Deep inferior epigastric perforator flap

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The deep inferior epigastric perforator flap is a tissue flap that is typically used in plastic surgery for reconstruction of the female breast . Also in German literature is as an alternative name DIEP Flap (Engl. D eep I nferior E pigastric P erforator) common. This reconstruction technique was first described in 1989 by Koshima and Soeda.

In this method, tissue from the lower abdomen, consisting of skin and subcutaneous fat, serves as a donor for breast reconstruction. In contrast to the TRAM flap , no abdominal muscle tissue is integrated into the graft when the DIEP is lifted. Blood vessels are prepared that emanate from the deep epigastric vessels (Vasa epigastricae profundae) and perforate the straight abdominal muscle.

In a flap transplant, skin and subcutaneous fatty tissue is removed from the lower abdomen. The blood vessels of the transplant are microsurgically connected to blood vessels in the chest area (arteria and vena thoracica or mammaria interna). This ensures the blood flow to the patient's own tissue. A natural breast shape is modeled from the transplanted tissue.

After the healing process is complete, the plastic reconstruction of the nipple (e.g. star-flap) and areola (through full-thickness skin transplantation e.g. from the upper eyelids, blepharoplasty) can take place in further steps . The reconstruction of the breast with own tissue enables a cosmetically optimal result. Patients are spared the implantation of silicone prostheses, which have to be replaced after approx. 10 to 15 years. Due to the demanding surgical technique, this method is only performed by a few trained plastic surgeons , despite its advantages .

Individual evidence

  1. ↑ A. Berger et al .: Plastic Surgery: Mamma, Stamm, Genitale Volume 3 of Modern Plastic Surgery in four volumes . Springer, 2006, ISBN 3-540-00143-3 , pp. 199ff., Books.google.de
  2. ↑ J. Jähne et al .: What's new in surgery? Annual volume 2010: Reports on surgical advanced and advanced training . Hüthig Jehle Rehm Verlag, 2010, ISBN 3-609-76985-8 , p. 422, books.google.de
  3. ↑ I. Koshima et al .: Inferior epigastric artery skin flap without rectus abdominis muscle. In: Br J Plast Surg , 1989; 42, pp. 645-648, PMID 2605399
  4. ↑ M. Pierre et al .: Update on Breast Reconstruction Using Free TRAM, DIEP, and SIEA Flaps . In: Semin Plast Surg. 2004 May; 18 (2), pp. 97-104, PMC 2884730 (free full text)