Breast Reconstruction with Stacked DIEP Flap
Before undergoing a mastectomy, it is important to discuss whether you want a breast reconstruction with your doctor – and, if so, what type is most appropriate for you. As a modified version of the DIEP flap surgery, the Stacked DIEP flap℠ reconstructs the breast with soft tissue from the lower abdomen. However, where the traditional DIEP flap transfers this tissue as a single flap, the stacked version breaks it up into two separate flaps that are then folded on top of one another to rebuild breast volume. This technique is usually recommended when a single flap is simply not feasible because the patient does not have enough tissue or when only a single breast needs to be reconstructed.
Dr. Ravi Tandon performs this procedure at his New Orleans, LA, practice. With a passion for helping women who have recently undergone cancer treatment, Dr. Tandon’s primary goal is to restore the breasts back to a natural appearance so patients can live life with confidence.
Benefits of Stacked DIEP Flap
There are a number of advantages to undergoing this reconstruction technique, including:
- No repeat surgeries: Because the treatment uses your own tissue, the risk of post-surgical complications is significantly reduced. Furthermore, because your own tissue cannot rupture the way that implants can, you do not need to undergo maintenance imaging every few years.
- Reducing need for tissue expanders: Tissue expanders are often used during breast reconstruction to create room for a permanent implant. However, these inflatable implants can be uncomfortable and the process can be tedious. In contrast, the stacked DIEP flap technique eliminates this step entirely.
- Uncompromised abdominal muscle: Dr. Tandon can remove fat from your lower abdomen without undermining the muscles of the abdominal wall or placing an artificial mesh. Patients who undergo a stacked DIEP flap procedure can consequently maintain core strength.
Who Is an Ideal Candidate for Stacked DIEP Flap?
The best candidates are typically women preparing to undergo or who have recently undergone mastectomy of one breast and are interested in reconstruction. As a modified version of the DIEP flap technique, it requires less belly tissue than the traditional DIEP flap. Consequently, it is most often recommended to patients who do not have enough soft tissue on their lower belly for the traditional option or who have a pre-existing midline scar on their abdomen from previous surgery.
Patients who undergo a stacked DIEP flap procedure are better able to maintain core strength.
However, it is not a good fit for every patient. In particular, women who need to have both breasts reconstructed will need to consider alternative procedures. Other disqualifying conditions include:
- Certain abdominal surgeries, such as a colostomy or abdominoplasty
- Small abdominal blood vessels
Procedure and Recovery
Your procedure will begin with the administration of anesthesia by a certified anesthesiologist. During surgery, fat tissue, skin, and blood vessels are removed from the wall of your lower belly and transplanted to your chest. Like the standard DIEP flap, the stacked DIEP flap procedure has a much lower rate of complications compared to surgeries affecting the abdominal muscle, such as the TRAM flap procedure.
What to Expect During Recovery
Although this procedure is not as invasive as other options for breast reconstruction, you can still expect a lengthy healing process. In the days after surgery, be prepared for:
- Swelling and bruising (which should subside within a few weeks)
- Incision lines (which usually fade after one year)
- Discomfort and soreness
- Numbness or tingling near surgical area
After surgery, you will receive a detailed and customized recovery plan. It is generally advised to avoid strenuous activity for four to six weeks after surgery. Pain medication may interfere with your ability to drive safely, so be sure to arrange for someone else to drive you as necessary.