New Breast Reconstruction Alternative without Abdominal Muscle Loss
Now women in Colorado may consider the DIEP flap, a permanent surgical reconstruction that does not cause abdominal muscle loss. During DIEP surgery, surgeons remove the layer of fat and skin across the abdomen, similar to a “tummy tuck,” and use it to create a new breast. In contrast to TRAM flap operations (in which the rotated flap remains connected to the abdomen), DIEP flaps are removed entirely, and blood vessels are carefully removed from the abdominal muscles through leading-edge microsurgical techniques. Precisely reconnecting these blood vessels into vessels in the chest provides essential blood flow to the newly reconstructed breast.
Specialized Technical Training Required to Perform the DIEP Flap Procedure
By completely sparing the abdominal muscles, the DIEP is less likely to cause women to lose strength or function afterwards. The closure of abdominal tissue essentially constitutes a “tummy tuck” that most women appreciate as a side benefit, according to Dr. Christopher Williams. But because microsurgery is technically demanding and requires extensive training and expertise, far fewer surgeons perform DIEP flaps than TRAM flap reconstruction. He and Dr. Jeremy Williams have completed highly specialized training in microsurgical reconstruction during their Plastic Surgery residencies at Johns Hopkins Hospital in Baltimore, Maryland, and Dr. Christopher Williams completed additional fellowship training in microsurgical breast reconstruction after residency.
After Lisa researched her options in 2003 she knew she wanted a DIEP procedure, but at that time, only a few surgeons in the world were offering it. “I wanted to have reconstructive surgery after we were done having children, and I wanted the DIEP procedure because I like to be active. Our kids are so young, I wanted to have all my abdominal muscles so I could still do things with them.
Lisa underwent the first stage of DIEP reconstruction at Sky Ridge in January 2009. Two additional follow-up stages will be performed to lift her right breast (to match the left) and to complete the nipple, but Lisa is thrilled with her results so far. “I'm loving it,” Lisa says. “I'm so excited about it, and my muscles are not affected at all.”
Bilateral Mastectomy on the Rise
Despite its complexity and limited numbers of qualified surgeons, breast cancer patients are increasingly requesting DIEP because of its compelling advantages, says Dr. Jeremy Williams. He explains that even though most breast cancers occur in just one breast, many of the women in their practice are choosing to undergo bilateral mastectomies. “This reduces the risk of breast cancer in the second breast by 95%. Patients are making this choice because the reconstructive options are so good, and they want to stay active -- they would rather have a bilateral mastectomy than worry for the rest of their lives,” he explains.