During stacked DIEP flap surgery, an incision is made along your bikini line and the surgeon removes one long flap of skin, fat, and blood vessels from the lower half of your belly, or he removes one flap from each side. This tissue is moved up to your chest and formed into a breast shape. No muscle should be moved or cut in a stacked DIEP flap.
The tiny blood vessels in the flap (or flaps), which will feed the tissue of your new breast, are matched to blood vessels in your chest and carefully reattached under a microscope.
Stacked DIEP flap reconstruction surgery takes about 4-6 hours.
After stacked DIEP flap reconstruction surgery: You'll be moved to the recovery room after surgery, where hospital staff members will monitor your heart rate, body temperature, and blood pressure. If you're in pain or feel nauseated from the anesthesia, tell someone so you can be given medication.
You'll then be admitted to a hospital room. For a stacked DIEP flap, you usually stay in the hospital for about 3-4 days.
Your doctor will give you specific instructions to follow for your recovery. For detailed information on how to care for the dressings, stitches, staples, and surgical drains, visit the Mastectomy: What to Expect page.
Stacked DIEP incision lines where you'll likely have scars
It can take about 6 weeks to recover from stacked DIEP flap reconstruction surgery. Your doctor may recommend that you wear a compression girdle for up to 8 weeks after surgery. Because you've had surgery at two sites on your body (your chest and your belly), if you’ve had immediate reconstruction you might feel worse than someone having mastectomy alone and it will probably take you longer to recover. You'll have to take care of multiple incisions: on your breast, your lower abdomen, and around your belly button, and you'll probably have drains in your reconstructed breast and in your abdominal donor site. If you had axillary nodes removed during this surgery, you could have yet another incision under your arm(s).
As with any abdominal surgery, you may find that it's difficult or painful to sit down or get up from a sitting position. It also might be hard to get in and out of bed. Your doctor or physical therapist can show you how to move until your abdominal area heals. If you have severe pain, ask your doctor about medications you can take.
It's important to take the time you need to heal. Follow your doctor's advice on when to start stretching exercises and your normal activities. You usually have to avoid lifting anything heavy, strenuous sports, and sexual activity for about 6 weeks after DIEP flap reconstruction.
It sometimes takes as long as a year or more for your tissue to completely heal and for your scars to fade.