DIEP Flap Reconstruction in New Jersey

DIEP Surgery in Monmouth County and the Jersey Shore, and West Long Branch NJ

Women who have undergone a lumpectomy or mastectomy can benefit from breast reconstruction surgery. Through this treatment, plastic surgeons use implants or autologous tissue to help women who have faced the scourge of cancer feel whole and confident again. As one of the leading breast reconstruction specialists in Monmouth County NJ, Dr. Rahul Vemula has worked with countless reconstruction patients from Monmouth County areas such as Long Branch, West Long Branch, Eatontown, Rumson, Fairhaven, and Redbank. Many of his patients also travel from surrounding Jersey Shore areas such as Brick, Toms River, Ocean County, Middlesex county, Central New Jersey , and New York City.

Dr. Vemula offers DIEP (deep inferior epigastric artery perforator)  flap reconstruction. This is a type of autologous technique where skin and tissue are taken from the abdomen and then transferred to the chest to reconstruct the new breast(s). Since the rectus abdominis  muscles are spared during DIEP reconstructions, this option has become very popular especially among women who would prefer to use their own natural body tissue instead of implants.

Am I a good candidate for DIEP flap surgery?

You may be a good candidate for DIEP flap reconstruction if:

• You are in good physical shape and can be able to withstand surgery 
• You have undergone a mastectomy, or are planning to undergo one 
• You have disfigurement of the breasts due to an injury, birth defect, radiation, lumpectomy, or mastectomy 
• You have a breast defect, abnormality, or asymmetry and are seeking an aesthetic improvement

Important Considerations

The following factors have a bearing on the surgery and should be considered before you decide to move forward with this procedure:

• Age – Although breast reconstruction surgery can be done at any age, older patients are more likely to have more medical comorbidities that may preclude them from withstanding the longer operative times needed for a DIEP flap. 
• Cancer Treatment – Ongoing cancer treatment can influence the timing of DIEP flap surgery. Dr. Vemula regularly attends Breast Tumor Boards at several area hospitals and discusses timing of surgery with his colleagues such as breast oncologic surgeons, oncologists and radiation oncologists. This multidisciplinary approach ensures optimal and safe outcomes for patients. 
• Anatomical Considerations– In order to have a DIEP flap one must have excess skin and abdominal tissue in the lower abdomen and intact vessels called “perforators.” In order to determine if you are a good candidate for a DIEP flap, and in person examination is needed as well as a CT Angiogram to assess the quality of the perforators. 
• Overall Health – Anyone in interested in DIEP flap must also be in overall good health without any major medical issues and be able to withstand general anesthesia.

How is DIEP Reconstruction Performed?

With DIEP flap reconstruction, Dr Vemula will use microsurgical techniques to excise skin, fat, and associated blood vessels from the lower abdomen without without harming the core muscles. The harvested DIEP flap is then transferred to the chest wall and the blood vessels are reconnected at the mastectomy site using microsurgery. An operating microscope is used to connect blood vessels that are approximately 2 mm in diameter. The stitches that are used to accomplish this are the thickness of a human eyelash.

One of the key advantages of this technique is that the reconstructed breast feels and looks much like a natural breast. In addition, there is an added benefit of removing unwanted skin and fat in the lower abdomen similar to what is done during a tummy tuck. Therefore, the DIEP flap is often nicknamed the “Tummy Tuck” breast reconstruction.

DIEP reconstruction may be performed at the same time as the mastectomy, or at a later date depending on the specific desires of patients as well as oncologic safety.

Unlike many other surgeons in the area, Dr. Vemula’s patients do not go to the ICU after a DIEP flap. Patients are transferred to a private room for a more comfortable recovery and family members are usually allowed to stay overnight. An enhanced Recovery after surgery (ERAS) protocol is used so that patients’ pain is adequately controlled and are usually discharged home within 2-3 days following surgery.