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It has been shown that patient satisfaction is superior in autologous breast reconstruction (using the patients own tissue) when compared to implant based reconstruction (reference). While these microsurgery cases are long and technically demanding, we believe that the benefits of autologous tissue breast reconstruction while preserving abdominal wall integrity makes it well worth our time and effort.


Dr. Theresa Wang and Dr. Samuel Shih are amongst only a handful of surgeons in Georgia that routinely utilize the DIEP and SIEA flaps in breast reconstruction. These techniques utilize the patients’ own abdominal skin and fat to recreate the breasts while sparing the abdominal muscles.




The DIEP flap is the latest modification of the traditional pedicled TRAM procedure. The TRAM was pioneered by Dr. Carl Hartrampf in 1981 and actually originated in Atlanta, Georgia. Since then, there have been several modifications such as free TRAM and muscle sparing TRAM. These modifications have resulted in a flap with a more robust blood supply and less abdominal wall morbidity.


The DIEP flap is a free flap where the abdominal muscles are preserved. Only the skin and fat is utilized in the breast reconstruction thus causing even less abdominal wall morbidity.


The skin and fat is removed from the abdomen via a tummy tuck incision while keeping the blood supply attached via the Deep Inferior Epigastric Vessels. The skin/fat flap is then transplanted to the chest where it is connected to blood vessels using a microscope. The skin and fat is then molded into the shape of a breast.




Due to the nature of free tissue transfers, patients are admitted post-operatively for close monitoring of the flaps. In our experience, patients recover quicker and have less pain than those receiving TRAM flap surgery and tend to ask to go home by day 3.


While we do try to offer the DIEP/SIEA flap to all our patients, there is a selection criteria that we follow that helps minimize potential complications in our patients.

DIEP Procedure (left)

DIEP Results (right)

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