Introduction: A Recovery Plan Built Around Comfort, Safety, and Predictability
Choosing DIEP flap breast reconstruction is a decision for natural, permanent results. Your recovery should feel just as thoughtfully planned. At Portsmouth Regional Hospital, The DIEP Group uses Enhanced Recovery After Surgery (ERAS) pathways, meticulous microsurgical monitoring, and clear at-home instructions to help New Hampshire and Southern Maine patients heal smoothly—whether you’re having immediate DIEP at mastectomy or converting from implants later.
Good to know: DIEP flaps are covered by insurance at any time—at the time of mastectomy or years afterward. You don’t need implant problems to switch; many patients choose DIEP to avoid future implant exchanges and the risk of silicone leakage.
We serve Portsmouth, Manchester, Concord, Nashua, Dover, Rochester, Keene, Derry, Salem, Hampton, Exeter and Southern Maine including Portland, York, Kennebunk, Biddeford, Kittery, Saco.
Visit our Before and After DIEP Flap Gallery
Your Hospital Stay: First 48-72 Hours at Portsmouth Regional Hospital
Typical stay: 2-3 days for specialized flap monitoring.
What to expect:
- Microsurgical flap checks: Nursing teams assess color, temperature, capillary refill, and Doppler signals to ensure perfect blood flow.
- ERAS pain control: Multimodal, nerve-block–supported pain plans reduce opioids and speed mobility.
- Early ambulation: Short, assisted walks begin within 24 hours to reduce clot risk and support lung function.
- Nutrition & hydration: Light meals and high-protein focus for wound healing.
- Incisions & drains: Chest and abdomen are dressed; 2–4 drains are common initially.
If you’re switching from implants to DIEP: We remove the implant and capsule (if indicated) and rebuild with your own tissue. Many patients describe instant relief from tightness compared with living with an implant shell.
Week-by-Week Recovery Timeline
Week 1: Home Setup & Gentle Routine
- Energy: Expect fatigue; alternate short walks with rest.
- Drains: Empty 2–3×/day and record output; we remove drains in clinic when outputs are low and steady.
- Compression & support: Wear your abdominal binder and a soft front-closure bra as directed.
- Sleeping position: Upper body elevated, knees slightly bent to reduce abdominal tension.
- Medication: Continue ERAS plan and stool softeners; hydrate well.
Weeks 2–3: Mobility Returns
- Walking: Increase steps daily; still avoid lifting >5–10 lbs.
- Driving: Often okay once off prescription pain meds and you can react quickly (typically late week 2–3).
- Incision care: Keep clean/dry; contact us for redness, warmth, or unusual drainage.
Weeks 4–6: Back to Routine
- Work: Many return to desk jobs by weeks 3–4; physical jobs may need 6–8 weeks.
- Exercise: No core/weights until cleared.
- Scar care: Start silicone gel/sheets, SPF 30+, and gentle massage once wounds are fully sealed.
Months 3–6: Refinement & Optional Touch-Ups
- Finalizing shape: Swelling resolves; breast and abdominal contours refine.
- Optional procedures: Symmetry tweaks, fat grafting, nipple reconstruction, and 3D areola tattooing as desired.
Pain Control: Why ERAS Makes a Difference
- Targeted nerve blocks + non-opioid meds smooth the early days.
- Scheduled dosing avoids peaks/valleys of pain.
- Early walking & breathing exercises reduce complications and speed recovery.
Patients usually describe DIEP discomfort as tightness or soreness, and many switch to over-the-counter medication within 7–10 days.
Drains, Binders, and Bras: Exactly What to Expect
- Drains (2–4): Empty and log twice daily; we remove them when outputs meet targets.
- Abdominal binder: Only when instructed – wear 24/7 for 4–6 weeks (off for showers).
- Bra: Soft, front-closure support; avoid underwire until cleared.
