Immediate vs delayed reconstruction?
The immediate reconstruction is the preferred choice by Dr Pouria Moradi, as the reconstruction is done at the same time as the mastectomy. Whereas, the delayed reconstruction is planned for after the mastectomy and radiotherapy.
What is DIEP flap surgery?
The DIEP flap provides the necessary tissue that breast reconstruction requires. The DIEP is the deep inferior epigastric perforator artery that runs through the abdomen.
In DIEP flap surgery, the blood vessels, fat and skin are cut away from the wall of the lower abdomen and used to rebuild the breast. No muscle is removed in the process of a DIEP flap, which makes it a better treatment over the TRAM flap procedure according to Dr Pouria Moradi.
The blood vessels are reattached in your chest through microsurgery and the tissue is stitched up.
The benefit of the DIEP flap is that it also acts as a abdominoplasty to increase the tightness and flatness of the stomach.
What is a breast lift?
The breast lift following a DIEP flap surgical procedure is done to raise the breasts up and reduce sagginess or drooping.
The lift helps to improve the breasts contours, firmness and aesthetics.
What is a nipple reconstruction?
In some cases, the nipple may not have been removed and left intact during the mastectomy, which means no reconstruction is required.
However, for women whose nipples and areola were removed during a mastectomy, they will be looking for nipple reconstruction. Nipple reconstructions can be done through medical tattooing to recreate a lifelike nipple and areola.
For patients who have large nipples, a graft may be taken from the unaffected breast to recreate the nipple on the new breast; this is known as an autologous graft.
Breast Microsurgery Reconstruction Results
Discover how Dr Pouria Moradi's before and afters for breast microsurgery. For more before and afters, please check out Dr Pouria Moradi on Instagram.
Am I a Candidate?
While the DIEP flap breast reconstruction is popular because it doesn't move or cut muscle, which means a shorter recovery time, a DIEP flap isn't for everyone. It's not a good choice for:
- Thin women who don't have enough extra belly tissue. However, there is a newer "stacked" approach that can sometimes work for these women.
- Women who already have had certain abdominal surgeries, including colostomy or abdominoplasty. This does not include midline incisions extending from the belly button to the pubic region or other routine abdominal operations.
- Women whose abdominal blood vessels are small or not in the best location to do a DIEP flap.
You can only take tissue from your abdomen once for breast reconstruction, so if you're thinking about prophylactic removal and reconstruction of the other breast, you may want to make that decision before you decide on reconstruction. If you have DIEP flap reconstruction on one breast and then later need reconstruction on your other breast, you can always have reconstruction with an implant.
Scarring
A DIEP flap does leave a long horizontal scar, from hipbone to hipbone, about one-third of the way between the top of your pubic hair and your navel. In most cases, the scar is below your bikini line. After the skin and fat are removed from your belly, the abdomen is closed.
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How much does the DIEP reconstruction cost?
The procedure is done through the public healthcare system and is absolutely free. You can choose to have the procedure privately, but it will be costly. DIEP surgery is free, this can all be done in the public hospital. Dr Moradi is fortunate enough to work at the Royal Hospital for Women in Sydney which is a hospital dedicated to women. You can pay to have the surgery in a private hospital, the only advantage is having your surgery performed sooner. The DIEP flap procedure requires special surgical training as well as expertise in microsurgery and it's not available at all hospitals. Dr Moradi is a qualified micro-surgeon.
Dr Moradi - Specialist Plastic Surgeon
"I am a consultant plastic, reconstructive and aesthetic surgeon working as a visiting medical officer at Prince of Wales, Royal Women's and Sydney Children's Hospitals, and an associate lecturer at UNSW Medical School.
Having studied medicine at UNSW as a Sam Cracknell Sport and Academic Scholar, I was then awarded Membership of the Royal College of Surgeons of England in 2005 and Fellowship of the Royal Australasian College of Surgeons in Plastic, Reconstructive and Aesthetic surgery."