DIEP Flap Reconstruction

What is DIEP Flap Reconstruction?

DIEP flap reconstruction is an advanced form of breast reconstruction that uses your own abdominal skin and fat to rebuild the breast after a mastectomy or breast cancer surgery. Unlike traditional methods that use implants, this technique uses a “flap” of tissue from your lower tummy — including its blood vessels — to recreate a natural-feeling breast.

Why Choose DIEP Flap Reconstruction?

Many women choose DIEP flap reconstruction for a more natural result that changes with the body over time and doesn’t require implants. Because the procedure preserves abdominal muscles, it helps maintain core strength and generally offers a quicker recovery than older flap techniques. 

This approach also has the potential “bonus” of a flatter tummy appearance due to the removal of lower abdominal tissue.

What to Expect After Surgery (Recovery & Aftercare)

After surgery most people stay in hospital for several days while the new blood supply is monitored. You’ll have incisions on your abdomen and chest, and drains may be in place temporarily to help reduce swelling. Swelling, bruising and some discomfort are normal in the first few weeks.

You will be advised to wear supportive garments and avoid strenuous exercise or heavy lifting for several weeks. Healing takes time — most women gradually return to normal activities over 6–8 weeks, while full recovery and scar maturation can take several months.

breast reconstruction image

* Previous case photos can be shown in person at a consultation in the clinic. 

How the Procedure Works

The surgery is usually performed under general anaesthetic and takes several hours. Your surgeon removes a flap of skin, fat and its blood vessels from the lower abdomen. Using specialised microvascular surgery, the blood vessels from the flap are reconnected to blood vessels in the chest, allowing the tissue to survive. Once the blood supply is restored, the new breast is shaped and positioned. 

DIEP flap reconstruction can be done at the same time as your mastectomy (immediate reconstruction) or later (delayed reconstruction).

Important Considerations & Long-Term Information

DIEP flap reconstruction is technically complex and takes longer than implant-based reconstruction, but it often provides very natural results. Suitable candidates need sufficient abdominal tissue and good overall health. It may not be recommended if prior abdominal surgery, medical conditions or insufficient donor tissue are present.

Risks include partial or total flap loss (very rare), infection, numbness, abdominal weakness or hernia, and visible scarring at both the chest and abdomen. Your surgeon will discuss all risks tailored to your situation.

Frequently Asked Questions

1How can I prepare for surgery?
This procedure is one not undertaken lightly and in order to reduce the risks of complications and optimise the outcome I recommend my patients have a BMI of 30 or less and are physically fit prior to surgery. Physical exercise such as pilates is helpful before surgery to strengthen your core which will aid a faster recovery.
2What about breast screening?
After a DIEP flap you will not have breast surveillance or screening on the reconstructed breast. The tissue here is from your tummy and it is not helpful to perform mammograms. If you have any lumpiness in the time after your reconstruction please talk to me about it and we may arrange a scan to check the tissue. If you find a lump some time after your surgery i.e. more than 3 months after surgery, I would recommend you see a breast surgeon and this can be arranged by calling your GP or Breast Care Nurse for an urgent review, or by letting me know.
3Where will my scars be?
You will have a long scar across your abdomen running from hip to hip. This is similar to a tummy tuck scar but may need to sit higher due to the location of the tiny blood vessels we need to transplant the tissue. You will also have scars on the breast and the pattern of these varies depending whether you are having an immediate reconstruction with or without nipple preservation i.e. at the same time as a mastectomy, or a delayed reconstruction. Implant registry – all implants are now recorded on a national database called the Breast and Cosmetic Implant Registry (BCIR). This is managed by NHS Digital and entry of your information onto the database is mandatory to allow you to be traced in the event of an issue with your type of implant in the future. For information on the Registry please click here.
4What are the risks of surgery?
The surgery is complex and so there are many risks to consider. The main risk is failure of the flap to survive and my rate of failure is less than 1%. This means there is inadequate blood supply into or out of the tissue we have moved from your tummy to build the new breast. Under these circumstances the reconstruction would be removed. Other risks include significant bleeding and weakness of the tummy wall. All risks will be discussed in clinic and provided in writing for you to consider ahead of your surgery.
5Can this be done at the same time as a mastectomy?
Yes, this surgery can be performed at the same time as a mastectomy. It is called an immediate breast reconstruction. I will liaise with your breast surgeon, and we will perform the surgery together. We will discuss whether you are a candidate to keep your nipple areola complex (this depends on the type and position of your breast cancer) and breast skin and whether the breast size should be altered.
6What is the post-operative recovery?
Your wounds will usually be healed in 2 weeks. Occasionally areas can take up to 6 weeks to heal. You will need to wear your post-surgical bra and underwear day and night for 6 weeks.
7How long does a flap last?
Once your reconstruction has settled (after about 6 months) there will be small changes only. An advantage of using your own tissue to reconstruct the breast is that it will change with you over time although it will behave differently to your native breast. It does not require further surgery or exchange like an implant would, it does not pose any risk to you, and as you change weight it will change with you.
8Is this the right operation for me?
This may be the right operation for you if: - You want a natural breast reconstruction using your own tissue. - You are not eligible for implant based reconstruction. - You have enough resource on the abdomen or thighs. - You can accept the possibility of failure, even if it is below 1 percent. - You are physically fit and have a BMI of under 30. Note common physical conditions do not prevent you from having this surgery. If you are not sure if your medical history is a problem, please ask.

