DIEAP - Advantages & Disadvantages



  • The DIEAP & SIEA flaps offer an abundant source of well vascularized soft tissue with a complication rate similar to that of other free flaps.
  • The donor site morbidity is significantly reduced because no muscle is sacrificed.
  • The donor site scars are easily concealed.
  • Removing excess tissue from this region also improves the abdominal contour.
  • The potential for abdominal wall and umbilical asymmetry, which may occur following a TRAM flap, are eliminated.
  • The long vascular pedicle of the DIEAP flap affords greater flexibility when positioning the flap. Shaping is therefore easier and better aesthetic results can be achieved.
  • Postoperative pain is minimal. A recent study has shown that patients undergoing DIEAP flap surgery require approximately three times less pain medication, than those undergoing TRAM flap surgery
  • The hospital stay is shorter, lowering health care costs.
  • Patients return to work and normal physical activity much more quickly.



  • The operating time can be marginally longer in comparison to a free TRAM flap, particularly if the vascular anatomy is unfavorable.
  • The volume of tissue safely perfused in the SIEA flap is slightly less than that in a DIEAP or TRAM flap.
  • The vascular pedicle of the SIEA flap is relatively short, making the insetting and shaping more difficult.
  • The SIEA is anatomically inconsistent and may be absent in up to one third of patients.