07539 710 740 / 07740 306 144

|

Mon – Sat: 9:00 am – 6:00 pm

Follow Us

NATURAL. YOURS. PERMANENT.

DIEP & Free Flap Surgery

Advanced microsurgical breast reconstruction using your own tissue — creating a breast mound that moves, ages and feels like a natural part of your body, with no implant required.

ABOUT THIS PROCEDURE

A Breast Built From Your Own Body

DIEP (Deep Inferior Epigastric Perforator) flap surgery is one of the most technically advanced breast reconstruction procedures available. It uses skin, fat and blood vessels harvested from the lower abdomen to rebuild the breast — without sacrificing the underlying abdominal muscle. The result is a soft, natural breast mound that integrates fully with your body over time.

Free flap procedures represent the gold standard in reconstructive microsurgery. They are used for patients rebuilding after mastectomy, and for those with significant tissue loss or damage resulting from trauma, injury, or failed previous reconstruction. The transplanted tissue is microsurgically connected to blood vessels in the chest, restoring circulation and allowing the new breast to live and function as part of you.

Reconstruction can be performed immediately at the time of mastectomy, or delayed until a later point — depending on your oncology treatment plan, your anatomy, and your readiness. The procedure may be completed in one stage or across multiple stages tailored to your goals and recovery.

UNDERSTANDING THE DIFFERENCE

How DIEP Flap Differs From Other Reconstruction Methods

DIEP vs Implant Reconstruction: Implants rebuild the breast using a silicone prosthesis. DIEP uses your own living tissue, producing a result that is softer, responds naturally to weight changes, and carries no risk of capsular contracture or implant failure.

DIEP vs TRAM Flap: Both use abdominal tissue, but TRAM flap surgery sacrifices the rectus abdominis muscle. DIEP spares the muscle entirely by isolating only the perforator blood vessels — preserving core strength and dramatically reducing the risk of abdominal weakness or hernia post-operatively.

DIEP Flap Advantages

  • No silicone implant — your own living tissue only
  • Abdominal muscle fully preserved (unlike TRAM flap)
  • Result ages naturally — no revision required for implant failure
  • Softer, warmer, more natural feel than implant reconstruction
  • Flatter abdomen as a secondary benefit of donor site harvest

PROCEDURE AT A GLANCE

What DIEP Flap Surgery Involves

Key procedure parameters to know before your consultation.

8 Hours

Surgery Time

General

Anaesthesia

3–5 Days

Hospital Stay

Yes

Drains Required

6 Weeks

Post-Op Garments

The exact surgical approach — augmentation, reduction, lift or combination — is determined at consultation based on your individual anatomy and goals.

RECOVERY TIMELINE

Recovery After DIEP Flap Surgery

Weeks 1–2

Hospital Discharge & Close Monitoring

Following discharge, you are seen at your first and second week appointments. Drains are managed, the flap is monitored closely, and any early concerns are addressed immediately. Rest is essential during this period.

Weeks 2–3

Return to Light Activity

Most patients can return to desk-based or light work within 2–3 weeks of discharge. The abdominal binder and supporting garment continue to be worn. Driving and lifting remain restricted at this stage.

Weeks 4–6

Moderate Activity Resumes

Energy improves and moderately physical work can resume. The reconstructed breast and abdominal donor site continue to heal. Garments are worn until the six-week mark as directed.

Weeks 8–12

Full Physical Return

Strenuous exercise and heavy lifting can be resumed from 8–12 weeks, guided by your surgeon’s assessment. The reconstructed breast continues to soften and settle into its final shape over 6–12 months.

WHAT TO EXPECT

Results That Look and Feel Natural

DIEP flap reconstruction consistently produces some of the most natural and durable results in reconstructive breast surgery. Here is what most patients experience:

  • A soft, warm breast mound that moves naturally with your body
  • No implant and no foreign material — the tissue is entirely your own
  • An abdomen that is flatter, often with a scar similar to a tummy tuck
  • Results that age naturally alongside the rest of your body
  • Long-lasting reconstruction with no requirement for replacement procedures

WHY DIEP FLAP

Why Patients Choose DIEP Flap Reconstruction

No Implant, No Foreign Material

DIEP flap uses only your own tissue. There is no silicone, no expander, and no risk of implant-related complications such as capsular contracture or implant failure over time.

Muscle Preserved Entirely

Unlike older TRAM flap procedures, DIEP surgery leaves the abdominal muscle completely intact. This preserves core strength and significantly reduces the risk of abdominal weakness or hernia after surgery.

Ages With Your Body

Because the reconstructed breast is made from living tissue, it responds to weight changes and ageing in the same way as the natural breast — maintaining proportion and symmetry over the long term.

A Flatter Abdomen as a By-Product

Harvesting the donor tissue from the lower abdomen results in an abdomen that is often noticeably flatter after surgery — an additional benefit for many patients alongside the primary reconstruction.

THE DONOR SITE

What Happens to Your Abdomen After Surgery?

Understanding the abdominal donor site is one of the most common questions patients have.

THE SCAR

Discreet & Positioned Low

A horizontal scar is left across the lower abdomen. It is positioned low — typically at or below the bikini line — so that it is concealed by underwear and swimwear. The scar matures and fades significantly over 12–18 months.

