DIEP Flap St. Louis - Breast Reconstruction Technique Missouri

Candidates for this procedure include patients who are having or have had a mastectomy or are unhappy with a previous expander/implant reconstruction. Patients with previous radiation are also excellent candidates for this procedure.

In this procedure, a woman’s own abdominal tissue is used to reconstruct the breast. This is the most natural appearing and natural feeling breast reconstruction available. Women who have had this procedure describe the breast as “their own” as opposed to an implant based reconstruction.

The abdominal tissue from the lower abdomen is transferred microsurgically up into the breast. The abdominal wall is entered, but the rectus (“six-pack”) muscle is preserved. This is in contrast to a conventional TRAM or a free muscle – sparing TRAM. The blood vessels which sustain the skin and fat of the abdomen are removed and transferred along with the skin and fat of the abdomen. These vessels are then reattached to blood vessels in the chest to sustain blood flow to the skin and fat flap. If you are having a double or bilateral mastectomy, half of each abdomen is used for each breast.

The area on the abdomen from which the abdominal wall is entered is closed, occasionally with mesh reinforcement, and the belly button/umbilicus is preserved and transposed to a new position after the remaining skin of the abdomen is stretched down. This is much like a tummy tuck with the exception being that the abdominal muscles are not tightened as in a tummy tuck.

The advantage of this operation versus a conventional TRAM or free muscle – sparing TRAM is that there is less abdominal wall morbidity in that the abdominal muscles are preserved. Also, the blood flow is more robust to the skin and fat as opposed to a conventional TRAM. The disadvantage of this operation is that the entire flap may fail (turn blue/purple) and need to be removed. A different type of reconstruction will then need to be done.

A breast lift or breast reduction may be needed on the other breast in order to improve symmetry. A new nipple can be made and areolar tattooing can be done if desired in the case of mastectomy.

Dr. Cabbabe incorporates his experience with reconstructive and cosmetic surgery of the breast to give his patients the best results possible to meet their desires. He is an expert in cosmetic, reconstructive and minimally invasive breast surgery. During your consultation, Dr. Cabbabe will carefully examine you and will make recommendations in order to help you achieve your desired result.

We believe that patients, their desires, and anatomy are all unique. Dr. Cabbabe believes that the key to a successful surgery is proper planning and discussion with the patient about their goals. Therefore, Dr. Cabbabe evaluates each patient and creates a customized surgical plan for all of his patients to meet their expectations. To schedule a consultation, call us at 314-842-5885 or complete the contact us form.

Good candidates for this surgery are women patients who are having or have had a mastectomy or are unhappy with a previous expander/implant reconstruction. Patients with previous radiation are also excellent candidates for this procedure.

Poor candidates for this surgery are women who are significantly obese as this may lead to problems with abdominal hernias. Also, patients with previous abdominal surgeries may not be candidates depending on the scars. Finally, women who have little fat on their lower abdomen may not be able to attain the breast size they desire.

Preparing for Surgery

Dr. Cabbabe will ask that you refrain from taking any aspirin, plavix, Coumadin or any other type of blood thinner. If you are taking chemotherapy, this may need to be finished or held prior to surgery.


You will be admitted to the hospital for two to four nights. Pain medication and antibiotics will be prescribed. Dr. Cabbabe and the nursing staff will continually monitor the tissue flap. You will take aspirin daily for up to 6 weeks and be asked to avoid caffeinated beverages for a couple of weeks. There may be some numbness on the breast and abdomen which improve with time. Most patients are able to shower within 24 hours. Drains will be placed inside the breast and in the abdomen. Recovery is approximately 3 to 6 weeks.

Types of Reconstruction: