DIEP Flap Breast Reconstruction

DIEP flap reconstruction rebuilds a breast after mastectomy using skin and fat from your lower abdomen, moved with its own small artery and vein (the deep inferior epigastric perforators) and reconnected to vessels in the chest under a microscope. The abdominal muscle is left in place.

It gives a soft, warm breast that ages and changes weight with you and needs no implant. It is a long operation with a longer recovery than implant reconstruction, and it leaves a hip-to-hip scar.

What DIEP Flap Breast Reconstruction involves

A CT angiogram before surgery maps the perforating vessels in your abdominal wall. Two teams often work together: one prepares the chest and exposes the internal mammary vessels behind a rib cartilage, while the other raises an ellipse of lower abdominal skin and fat and traces one to three perforators down through the rectus muscle, splitting rather than removing it. The flap is detached, moved to the chest and its artery and vein, each 2 to 3 mm wide, are joined with sutures finer than a hair. The flap is shaped into a breast, and the abdomen is closed as in a tummy tuck with the navel repositioned. Drains are placed in both sites.

Who is a good candidate for DIEP Flap Breast Reconstruction?

You need enough lower abdominal tissue and to be fit for 6 to 10 hours of anaesthesia.

• Women having or who have had mastectomy who prefer their own tissue
• Previous chest wall radiotherapy, where implants have high complication rates
• Failed or painful implant reconstruction
• Enough spare tissue on the lower abdomen
• Non-smokers in good general health
• Both breasts reconstructed at once using half the abdomen for each side

It is usually not the right choice if:

• Very slim women with too little abdominal fat
• A previous tummy tuck, or some earlier abdominal operations that cut the vessels
• Active smokers, who have much higher rates of wound and flap problems
• Severe obesity, uncontrolled diabetes or clotting disorders
• Women who want the shortest operation and recovery

Technique options

• Immediate reconstruction: Done at the same operation as mastectomy, preserving breast skin.
• Delayed reconstruction: Months or years later, commonly after radiotherapy is completed.
• SIEA flap: Uses superficial vessels without opening the muscle sheath, when those vessels are large enough.
• Muscle-sparing TRAM: Takes a small cuff of muscle when the perforators are poor.
• Thigh or buttock flaps (PAP, TUG, SGAP): Alternatives when the abdomen cannot be used.

What happens during your treatment

Surgery takes 6 to 8 hours for one side and 8 to 12 hours for both, under general anaesthetic. For the first 48 to 72 hours nurses check the flap hourly for colour, warmth and Doppler signal, because a blocked vessel must go back to theatre within hours. You stay 4 to 7 nights, kept warm and well hydrated, with a urinary catheter and drains.

Preparing for your trip

Plan for 3 weeks in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

Recovery and results

You walk slightly bent for the first week or two to protect the abdominal closure. Drains come out after 5 to 10 days. Expect 4 to 6 weeks off work and no heavy lifting or abdominal exercise for 6 to 8 weeks. Wear a supportive bra and an abdominal binder. Nipple reconstruction, tattooing, fat grafting and balancing surgery to the other breast follow from about 3 to 6 months.

• Back to everyday activity: 4 to 6 weeks off work; 3 months to full activity
• When results show: Shape at once; final result after revisions at 6 to 12 months
• How long they last: Lifelong; no implant to replace

Safety, risks and revision policy

Most flaps succeed, but this is major microsurgery and complications do occur.

• Complete flap loss in roughly 1 to 3 in 100 cases, with a higher rate of urgent return to theatre to rescue the blood supply
• Partial fat necrosis, felt as firm lumps
• Slow healing or wound breakdown on the abdomen or breast
• Abdominal bulge or weakness, less common than with muscle-removing flaps
• Seroma, bleeding and infection
• Blood clots in the legs or lungs
• Numbness of the new breast and lower abdomen
• Asymmetry needing revision

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of DIEP Flap Breast Reconstruction in Türkiye

Clinic-Y does not publish a single price for DIEP Flap Breast Reconstruction, because the honest figure depends on your case. What moves it:

• One breast or both
• Immediate reconstruction with mastectomy versus delayed
• Length of stay including high-dependency monitoring
• CT angiography and the two-surgeon microsurgical team
• Later stages: nipple, fat grafting and symmetry surgery

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions