DIEP/SIEA Flap Reconstruction

The DIEP (Deep Inferior Epigastric Perforator)/SIEA (Superficial Inferior Epigastric Artery) Flap is a relatively new reconstructive procedure developed by Dr. Robert Allen, Chief of Plastic and Reconstructive Surgery at the Louisiana State University Health Sciences Center in the early 1990s. This procedure is performed by a limited number of doctors in the United States.

In Sweden this procedure has totally replaced the TRAM Flap procedure that was developed in the 1980s.

In the DIEP/SIEA Flap reconstruction, fat and skin from the abdomen are used to reconstruct the breast, leaving the muscles of the abdomen intact.

The procedure generally takes between six and nine hours and requires a hospital stay of several days. The fat and skin are removed from the donor area and then formed into the shape of a breast on the chest wall.

Expect to take between 4 to 6 weeks off from work following this procedure. Within three or four months, additional surgery can be preformed to create a new areola/nipple complex.

There are the following variations:

* The GAP (gluteal artery perforator) Flap uses skin and fat taken from the buttocks.
* The LTP (lateral thigh perforating vessels) Flap takes skin and fat from the "saddlebag" area of the outer thigh.
* The T-DAP (perforating vessels of the thorocodorsal artery) Flap uses skin and fat from the patient's back.

The doctors who perform this procedure are of the opinion that it produces the same results as the TRAM Flap procedure while maintaining the muscle integrity of the abdomen. Recovery involves less pain because no muscle is used.  Again, this technique is used in only a few areas of the United States and Europe.

We have found the following doctors who do the procedure.  

J. Craig Merrell, M.D., Helena M. Guarda, M.D., and Adam Billet, M.D.
Harbour View Center For Excellence in Plastic and Reconstructive Surgery
5818 Harbour View Blvd., Suite 200
Suffolk, Virginia 23435
Phone: (757) 673-6000
Fax: (757) 673-6007


Chesapeake Center For Excellence in Plastic and Reconstructive Surgery
300 Medical Parkway, Suite 316
Chesapeake, Virginia 23320
Phone: (757) 673-6000
Fax: (757) 673-6007

Alex Keller, M.D.
Suite 130
900 Northern Boulevard
Great Neck NY 11021 5302
Phone: (516) 482-1100
Fax: (516) 482-6863

Robert J. Allen, M.D., F.A.C.S.
Plastic and Reconstructive Surgery
4429 Clara Street, Suite 440
New Orleans, Louisiana 70115
Phone: (504) 894-2900
Fax: (504) 894-2901

Dr. Gary J. Rosenbaum, M.D., P.A.
Mount Sinai Hospital Medical Staff Office Pavillion
4302 Alton Rd, Suite 420
Miami Beach, FL 33140
Phone: (305) 538-7726
Fax: (305) 538-7725

Mercy Health Services
301 St. Paul Place
Baltimore, MD 21202

DIEP Flap is also done at John Hopkins Medical Center
The Johns Hopkins Hospital
600 North Wolfe Street
Baltimore, Maryland 21287

Kamran Khoobehi, M.D.
Advanced Plastic Surgery
4720 I-10 Service Road Suite 403
Metairie, La 70001
(800)854-4445 or (504)779-5538

Dr. Khoobehi states that he averages 3.5 to 4.5 hours in the operating room when doing a DIEP flap.  This time also includes the mastectomy preformed by the general surgeon.  His patients stay in the ICU (Intensive Care Unit) for 24 hours and are generally discharged from the hospital at 3 days post operative.

  • Friday, 15 June 2012