Perforator Flap Breast Reconstruction
One of the newer advances in autologous breast reconstruction are the
development of perforator flaps. Perforator flaps allow surgeons to transfer the fat
and skin necessary to recreate a breast without sacrificing the muscle. The blood
vessels necessary to keep the flap alive are microsurgically dissected through the
muscle. Since the muscles are spared, patients have less pain at the donor site,
faster recovery, and lower hernia rate.
DIEP FLAP (Deep Inferior Epigastric Perforator)
The tummy skin and fat are transferred to the chest wall with the necessary blood
vessels. The rectus abdominus muscle is left intact and the blood vessels and
reconnected to the chest under the microscope.
ADVANTAGES
- Since the abdominal muscles are left intact, patients generally have a faster
recovery
- The risk of hernia is very low and the strength of the abdominal wall is
maintained
- Patients obtain a flatter appearance to the abdomen (i.e tummy tuck)
DISADVANTAGES
- Due to the complexity of reattaching the small blood vessels, the DIEP flap
surgery takes more time
- If blood flow to the flap is interrupted, some or all of the flap may be lost
requiring further surgery
SIEP FLAP (Superficial Inferior Epigastric Perforator)
The tummy skin and fat are transferred to the chest wall with the necessary blood
vessels. The abdominal wall fascia and integrity is left untouched along with the
abdominal muscles.
ADVANTAGES
- Since the fascia is left intact, the SIEP flap is even less invasive than the
DIEP flap
- The risk of hernia is eliminated since there are no fascia incisions.
- Patients obtain a flatter appearance to the abdomen (i.e tummy tuck)
DISADVANTAGES
- Only a small percentage (5%) of patients have the particular anatomy
required for the SIEP flap to be a viable option
- If blood flow to the flap is interrupted, some or all of the flap may be lost
requiring further surgery
SGAP / IGAP FLAP
(Superior & Inferior Gluteal Artery Perforator)
The skin and fat from the upper buttocks is occasionally used for breast
reconstruction in patients that have very little abdominal tissue or have had
abdominal operations that eliminate the DIEP flap or TRAM flap as an option. The
gluteal muscle is spared and the blood vessels are reattached to the chest with the
aid of a microscope.
ADVANTAGES
- Since the abdominal muscles are left intact, patients generally have a faster
recovery
- The risk of hernia is very low and the strength of the abdominal wall is
maintained
DISADVANTAGES
- Due to the complexity of reattaching the small blood vessels, the SGAP flap
surgery takes more time and has a lower success rate than the DIEP flap
- If blood flow to the flap is interrupted, some or all of the flap may be lost
requiring further surgery.
- Fat from the buttocks is less pliable and soft, making it more difficult to shape
the flap
- The buttock donor site will have some change in contour creating
asymmetry, which is usually covered by clothing
Our Jacksonville breast reconstruction team will help guide you through the process
one step at a time. At the Desai Center of Plastic and Reconstructive Surgery, we
believe that patients, their desires, and anatomy are all unique. Therefore, Dr. Desai will explain all the options and listen to your particular wishes to create a
personalized approach to your reconstruction. To schedule a consultation, call us
now at (904) 262-DESAI (3372) or complete the contact us form.
Options for Breast Reconstruction
Reconstruction using only your own tissue
Insurance for your Breast Reconstruction Surgery in Jacksonville
Our breast surgery team will work with you to ensure your treatment and
surgery are covered by your insurance company. Pre-authorization from your
insurance company is generally required. At Desai Plastics, our office staff
will work with you and act as your advocate to the insurance company.
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