Exciting New Procedure for Breast Cancer Patients  

Innovative Reconstruction Option Equals More Natural Results, Faster Recovery

While Konstantinos Lekkas was a surgical resident at Southern Illinois University, he learned a revolutionary procedure that would later transform the way many Central Iowa women recover after mastectomy. However, this procedure, called the DIEP flap, had not caught on throughout the surgical community. 

Like its predecessor, the TRAM flap, the DIEP flap involves removing fat and skin from a woman’s lower abdomen to reconstruct the breast. The most notable difference between the two procedures is that the DIEP flap does not harvest the underlying muscle, so a woman’s abdominal strength remains intact and recovery time is lessened. Hernias and bulges are often side effects of the older TRAM procedure, but are much less common with the DIEP flap. The procedure’s incision is low enough to be hidden by a swimsuit and the need for pain medication is drastically reduced as well. The DIEP flap may be better for the patient, but the surgery is more difficult for the surgeon because it involves meticulous dissection and microvascular surgery connecting two-millimeter vessels.

“I had the ability to perform the DIEP flap, but it just wasn’t being presented as an option in Iowa at the time,” says Dr. Lekkas of his 2005 arrival in Des Moines. “Then a mastectomy patient who was a good candidate for a TRAM flap came to me for a consultation. When she asked if there were any newer options, I told her about the DIEP flap.” 

That patient, Marlene Siegel, is a Waukee business owner who could not afford to take six weeks off. “Dr. Lekkas told me about this procedure that he’d done as a resident. I talked with my family members – many of whom are in medicine – and learned as much as I could about the DIEP flap. It didn’t concern me that I would be the first woman to have the procedure done in Iowa – it’s important to know what all of the options are and choose what’s best. This was best for me.” 

Marlene’s January 2008 surgery was on a Wednesday; she was back working at her desk the following Monday. She may have been the first to have the DIEP flap procedure, but now Dr. Lekkas and his partner, Dr. Lester Yen, perform about two per month, and demand is increasing as word gets out. Helping spread that word is Marlene Siegel, who promptly acquired a personalized breast cancer awareness license plate emblazoned with DIEP 1 after the positive experience of her surgery. 

Dr. Lekkas says the DIEP flap is not ideal for every mastectomy patient. Health, body composition and lifestyle factors enter into the equation. “I need to meet patients and talk with them to determine if DIEP flap is their best option,” says Dr. Lekkas. “But the bottom line is, most women want to feel like themselves again after a mastectomy. The DIEP flap can help them achieve that quicker and more naturally with fewer complications – and that’s why it’s so rewarding for us.”

The Iowa Clinic Plastic Surgery Department
515-875-9744

Learn about comprehensive breast imaging available at The Iowa Clinic.