THE MUSCLE

Core Strength Fully Preserved

The defining feature of DIEP over older techniques is complete muscle preservation. The rectus abdominis muscle is left entirely untouched — only the perforating blood vessels passing through it are used. This protects your core strength and minimises the risk of abdominal hernia or weakness.

THE SHAPE

A Noticeably Flatter Abdomen

Removing the abdominal fat used for reconstruction leaves the donor area noticeably flatter. The result is similar in effect to an abdominoplasty — many patients regard this as one of the most welcome and unexpected benefits of DIEP surgery.

PATIENT STORIES

In Their Own Words


The DIEP reconstruction gave me a breast that truly feels like my own. I had worried about the length of the operation, but the result was worth every moment of recovery.

— H.L.


Prof. Hindocha explained every detail before surgery. The outcome has exceeded everything I hoped for — soft, natural, and symmetrical. I feel whole again.

— K.P.


Having a flatter stomach as a side effect was something nobody told me to expect. The whole experience, from consultation to recovery, was handled with such care.

— F.N.

SPECIALIST MICROSURGERY

“DIEP flap surgery is one of the most technically demanding procedures in reconstructive surgery. The outcome depends entirely on the precision and experience of the surgeon performing it.”

Why Microsurgical Expertise Makes the Difference

DIEP flap surgery requires the surgeon to map, harvest, and microsurgically re-anastomose blood vessels smaller than 1–2 millimetres in diameter. This level of precision demands specialist training that goes beyond general plastic surgery — it is the domain of dedicated reconstructive microsurgeons.

Prof. Hindocha brings extensive experience in free flap and perforator flap reconstruction, including complex revision cases and patients who have had previous abdominal surgery. Every DIEP procedure begins with careful pre-operative vessel mapping to plan the safest and most efficient harvest before a single incision is made.

  • Pre-operative perforator vessel mapping for every case
  • Specialist microsurgical training and extensive flap experience
  • Complex revision and secondary reconstruction cases accepted
  • Dedicated reconstructive team throughout surgery and recovery

ARE YOU A CANDIDATE?

Are You a Candidate for DIEP Flap Surgery?

DIEP flap surgery is suitable for many patients seeking breast reconstruction, but it requires a thorough assessment to confirm suitability. You may be a good candidate if you:

  • Have had or are planning a mastectomy for cancer or preventative reasons
  • Have sufficient lower abdominal tissue to serve as a donor site
  • Have not had previous abdominal surgery that may have affected donor vessels
  • Are in good general health and able to tolerate an 8-hour general anaesthetic
  • Are a non-smoker or willing to stop smoking at least 6 weeks before surgery
  • Are at a stable weight and not planning significant weight changes

EXPLORE FURTHER

Other Reconstructive Procedures

Explore the full range of reconstruction options available to you.

RECONSTRUCTIVE SURGERY

Breast Reconstruction

An overview of all reconstruction techniques — your starting point for understanding your options.

RECONSTRUCTIVE SURGERY

Implant Based Reconstruction

Breast reconstruction using silicone implants or tissue expanders.

RECONSTRUCTIVE SURGERY

Trauma Reconstruction

Surgical restoration following injury, accident, or complications from previous surgery.

START YOUR JOURNEY

Take the First Step Towards Reconstruction

A private consultation with no obligation.

DIEP flap surgery requires careful planning, thorough pre-operative assessment, and a surgeon with specialist microsurgical experience. A consultation with Prof. Hindocha is the right place to begin — ask every question and understand exactly what is possible for you.

FREQUENTLY ASKED QUESTIONS

Your DIEP Flap Surgery Questions, Answered

Clear answers to what patients most want to know.

DIEP (Deep Inferior Epigastric Perforator) flap surgery is an advanced microsurgical breast reconstruction technique. It uses skin, fat and blood vessels from the lower abdomen to rebuild the breast following mastectomy — without removing or damaging the abdominal muscle. The harvested tissue is microsurgically reconnected to blood vessels in the chest, where it becomes living tissue that integrates permanently into your body.
DIEP reconstruction uses your own living tissue rather than a silicone implant. The result tends to be softer, more natural in feel, and improves over time as the tissue settles and ages with your body. There is no risk of implant failure or capsular contracture. However, DIEP is a longer, more complex operation and requires sufficient abdominal donor tissue, so not every patient is a suitable candidate.
Yes — a horizontal scar is left on the lower abdomen where the donor tissue was harvested. It is positioned low, typically within or just above the bikini line, and is usually concealed by underwear and swimwear. Most patients find the scar fades significantly over 12–18 months and consider the trade-off very acceptable given the quality of the reconstruction achieved.
DIEP flap surgery typically takes around 8 hours. This reflects the precision required in mapping and harvesting the perforator vessels, performing the microsurgical anastomosis (reconnecting blood vessels), and shaping the new breast. The length of the operation is a mark of its technical complexity — it requires a highly experienced microsurgical team.
Initial results are visible shortly after surgery, but the reconstructed breast continues to settle, soften and take its final shape over 6–12 months as swelling resolves and the tissue integrates. Most patients feel the result reaches its best appearance at around the one-year mark. Nipple reconstruction and any symmetry refinements are typically planned once the main result has stabilised.
Yes — DIEP flap reconstruction is available on the NHS in the UK, though availability varies by hospital and the specialist microsurgical teams who perform it. Some patients choose to pursue private care for greater flexibility over timing, surgeon choice, and a more personalised consultation process. Prof. Hindocha offers DIEP and free flap reconstruction privately.