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Pushing the DIEP Envelope: Where Are We Now?

Chase Clark1, David A Daar2, Ara A Salibian1

  • 1Division of Plastic and Reconstructive Surgery, Davis School of Medicine, University of California, Sacramento, CA 95817, USA.

Journal of Clinical Medicine
|September 13, 2025
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Summary
This summary is machine-generated.

Deep inferior epigastric perforator (DIEP) flap breast reconstruction offers ideal autologous results with minimal donor site issues. Innovations enhance flap volume, perfusion, and patient satisfaction for optimal aesthetic and quality-of-life outcomes.

Keywords:
DIEP flapbreast cancerbreast reconstructionconjoined flapmicrosurgeryresensationrobotic surgery

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Area of Science:

  • Plastic Surgery
  • Reconstructive Surgery
  • Oncology

Background:

  • The deep inferior epigastric perforator (DIEP) flap represents an advancement in autologous breast reconstruction.
  • Minimizing donor site morbidity is a key goal in DIEP flap procedures.

Purpose of the Study:

  • To review the evolution and current status of abdominally-based breast reconstruction using DIEP flaps.
  • To highlight innovations optimizing flap volume, perfusion, and patient outcomes.

Main Methods:

  • Review of innovations in flap design, vasculature, and abdominal anatomy.
  • Analysis of techniques enhancing aesthetic and quality-of-life outcomes.
  • Consideration of mastectomy and recipient site modifications.

Main Results:

  • Improved flap volume and perfusion through alternative designs and modifications.
  • Decreased donor site morbidity and enhanced abdominal outcomes due to better anatomic understanding.
  • Increased patient satisfaction with aesthetics and quality of life via sensory innervation.

Conclusions:

  • DIEP flap breast reconstruction has evolved significantly, offering improved aesthetic and functional results.
  • Ongoing innovations continue to optimize outcomes and minimize complications in abdominally-based reconstruction.
  • Patient-reported outcomes and quality of life are central to the advancement of DIEP flap techniques.