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PRMA Plastic Surgery

Alternative Flap Options if You are not a Candidate for DIEP Flap Breast Reconstruction

July 17, 2020

What are the breast reconstruction options if a patient is not a candidate for DIEP flap reconstruction?

In our practice, we find most patients prefer the DIEP flap technique compared to implant breast reconstruction. The DIEP flap uses a patient’s lower abdominal tissue (while sparing all abdominal muscles) to reconstruct a warm, soft and natural breast following a mastectomy. Although we consider the DIEP flap to be today’s ‘gold standard’ in reconstruction, it is a technique that may not be an option for patients who have had a previous tummy tuck, who do not have adequate abdominal fat, or who want to avoid a scar on their abdomens.

If a patient is not a candidate for the DIEP flap, implants are not the only option! There are a variety of other flap options available!

Thigh Flaps

The TUG (Transverse Upper Gracilis) flap uses tissue from the inner portion of the upper thigh just under the groin crease.

The LTP (Lateral Thigh Perforator) flap uses tissue from the outer buttocks and the top of the outer thigh.

The PAP (Profunda Artery Perforator) flap uses tissue from the upper posterior thigh, just below the buttock crease.

The VUG (Vertical Upper Gracilis) flap (similar to the TUG) uses tissue from the upper inner thigh.

The ALT (Anterolateral Thigh) flap uses the outer thigh tissue.

Buttock Flaps

The GAP (Gluteal Artery Perforator) flap uses skin and fatty tissue from the upper or lower buttock.

Back Flaps

The Latissimus flap is one of the oldest methods of breast reconstruction. The procedure uses skin, fat and muscle from the back, beneath the shoulder blade area. The tissue flap is then brought around to the chest to create a new breast.

Regardless of the type of flap procedure being performed, using your own tissue has many benefits compared to the more commonly performed implant reconstruction. Flap reconstruction options are permanent. Unlike implants (which typically require replacement at some point in a patient’s lifetime), flap options never have to be replaced. It is your own living tissue! Patients enjoy a warm, soft and natural breast reconstruction result.

In the setting of radiation, we strongly recommend using your own tissue for breast reconstruction. Implant reconstruction failure rates following radiation treatment is about 1 in 3! In experienced hands, flap reconstruction procedures have an over 99% success rate—even after radiation!

Regardless of the type of breast reconstruction you are considering, it is important to be informed of ALL your options to make the best choice for you and your needs.

Want to learn more about your options? Fill out our FREE Virtual Consultation form HERE.

Author: Dr. Steven Pisano and Courtney Floyd

If a patient is not a candidate for the DIEP flap, implants are not the only option! There are a variety of other flap options available!

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