Surgical Procedures
Women who have completed radiation or chemotherapy may be candidates for natural breast reconstruction as soon as three to six months after treatment. The procedure typically involves a hospital stay of about four days. Afterward, most women return to work and normal activity within four weeks. Some of our surgical procedures include:
DIEP Flap
Perforator flaps represent the state-of-the-art in breast reconstruction. Replacing the skin and soft tissue removed at mastectomy with soft, warm, living tissue is accomplished by borrowing skin and fatty tissue from the abdomen.
A slim incision along the bikini line is made much like that used for a tummy tuck. The necessary skin, soft tissue, and tiny feeding blood vessels are removed. These tiny blood vessels are matched to supplying vessels at the mastectomy site and reattached under a microscope.
The use of our refined perforator flap technique allows for the collection of this tissue without sacrifice of underlying abdominal muscles. This tissue is then surgically transformed into a new breast mound. This is the most often performed procedure, since excess fat and skin are usually found in this area. In addition to reconstructing the breast, the contour of the abdomen is often improved much like a tummy tuck.
SIEA Flaps
For some women, the blood vessels just under the skin in the lower abdomen may be chosen as the feeding vessels for the required tissue. The procedure is otherwise the same as the DIEP flap. A bikini line incision is designed and the necessary skin, fat, and tiny supplying blood vessels are taken.
Restoration of the nipple and areola follow. Scars fade substantially with time. For many women, the reconstructed breast may be firmer and have a more youthful appearance than their natural breasts.
GAP Flap
For the thin woman or those with otherwise inadequate tummy tissue the breast may be reconstructed with tissue borrowed from the gluteal area. Skin, fat, and the tiny feeding blood vessels are taken using a fine incision along the panty line.
This is accomplished again using microsurgical muscle sparing techniques to avoid injury or sacrifice of the underlying gluteal muscles. A microscope is used to connect the blood vessels supplying this tissue to those at the mastectomy site. The tissue is then sculpted into the new breast mound. A buttocks/thigh lift results at the donor area.
Autologous Augmentation
The skin and fat on the lateral chest wall can be used to augment the breast. This tissue is taken from under the arm, next to the breast. The tissue used is named according to the blood vessels which supply it. The blood supply to this tissue is either from perforators through the muscle between the ribs (intercostal perforator artery or ICAP flap), from the blood vessels in the armpit (axilla), or from perforators through the latissimus dorsi muscle (thoracodorsal artery perforator or TDAP flap). The living tissue is turned over and secured under the breast.
Scarless Mastectomy with Reconstruction
We now offer mastectomy and reconstruction with no scars on the breast. This new technique is exciting because for some patients, all breast skin including the nipple and areola can be preserved. The mastectomy is performed via an incision under the arm. The reconstruction is done using a perforator flap (DIEP, SIEA or GAP flap) placed through the same incision. The result is a natural, normal appearance with no scars on the breast.
To learn more about our surgical procedures or to schedule an appointment and consultation please contact us.