[2] Many women who undergo this form of reconstruction enjoy the added benefit of a flatter abdomen with results that mimic a “tummy tuck” procedure.
It is a more complicated operation than other autologous or alloplastic options, but provides significantly better cosmetic results, which means better psychological outcomes and with a lower risk of reconstruction failure.
[4] Recent advances in preoperative imaging of the blood vessels in the abdomen (using CT or MRI scans), operative time and complication rates can be reduced in DIEP flap breast reconstruction.
Usually there is no long term follow-up surgery required in the future as may be the case with silicone implants, however patients may require a longer hospital stay at the time of the operation to monitor the flap in the immediate post-operative phase where those receiving implants can sometimes be done as a day case.
[7] Compared to a standard tummy tuck where excess abdominal skin and fat are removed, the DIEP flap procedure involves a longer recovery time as significant surgery is performed to the 2 vertical abdominal Rectus muscles in the process of careful "scratching" and finding the tiny blood vessel or "perforators" required to provide blood supply to the fat tissues.
The reasons for this vary, though wound healing issues and sacrificing nerves seem to be correlated[11] with increased incidence of an abdominal bulge or hernia.
A corrective surgery placing supportive mesh can be performed to provide strength to the abdominal wall if needed.
In the case of a single mastectomy, the second breast cannot be rebuilt at a later time with a flap of fat tissue from the belly.
Sensation in the nipples, much of the breast and an area surrounding the tummy tuck scar is significantly less after this operation, as microsurgery is routinely focused on vascular supply leaving the nerves untreated.
[14] Although it is more technically challenging, cutaneous sensation can potentially be restored by identifying and connecting intercostal nerve branches.