The Deep Inferior Epigastric Artery Perforator (DIEP) flap was developed to reduce the complications associated with its predecessor, the TRAM flap. These earlier flaps harvested from the patient’s abdominal wall often left women with bulges, weakness, or hernias. When a DIEP flap is performed we attempt to preserve all nerves to the underlying muscle, all or nearly all the muscle, and all the fascia that covers the muscle. Since the fascia is preserved we rarely if ever use mesh when we close the abdominal wall. In addition to having far fewer complications from harvesting the tissue from the abdominal wall, recovery from DIEP flap surgery is quicker than TRAM flap surgery. Patients leave the hospital sooner, drive sooner, and are back to work quicker.
Dr. Duffy was the first surgeon in Dallas to perform DIEP flap breast reconstruction in 1998. He learned from other surgeons and at international meetings and courses as the technique was not being done in Boston when he trained. He often talks about the durability of the breast reconstruction and using the patient’s own tissue is always the most durable approach. Many patients are not candidates for a variety of reasons but he will always recommend this as the best option if patients are candidates.