DIEP Flap
A DIEP (Deep Inferior Epigastric Perforator) free flap is considered the gold standard in autologous breast reconstruction. It uses skin and fat from the lower abdomen—without sacrificing the abdominal muscles—to recreate a soft, natural-looking breast following mastectomy. The tissue is transferred to the chest, where tiny blood vessels are reconnected using advanced microsurgical techniques to restore its blood supply.
Advantages of a DIEP Free Flap
- Natural look and feel – Your reconstructed breast is made from your own living tissue, providing a soft, natural result that changes with your body over time.
- Preserves abdominal muscles – Unlike older techniques, the abdominal muscles are left intact, helping to maintain core strength and reduce the risk of weakness or hernia.
- Long-lasting results – The reconstructed breast is permanent and does not require replacement, unlike breast implants.
- A flatter abdomen – Tissue is taken from the lower abdomen, providing a contour similar to a tummy tuck.
- Lower long-term maintenance – Once healed, there is typically no need for future implant replacement or concerns about implant-related complications.
- Excellent aesthetic outcomes – The breast can be shaped to closely match your natural breast, with the potential for further refinement if needed.
- Improved confidence and wellbeing – Many women value the natural feel and durability of a DIEP flap, helping them feel more like themselves after breast cancer treatment.
Every patient is unique, and a DIEP flap is not suitable for everyone. During your consultation, I will carefully assess your anatomy, medical history and personal goals to determine whether a DIEP flap or another reconstructive option is the best choice for you.
Procedure details at a glance
| Procedure Details | Information |
|---|---|
| Anaesthetic | General anaesthetic |
| Surgery Time | Approximately 6 hours |
| Drains | Yes |
| Hospital Stay | Average 3 nights |
| Recovery Garments | Supportive surgical bra ( front fasting) and abdominal compression garment |
| First Follow-up | 1–2 weeks after surgery |
| Return to Office Work | 2–3 weeks (depending on recovery and job demands) |
| Return to Driving | Approximately 4 weeks |
| Return to Sport & Exercise | 6 weeks (gradual return as advised) |
| Places performed | HCA London Bridge / St Thomas’ Hospital (Guy’s and St Thomas’ Specialist Care) |
I personally plan and perform every stage of the procedure, using advanced microsurgical techniques to maximise flap survival while achieving a breast that looks and feels as natural as possible, with balance and harmony in mind.
Planning & imaging
A CT angiogram maps the blood vessels in your abdomen beforehand, so the best perforator vessels for your flap are identified before you reach theatre.
Tissue harvest
Skin and fat are raised from the lower abdomen through a hip-to-hip incision, carefully preserving the underlying abdominal muscles and their nerve supply.
Microsurgical transfer
The tissue is moved to the chest and its tiny blood vessels — often under a millimetre wide — are reconnected to vessels in the chest wall under the operating microscope.
Shaping & closure
The flap is shaped to recreate a natural breast contour, and the abdominal donor site is closed to give a flatter abdominal profile, similar to a tummy tuck.
Who is it for?
Every patient is unique, and a DIEP flap is not suitable for everyone. During your consultation, I will carefully assess your anatomy, medical history and personal goals to determine whether a DIEP flap or another reconstructive option is the best choice for you. You may be a good candidate if you:
Are undergoing, or have had, a mastectomy for breast cancer, or are considering risk-reducing mastectomy
Have sufficient lower abdominal tissue to recreate a natural-looking breast
Would prefer reconstruction using your own tissue rather than an implant
Have not had previous major abdominal surgery that would rule out using this donor site
Are fit for a longer microsurgical operation and the recovery it involves
Before & After
Coming soon
Before-and-after photographs are shared only with each patient’s consent. Examples will be added here in due course — in the meantime, Dr Borges is happy to discuss expected results at your consultation.
As with an abdominoplasty, the donor-site scar runs low across the abdomen, hip to hip, hidden within the underwear line. A second scar sits around the reconstructed breast where the flap is inset. Scars are red and firm at first, then soften and fade over the following 12–18 months — how well they settle depends on your skin type and how you care for them during recovery.
What to expect
A DIEP flap is major surgery, and recovery takes time. Every patient has 24-hour access to advice from my team throughout, and your recovery is monitored closely at each follow-up.
Hospital stay
You will stay in hospital for around 3 nights while the flap is monitored closely to confirm its blood supply is well established.
Weeks 1–2
Rest is the priority. You will wear your recovery garments day and night, and your first follow-up appointment takes place towards the end of this period.
Weeks 2–4
Most patients return to office-based work and are cleared to drive again by around 4 weeks, once movement is comfortable and reaction times have recovered.
From week 6
A gradual return to sport and exercise can begin, building back up over the following weeks as advised at your review.
Risks
As with any surgical procedure, it's essential we discuss the risks together so you're fully informed. While most patients experience no significant complications, potential risks include:
Flap failure
A rare but serious risk specific to free-flap surgery, where the transferred tissue loses its blood supply. Close monitoring after surgery is aimed at catching and addressing this early.
Infection
Superficial infections may occur but are generally treatable with antibiotics.
Bleeding or haematoma
A collection of blood under the skin may occasionally require a return to theatre to drain.
Delayed wound healing
Some areas, particularly the abdominal incision, may take longer to heal than expected.
Scarring
Scars can be lumpy or thicker than expected and may take up to two years to fully settle and fade.
Blood clots
Deep vein thrombosis or pulmonary embolism are serious but rare complications of major surgery.
Every operation is different, so an exact quote follows your first consultation. A price guide is available on request, and many private medical insurers recognise consultant fees for breast reconstruction following cancer — do check your policy or ask about this at consultation.
Book a ConsultationLocations
Consultations and surgery take place at accredited hospitals and clinics across Kent and London, with consultations available in English, Portuguese and Spanish.
Nuffield Health Tunbridge Wells Hospital
Kingswood Road, Tunbridge Wells, Kent, TN2 4UL
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Wells Health, Fordcombe Hospital
Fordcombe Road, Fordcombe, Tunbridge Wells, Kent, TN3 0RD
Google Map →Wells Health, Tunbridge Wells Hospital
Tonbridge Road, Pembury, Tunbridge Wells, Kent, TN2 4QJ
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