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What You Need to Know

Breast reconstruction after a mastectomy is an important decision for women who have undergone breast cancer treatment. Among the various options available, the deep inferior epigastric perforator (DIEP) flap reconstruction is widely used due to its ability to provide natural-looking and feeling breast reconstruction. However, patients often face a critical choice when considering DIEP flap reconstruction: immediate or delayed reconstruction.

In this article, we explore the key differences between immediate and delayed DIEP flap reconstruction to help you make informed decisions regarding your breast reconstruction.

Immediate DIEP Flap Reconstruction

Immediate DIEP flap reconstruction refers to the breast reconstruction procedure performed at the same time as a mastectomy. During this procedure, the plastic surgeon utilizes your abdominal tissue to create a new breast mound immediately after removing the breast tissue.

Single Surgery, Faster Recovery
One of the primary benefits of immediate DIEP flap reconstruction is that it reduces the number of surgeries required. Patients undergo a single procedure, which can minimize overall recovery time compared to delayed reconstruction, which involves multiple surgeries.

Improved Aesthetic Outcome
Immediate reconstruction allows for better preservation of the breast skin, nipple, and areola, resulting in a more natural-looking breast. This can be particularly important for patients who wish to maintain their breast appearance.

Emotional Benefits
Many women find that immediate DIEP flap reconstruction provides emotional benefits by allowing them to wake up from the mastectomy surgery with a reconstructed breast. This can contribute to improved body image and self-esteem during the recovery process.

Possible Drawbacks:

  • Harder to identify mastectomy skin problems
  • Longer downtime after the procedure than if you only undergo a mastectomy
  • More post-treatment scarring than just a mastectomy

Delayed DIEP Flap Reconstruction

Delayed DIEP flap reconstruction involves reconstructing the breast mound at a later date, typically months or even years after mastectomy. During this time, you may opt for temporary measures such as wearing prosthetic breast forms or living without reconstruction.

Time for Recovery and Decision-Making
Delayed DIEP flap reconstruction allows patients to focus on their cancer treatment and initial recovery from the mastectomy before making decisions about reconstruction. This extra time can be valuable for patients who need to weigh their options carefully.

Radiation Therapy Compatibility
Some patients may require post-mastectomy radiation therapy as part of their cancer treatment. Delayed reconstruction can often be a better choice in these cases, as it allows for more predictable results and reduces the risk of complications associated with radiation.

Adjustments and Improvements
Delayed reconstruction gives patients the opportunity to adjust their surgical plans and make improvements to the aesthetic outcome based on their preferences and goals. This gives plastic surgeons more flexibility to create a customized reconstruction plan.

Possible Drawbacks:

  • Leaves a mastectomy scar on the chest
  • Involves two surgeries instead of just one
  • Reconstruction may be more challenging due to the scar tissue

Choosing Between Immediate and Delayed DIEP Flap Reconstruction

Immediate and delayed DIEP flap reconstruction are both viable options for breast cancer survivors seeking breast reconstruction after a mastectomy. Each approach has its own set of advantages and considerations. Ultimately, the choice should be based on individual medical needs, emotional well-being, and lifestyle preferences.

The board-certified plastic surgeons at the New York Group for Plastic Surgery carefully discuss your options, review your medical history, consult your oncology team, and recommend the most appropriate option. Regardless of the choice, DIEP flap reconstruction offers a remarkable opportunity for cancer survivors to achieve natural-looking breast reconstruction.


New York Group for Plastic Surgery specializes in breast reconstruction, DIEP flap, augmentation, reduction, and implant revision to name a few. To learn more about the aesthetic procedures we offer and their cost, contact us and we’ll provide you with all the information you need to make a decision and start your journey to a more confident you.

Contact Us (914) 366-6139