Scars & Scar Care (Breast + Abdomen)
You’ll have a low horizontal abdominal scar (concealed under underwear) and breast scars based on your reconstruction pattern. With silicone therapy, sun protection, and massage, most scars soften and fade over 6–18 months.
After radiation? Autologous tissue almost always behaves better than implants in radiated fields—less tightness, fewer long-term issues like capsular contracture.
The “Tummy Tuck” Benefit: What Patients Should Know
People often Google: “Do you get a tummy tuck with DIEP flap?”
While the DIEP flap’s goal is reconstruction, patients typically enjoy a tummy-tuck–like effect:
- Flatter, smoother lower abdomen
- Rectus diastasis muscle plication
- Improved waist contour
- Muscle-sparing (unlike older TRAM flaps) preserves core function
Converting from Implants: Recovery Differences You May Feel
If you’re switching because of capsular contracture, post-radiation problems, suspected rupture/leak, or recalled textured implants, recovery often feels more natural:
- No implant shell = less chest tightness
- No future exchanges every 10–15 years
- Warm, soft tissue that adapts with weight and ages naturally
Remember—insurance covers implant-to-DIEP conversions even when you choose to switch proactively.
When to Call The DIEP Group
Reach out right away for:
- Fever >101.5°F, chills
- Worsening redness, warmth, or drainage at incisions
- Sudden color/temperature change or fullness in the flap
- Calf pain, chest pain, or shortness of breath
You’ll leave the hospital with detailed instructions and 24/7 on-call information.
Patient Testimonial — New Hampshire
“I had two implant surgeries and still felt tight and uneven after radiation. Switching to DIEP at Portsmouth Regional Hospital was the best decision. Recovery was manageable with the ERAS plan, and my chest finally feels soft and natural. The tummy area is flatter, too.”
— J.B., Manchester, NH
Insurance Coverage: Immediate or Delayed — You’re Covered
Under the Women’s Health and Cancer Rights Act (WHCRA), insurance typically covers:
- Immediate or delayed DIEP flap reconstruction
- Opposite-breast symmetry procedures
- Revisions to improve contour or address issues
- Nipple reconstruction and 3D areola tattooing
This applies to NH and Southern Maine carriers. Our team handles benefit checks, preauthorization, documentation, and appeals.
Service Areas
New Hampshire: Portsmouth, Manchester, Concord, Nashua, Dover, Rochester, Keene, Derry, Salem, Hampton, Exeter
Southern Maine: Portland, York, Kennebunk, Biddeford, Kittery, Saco, Scarborough
FAQs — Real Questions from NH & Southern Maine Patients
How long is the hospital stay after DIEP flap in Portsmouth?
Usually 2 days with specialized flap monitoring.
When can I pick up kids or lift heavy items?
Plan for 6–8 weeks before heavy lifting; light lifting (≤10 lbs) after you’re cleared.
When can I sleep flat?
Most transition from reclined to flat by 2–3 weeks, based on comfort.
Do DIEP flaps feel warm and natural?
Yes—because it’s your tissue, not a device.
Will my DIEP breast change with weight?
Typically yes—it increases/decreases with your body, maintaining proportion.
Do I need implant problems to switch to DIEP?
No. You can switch anytime, even electively, and insurance still covers it.
Is DIEP the same as a tummy tuck?
Not exactly, but the donor site often heals with a flatter, tummy-tuck–like contour.
Internal Links
- DIEP Flap Breast Reconstruction in Portsmouth, NH — Complete Guide
- DIEP Flap Recovery in Portsmouth, NH — What to Expect
- Insurance Coverage for DIEP Flap in NH & Southern Maine
Ready to Plan a Smooth Recovery with The DIEP Group?
If you’re considering immediate or delayed DIEP—or you’re ready to switch from implants—we’ll guide every step of your recovery at Portsmouth Regional Hospital.
The DIEP Group
203-200-0828
thediepgroup.com
Portsmouth Regional Hospital, Portsmouth, NH
