You may have had or are about to have a mastectomy, either because you’ve been diagnosed with breast cancer or are at very high risk of developing it in the future. If so, your doctor may have told you about options to rebuild your breast or breasts — a surgery called breast reconstruction. Typically, breast reconstruction takes place during or soon after mastectomy, and in some cases, lumpectomy. Breast reconstruction also can be done many months or even years after mastectomy or lumpectomy. During reconstruction, a plastic surgeon creates a breast shape using an artificial implant (implant reconstruction), a flap of tissue from another place on your body (autologous reconstruction), or both.

Whatever your age, relationship status, sexual activity, or orientation, you can't predict how you will react to losing a breast. It’s normal to feel anxious, uncertain, sad, and mournful about giving up a part of your body that was one of the hallmarks of becoming a woman: a significant part of your sexuality, what made you look good in clothes, how you might have fed your babies. Moving forward, you now have the opportunity to determine what you want to have happen next. But first you must do some careful thinking and delving into your feelings in order to figure out what is best for you. It's also important to know that while breast reconstruction rebuilds the shape of the breast, it doesn't restore sensation to the breast or the nipple. Over time, the skin over the reconstructed breast can become more sensitive to touch, but it won't be exactly the same as it was before surgery.

Breast reconstruction Types

Broadly there are two types of reconstruction, one is autologous meaning that your own tissues are used to reconstruct the breast and the other is implant based reconstruction where either a fixed volume implant or tissue expander is placed under your tissues. Going ahead with implant based or Autologous based reconstruction is dependant on patient choice. It also depends on the patients body habitus; some patients will not have enough donor tissue to reconstruct the breast.

Here we describe the use of the DIEP flap in breast reconstruction.

DIEP Flap

DIEP stands for "Deep Inferior Epigastric Perforator flap", and is tissue that is taken from the abdomen with its blood supply to reconstruct the breast. This is a long microsurgical procedure that can take up to 6 - 8 hours. However its advantages include replacing like with like tissues that have same consistency and feel as the native breast. Furthermore the tissues will change as the patients body gains or loses weight. In contrast to a breast implant reconstruction that may eventually need replacing as it is a foreign body.