DIEP Flap

  • The DIEP (Deep Inferior Epigastic Perforator) Flap is one of the most advanced operations. Expert execution requires exceptional microvascular surgical skill to perform safely and effectively.
  • Dr. Rad is one of only 5% of plastic surgeons worldwide, and one of a handful in the northern VA and DC area, who has the technical expertise to perform this flap routinely and safely. For this reason, Dr. Rad treats many patients for whom traditional reconstructive procedures have failed.
  • For tissue reconstruction, the DIEP Flap is the gold standard because, unlike the TRAM flap, it spares the abdominal muscles which are important for core stability.

Recommended Procedures

  • The best DIEP Flap candidates:
    • have plentiful abdominal fat
    • do not want, or can not have (due to healing problems), implant reconstruction
    • want their breasts to be rebuilt with their own healthy tissue
  • Dr. Rad works with the cancer surgeon to minimize scars and to hide them in concealed areas such as the natural under-fold of the breast.  Dr. Rad often collaborates with his wife and Board certified dermatologist, Dr. Noëlle Sherber, to perform Laser Scar Therapy to fade and soften scars. 

Other Options

  • Implant Reconstruction is the most popular option owing to the ease of recovery and simplicity of surgery; however, implant reconstruction often is not a good option due to scar tissue problems caused by prior breast radiation.
  • DIEP Flap Reconstruction is the gold standard in tissue reconstruction as it spares critically important core abdominal muscles (unlike the outdated TRAM flap) with the results of Abdominoplasty as a benefit.
  • Dr. Rad performs Corrective Reconstruction for many women who have had botched breast reconstruction by other surgeons.
  • Lumpectomy Reconstruction with Oncoplasty is a win-win as the benefits of a Breast Lift far outweigh the downsides.
Staged Reconstruction
  • Stage 1: A Tissue Expander (TE) is placed at the time of a mastectomy. A TE acts as a spacer to hold the breast shape until stage 2. A TE is necessary when we don't know whether patients will need radiation treatment because it depends on the results of the sentinel lymph node biopsy. If radiation is needed then the TE maintains breast shape during treatment and damage to the DIEP flap is avoided. 
  • Stage 2: After a healing period (lasting several months, depending on whether radiation is needed), the tissue expander is removed and DIEP flap reconstruction is performed. Damaged tissue from radiation is replaced by healthy DIEP flap tissue. This is Dr. Rad's preferred method for reconstruction when radiation has been performed.
  • Stage 3: An outpatient touch-up procedure is usually (but not always) necessary to achieve symmetry – this can involve scar revision, fat grafting for volume and contour improvement, nipple reconstruction (if necessary), and/or breast lift on the normal side for unilateral reconstruction.

Safety

  • Breast reconstruction is safe and is performed under general anesthesia and a short 3 hospitalization is standard for DIEP flap surgery.
  • Dr. Rad works with board certified anesthesiologists and performs surgery at the top hospitals in the region.

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Patient Focus

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Photos are of patients who have given explicit written agreement to have them displayed. For patient privacy reasons, the majority of Dr. Rad's patients prefer their before/after photos to remain off-line. However, Dr. Rad will be happy to show you, in the setting of a confidential consultation, a series of before/after photos, not displayed here, to address your specific concerns.

Breast Aesthetics a front view of ample, symmetrical breasts in a deep cut black V-neck shirt

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Face Aesthetics - Dr. Rad with surgical binoculars and scrubs, preparing patient for surgery

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Body Contouring Before & After

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