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DIEP Flap Breast Reconstruction

DIEP Flap Surgery is considered to be a type of breast reconstruction and not necessarily cosmetic surgery. Our surgeons remove blood vessels and skin from a patient’s lower abdomen and transfer it to the chest in order to reconstruct a breast after a mastectomy.

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The Deep Inferior Epigastric Perforator (DIEP) flap is the procedure of choice for breast reconstruction using the patient’s own tissue. Despite its versatility and excellent cosmetic results, the DIEP flap may not be ideal in patients with history of a tummy tuck or abdominal hernia repair. Also very thin patients may not qualify. Other reconstruction techniques will be recommended for patients who do not qualify. 


This technique utilizes the lower abdominal skin and fat to reconstruct the breast. The major benefit is that most patients who come for breast reconstruction will have extra tissue in the abdomen that can be used for breast reconstruction. The patients get  a “tummy tuck,” but instead of throwing that tummy tuck tissue away, our surgeons use it for reconstruction.

Additionally, this technique leaves patients with a tighter and flatter abdomen, in addition to a natural feeling autologous breast reconstruction. Also, this breast reconstruction tends to be soft and supple though somewhat fuller, higher and “perkier” that a natural breast. The reconstruction moves none of the muscle and therefore the patients are left with almost no complications.


The average length of stay following Deep Inferior Epigastric Perforator (DIEP) flap breast reconstruction is two days, due to the fact that no rib or abdominal muscles are taken during the procedure. Moreover, some patients require little or no narcotics to treat their postoperative pain. This much shorter length of possible stay is significantly advantageous for the patients, decreasing the risk of hospital-acquired infections or other issues associated with prolonged hospital stays.

Following the vast experience collected over the past few years, our meticulous techniques permit surgeries with minimal blood losses, thus obviating the need for blood transfusions. In patients who have not undergone chemotherapy, there have been no blood transfusions in over seven years. The patients who have had chemotherapy still maintain a less than 1% transfusion rate with transfusions only necessary in patients with low blood level secondary to chemotherapy. This avoids an entire set of problem that can come with blood transfusion, including immunosuppression, transfusion reactions, and rare contamination with HIV or hepatitis C.

Benefits of DIEP Flap

The procedure can provide:

  • Rebuilt breasts after mastectomy
  • Natural looking and feeling breasts
  • Restored femininity and sexuality

Before & After

Integrity is Key

Integrity in DIEP flap surgery is paramount. As the popularity of the DIEP flap has become more widespread, an unfortunate side note is surgeons stating that they perform a DIEP flap when in reality, they are performing a Transverse Rectus Abdominis Muscle (TRAM) flap. During a TRAM procedure, muscle is removed from the abdomen and the patient is left with a weak spot in the abdominal musculature, resulting in a propensity for bulging and pain.

At My Houston Surgeons, all patients have access to a photograph of the flap showing that no muscle is taken. This is unique amongst other surgeons, as our surgeons can definitely, without a question, guarantee that no muscle will be taken in during this type of flap-based reconstruction.

Further excellence is noted in the fact that no rib is removed during this type of procedure. Many surgeons, when performing flap-based reconstruction, remove a section of the rib in order to attach the vessels that supply the blood to the flap. This, like the removal of the abdominal muscles, leaves the patient with long term pain and deformity of the chest. By avoiding this, patients are left with less pain and almost no long-term problems in the chest. Furthermore, if you have any questions, you can ask your surgeon more about rib removal at your consultation for DIEP flap breast reconstruction.

Why Choose Us?

Dr. Sean Boutros, the senior surgeon at My Houston Surgeons, has been a leader in DIEP flap breast reconstruction. He had presented at national and international meetings about DIEP flap breast reconstruction for many years. He has published numerous papers about the DIEP flap breast reconstruction in both national and international journals. His lead article in the March 2014 plastic and reconstructive surgery is the largest series ever published in DIEP flap. Dr. Boutros has personally performed over 1300 DIEP flaps giving him one of the highest success rates ever reported amongst any surgeon.

Quality Patient Care

Our surgeons along with the supporting staff at the practice provides full support and care for patients right from their initial consultation stage through recovery.

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9230 Katy Freeway, Ste 600

Houston, TX 77055

The Woodlands

9303 Pinecroft, Ste 390

The Wooldands, TX 77080