Key Features To Be Aware Of:

  • Surgical time – 6-8 hours
  • Anaesthetic type – General anaesthetic
  • Time off work – 2-4 weeks office work, 6 weeks manual work
  • Hospital stay – 2-3 nights
  • Shower – 72 hours after being discharged
  • Reasonably mobile – 2 days
  • Sleeping position – back for 4 weeks
  • Exercise including gym – 6 weeks
  • Bras – front fastening post-op bra and underwear for 6 weeks day and night
  • Sexual activity – after 4-6 weeks when comfortable
  • Full recovery – 18 months
  • Driving – up to 6 weeks (check with insurer)
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PATIENT TESTIMONIALS

  • 16 May 2024 C.A. Verified patient
    I can not speak highly enough of the care I received under Philippa Jackson. From initial consultation, through surgery, follow up and beyond, my treatment has been exceptional. Any questions/concerns were explained and reassured and my results are far better than expected.
    16 May 2024 C.A. Verified patient
  • 16 May 2024 S.S. Verified patient
    The care I have received from Miss Jackson is faultless. From the first consultation to the ongoing care after the surgery it has been amazing. She is always available to answer any queries I have and made me feel at ease and comfortable throughout.
    16 May 2024 S.S. Verified patient
  • 17 May 2024 J.M. Verified patient
    Exceptional care throughout. Had some complications and was amazed at how many times Ms Jackson insisted on coming in to the hospital daily to insure progress and high standard of post op.
    17 May 2024 J.M. Verified patient
  • 19 May 2024 K.W. Verified patient
    I can't fault Miss Jackson's care, consideration and expertise. Clinical treatment and administration were both excellent.
    19 May 2024 K.W. Verified patient
  • 11 June 2024 E.K. Verified patient
    Philippa is so empathetic, professional and skilled. I felt listened to and knew I was in safe hands. She achieved an incredible outcome with my reconstruction - beyond even my most optimistic expectations. Philippa gave me back ownership of my body and I recognise myself again.
    11 June 2024 E.K. Verified patient
  • 15 November 2024 S.L. Verified patient
    Miss Jackson was just brilliant in my consultation with her. She is compassionate and kind, actively listens and exudes calm professionalism. She laid out my options clearly and didn't try to influence me into a decision that I wasn't ready to make.
    15 November 2024 S.L. Verified patient
  • 30 January 2025 F.L. Verified patient
    Philippa has been absolutely amazing throughout the whole surgery process, from initial consultation, to surgery day and post-op. She explained everything very clearly and was more than happy to speak to me outside of appointments to answer any questions I had.
    30 January 2025 F.L. Verified patient
  • 21 July 2025 A.C. Verified patient
    Extremely informative and thorough, happy to talk through all procedures in detail and great after care. Very happy with surgery results. Thank you.
    21 July 2025 A.C. Verified patient
  • Miss E.S.
    Thank you so much for everything! You have given me confidence in my body that I never had before! I am truly so happy and cannot thank you enough!’.
    Miss E.S.
    Breast Reduction
  • Ms R.S.
    ‘A massive thank you for the amazing work you have done and for the end result. You have given me my confidence back and I cannot thank you enough. You’re an amazing surgeon and I’m glad I listened to your advice. Your kindness, support and knowledge and friendly smile put me at ease on every appointment. I feel like a new woman that can finally wear my summer dresses and go swimming with convince again. A massive, massive thank you’.
    Ms R.S.
    Breast Asymmetry Correction
  • Mrs A.D.
    ‘I just wanted to write a note to say a huge thank you for all your work on my reconstruction. Even though the journey was sometimes hard, you have always been so positive and supportive. Your skill is not only in the technical side of surgery but also in the psychological support and guidance you offer. The results of my surgeries are both physical and emotional - I am more confident and so pleased with the outcome. Thank you for all that you’ve done’.
    Mrs A.D.
    Breast Cancer Reconstruction

Further information on Miss Jackson's work and independent testimonials can be found on her TopDoctors profile.