June 11, 2026 Author : Luís Vieira (reconstructive and aesthetic plastic surgery ) Breast cancer is the most common cancer in women. In recent decades, greater awareness on screening and earlier diagnosis, as well as advances in diagnostic techniques and treatment modalities, significantly reduced the mortality rate associated with this disease. However, due to its high prevalence, breast cancer and its treatment are responsible for various sequelae . When breast cancer requires surgery, in most cases a conservative approach is possible, that is, a procedure preserving the breast. However, in some situations, it is necessary to perform a mastectomy, which means removing the entire breast. In these cases, it is possible to proceed immediately with breast reconstruction. Currently, breast reconstruction can be performed in two main ways : With breast implants ; Using transplantation of the patient’s own tissues, that is, autologous transplantation . Breast reconstruction plays an important role in the woman’s physical and emotional recovery, contributing to improved body image and quality of life. What is autologous breast reconstruction? Autologous breast reconstruction is a surgical technique in which the replacement of the diseased breast excised is done using similar tissues from the same person , mainly fat and skin. Most commonly, this tissue is transferred through microsurgical techniques from the abdomen (DIEP flap), but other tissues can be used, such as from thigh, lower back region, or the gluteal region, depending on the patient’s anatomy. In patients without clinical conditions for microsurgery, autologous reconstruction can be performed with pedicled flaps, as the TRAM flap ( transversus rectus abdominis muscle) and latissimus dorsi flap. What is a DIEP flap and what are its advantages? DIEP stands for deep inferior epigastric perforator, and in the context of breast reconstruction it means that the flap used to reconstruct the breast will include abdominal skin and fat while preserving the abdominal muscles . The flap tissues are transferred to the breast area and connected to new blood vessels using microsurgery techniques. In the same operation, an abdominoplasty is performed to improve abdominal contour with transposition of the umbilicus and plication of the rectus abdominis muscles. DIEP flap surgery, which is one of the most advanced techniques in autologous breast reconstruction, has the following main advantages : Allows the breast to be recreated with a natural consistency and appearance , and with a shape and volume similar to the contralateral breast; Does not interfere with abdominal strength because it does not remove muscle from this region, reducing the risk of abdominal weakness that may, for example, favor the formation of abdominal hernias; Improves the aesthetic appearance also of the abdomen , as an abdominoplasty is also performed; Possibility to restore breast sensibility through techniques of breast reconstruction; When carried out by experienced and dedicated teams, it is associated with high success (> 95%) and satisfaction rates . Who may have indication for microsurgical autologous breast reconstruction? Autologous breast reconstruction can be used in various clinical situations. In patients with breast cancer who will undergo mastectomy, this reconstruction can be performed during the same surgical procedure. Thus, the patient will not go through any period without a breast. In women who underwent mastectomy more than six months earlier and who have completed adjuvant treatments for breast cancer, these procedures are also possible. What to expect from microsurgical autologous breast reconstruction? Microsurgical utologous breast reconstruction is a safe and effective procedure with natural and long-lasting results . The DIEP flap procedures lasts 4–6 hours, followed by a hospital stay of 4–6 days. After hospital discharge, it is expected that daily routines can be resumed 6–8 weeks after surgery. Surgical scars will only have their final appearance after several months, during which medical follow-up should be maintained and all indications followed. Compared with reconstruction using implants , autologous reconstruction: Allows for more natural and long-lasting results; Has a lower risk of rejection because no foreign bodies are involved; Involves a longer surgery and recovery period; It is related to less reoperation need in the medium/long term. Meet the reconstructive and aesthetic plastic surgery clinical team from Hospital da Luz network and book your consultation. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
