Breast · Interactive 3D

DIEP flap

A deep inferior epigastric perforator flap: lower-abdominal skin and fat carried on perforators of the deep inferior epigastric vessels, with the pedicle dissected free of rectus abdominis — the standard autologous breast reconstruction.

Interactive — drag to rotate

What to look at

1Turn the flap over to see the perforators branching into the fat from the single pedicle below.
2The pedicle is the deep inferior epigastric artery and vein, traced through rectus abdominis to the external iliac vessels without taking muscle.
3The ellipse is the same tissue as an abdominoplasty — Hartrampf zones I–IV describe its perfusion from the chosen perforator.
4Anastomosed to the internal mammary vessels at the chest; previous abdominoplasty is a contraindication.

Hotspots

1Skin paddle — Lower abdominal skin — the same ellipse as an abdominoplasty, giving a natural, warm, ageing breast mound.
2Subcutaneous fat — Volume comes from the fat; perfusion falls away across Hartrampf zones I to IV.
3Perforators — Musculocutaneous perforators in medial and lateral rows — dissected through rectus abdominis, which is left intact.
4Pedicle — Deep inferior epigastric artery and vein from the external iliac vessels; typically 10–12 cm long.

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