New research conducted by a physician at Fox Chase Cancer Center indicates that DIEP flap surgery is notably safe, exhibiting low rates of readmission and complications. This procedure uses fat and tissue from the lower abdomen to reconstruct one or both breasts following a mastectomy.
Senior author Patel, Chief of Surgery at Fox Chase, emphasized the significance of these findings in supporting broader availability and insurance reimbursement for DIEP flap surgery. “We have been able to show that the outcomes are very good and that readmission and complication rates are low,” Patel stated. He further noted that while breast implants remain the most common reconstruction method covered by insurance, DIEP flap surgery presents distinct advantages.
The DIEP flap procedure involves a complex initial surgery requiring specialized surgical training but offers benefits over implants, such as eliminating the need for ongoing monitoring and replacement every 10 to 20 years. “That can be burdensome, especially for younger patients — they’re looking at multiple exchanges during their lifetime and screening throughout,” Patel explained. “DIEP flap doesn’t require any of that, and it also gives you a more natural appearing result.”
Despite its advantages, DIEP flap surgery is not widely offered due to perceptions of complexity or risk. Some insurers have recently reduced reimbursements for this procedure.
Researchers analyzed data from over 32,000 patients nationwide who underwent DIEP flap surgery, making it the largest dataset studied for this procedure. The study found a reoperation rate of 7% and a 2% infection rate requiring readmission. Other complications like wound dehiscence and thromboembolic events occurred at rates less than 1%.
Lead author Heather Peluso highlighted that infections were the primary reason for readmissions rather than issues related to flap survival or thromboembolic problems. “It’s not because of issues related to flap survival, or thromboembolic issues; it’s actually infection that seems to be driving readmission,” she said.
Patel concluded by noting the safety and cost-effectiveness of DIEP flap surgery compared to implants: “The big picture here is that this is a safe operation that does not add a lot of cost to the health system.” Future studies will explore causes and outcomes of reoperation after DIEP flap surgery.
The paper was published in Plastic and Reconstructive Surgery Global Open.
