What is DIEP Flap Reconstruction?
The Deep Inferior Epigastric Perforator (DIEP) flap is Mr. Blackburn's most frequently performed reconstructive procedure. Skin and fat are taken from the lower abdomen — without sacrificing the underlying rectus abdominis muscle — and transferred microsurgically to the chest to form a new breast mound. The blood vessels supplying the flap are carefully dissected out and reconnected to vessels in the chest using microsurgical technique under high magnification.
Because the tissue comes from your own body, a DIEP flap reconstruction tends to feel soft, warm and natural, and ages with you over time — it gains and loses weight along with you, and continues to feel like normal breast tissue for life. There is no implant, and no foreign material.
The abdominal donor site also benefits from a similar improvement to that seen after a tummy tuck, with the lower abdominal scar placed within the bikini line. Many patients consider this an added benefit of the procedure.
Two-Consultant Operating
Mr. Blackburn operates alongside a fellow consultant surgeon for all microsurgical breast reconstructions. A 2024 audit of 453 patients showed that two-consultant operating was associated with a return-to-theatre rate of just 1.5% with no flap losses, compared to 4.5% and 1.2% flap loss in the single-consultant group. This evidence directly informs his practice — two-consultant working reduces operating time, surgical fatigue and complication rates.
This approach also has important implications for insured patients: AXA Health requires specific authorisation for two-consultant operating. Read more about insurance and two-consultant working.
When to Have DIEP Flap Reconstruction
Reconstruction can be performed at the time of mastectomy (immediate reconstruction) or at a later date (delayed reconstruction). Mr. Blackburn works closely with oncological teams to determine the optimal timing for each patient, taking into account any planned radiotherapy or chemotherapy. Radiotherapy in particular can affect tissue quality and reconstructive outcomes, and timing around it requires careful MDT discussion.
Recovery
Most patients go home within 1–2 days of surgery — one in four of Mr. Blackburn's DIEP patients is discharged on the first post-operative day, placing his outcomes among the best length-of-stay data in the world for this type of surgery. Return to normal activity takes 6–8 weeks, and full recovery is typically at 3–4 months. The reconstructed breast continues to settle and soften over 6–12 months.
- Entirely own-tissue reconstruction — no implant required
- Soft, warm and natural result that ages naturally
- Muscle-sparing technique preserves abdominal strength
- 100% flap success rate across Mr. Blackburn's entire career
- 1 in 4 patients home the day after surgery
- Two-consultant operating for optimal outcomes