tissue are matched to supplying vessels at the mastectomy site and microsurgically reattached. Collected tissues and fat are transformed into a new breast mound, followed by the restoration of the nipple and areola.

For many women, the reconstructed breast may be firmer and have a more youthful appearance than their natural breasts. In addition to reconstructing the breast, the contour of the abdomen is often improved following a DIEP flap, much like the results of a tummy tuck.