loading
Breast Reconstruction With Tummy Tissue (Abdominal Flaps) PRMA Plastic Surgery

Breast Reconstruction With Tummy Tissue (Abdominal Flaps)

Breast Reconstruction With Tummy Tissue (Abdominal Flaps) PRMA Plastic Surgery

What are the different flap breast reconstruction options using tummy tissue?

DIEP flap? TRAM flap? SIEA flap? With so many breast reconstruction options available these days it’s difficult to understand what these terms really mean and what the differences are between all these “tummy flap” procedures.

It is important for women considering these reconstructive options to realize that not all tummy tissue options are created equal. For example, a DIEP flap is not the same as a TRAM flap just because both provide the benefit of a tummy tuck.

Many women are now rejecting breast implants preferring to use their own abdominal tissue for reconstruction after mastectomy. A breast that has been reconstructed with the patient’s own tissue typically looks and feels more natural than an implant reconstruction, will last longer without the long-term complications that can be associated with implants, and will also age like a natural breast. Women wanting to use their abdominal tissue have 3 reconstructive options: a TRAM flap, DIEP flap, or SIEA flap.

The TRAM flap is a very common breast reconstruction technique that requires the sacrifice of at least a portion of the rectus abdominus (sit-up) muscle. There are 3 different types of TRAM flap (“pedicle”, “free”, and “muscle-sparing free”): the exact type is defined by the amount of abdominal muscle removed. Unfortunately, TRAM surgery can be associated with significant post-operative pain, prolonged recovery and a host of abdominal complications such as loss of abdominal muscle strength (up to 20 % or more), bulging (or “pooching”), and even abdominal hernia.

The DIEP flap procedure is similar to the TRAM flap except that it spares the rectus abdominus muscle completely. Only skin and fat are removed from the abdomen. This tissue is disconnected from the body completely, transplanted to the chest and re-connected using microsurgery to create the new breast. As the sit-up muscle is saved completely and left behind in its natural place, the risk of abdominal complications is much less than with a TRAM. There also tends to be less pain and a quicker recovery time because the abdominal muscles are preserved and left in place.

Like the DIEP flap, the SIEA (Superficial Inferior Epigastric Artery) flap completely preserves the abdominal muscles. The main difference between these two procedures is the artery used to supply blood flow to the newly reconstructed breast. The SIEA blood vessels are generally found in the fatty tissue just below skin whereas the DIEP” blood vessels run below and within the abdominal muscle (making the DIEP more technically challenging).

Recovery from the SIEA flap is even easier than the DIEP since the abdominal muscles are not disturbed at all during the surgery. Despite the similarities between these two surgeries the SIEA flap is used much less frequently than the DIEP flap because less than 20 % of patients have the appropriate anatomy. Unfortunately, there are no pre-operative tests to reliably show which patients have the appropriate anatomy and the decision as to which procedure to perform is made intra-operatively by the plastic surgeon based on the anatomy found at the time of surgery.

Since the TRAM, DIEP and SIEA procedures all use the patient’s lower abdominal skin and fat, all these abdominal flap options provide the added benefit of a tummy tuck at the same time as the breast reconstruction.

Author: Dr. Minas Chrysopoulo

 

abdominal flap breast reconstruction options prma plastic surgery

It is important for women considering these reconstructive options to realize that not all tummy tissue options are created equal. 

Sign Up for Our Monthly Newsletter

Online Form – Newsletter Signup

Continue Reading

Breast Reconstruction With Tummy Tissue (Abdominal Flaps) PRMA Plastic Surgery

Breast Reconstruction With Tummy Tissue (Abdominal Flaps)

Read More

Traveling for Breast Reconstruction Just Got a Lot Cheaper

Traveling for Breast Reconstruction Just Got a Lot Cheaper

Traveling for Breast Reconstruction Just Got a Lot Cheaper July 08, 2020 Share on Facebook Twitter Linkedin What is the cost of traveling for breast reconstruction? Great news! Well, to be honest, it’s not really “news” anymore since it happened a few of months ago but I have come across several patients that didn’t know […]

Read More

How To Boost Wound Healing After Surgery PRMA Plastic Surgery

How To Boost Wound Healing After Surgery

How To Boost Wound Healing After Surgery July 08, 2020 Share on Facebook Twitter Linkedin Wounds need a lot of energy to heal well. Since energy can only come from food, it is vital that patients eat as healthily as possible especially before and after surgery. Crucial nutrients for wound healing include protein, zinc and […]

Read More

Breast Reconstruction Timing_ Immediate vs Delayed Reconstruction PRMA Plastic Surgery

Breast Reconstruction Timing: Immediate vs Delayed Reconstruction

Breast Reconstruction Timing: Immediate vs Delayed Reconstruction July 08, 2020 Share on Facebook Twitter Linkedin When is the best time to have breast reconstruction?  With so much to think about after a breast cancer diagnosis, many patients facing mastectomy do not fully understand how the timing of breast reconstruction influences how the reconstructed breasts will ultimately […]

Read More

TRAM Flap vs DIEP Flap: What’s the Difference?

TRAM Flap vs DIEP Flap: What’s the Difference? July 08, 2020 Share on Facebook Twitter Linkedin What’s the difference between the TRAM and DIEP flap?  Up until a few years ago, the TRAM flap was the gold standard in breast reconstruction after mastectomy. The TRAM has now been surpassed by the DIEP flap for that honor. For […]

Read More

are you a diep flap candidate prma plastic surgery

Are You A DIEP Flap Candidate?

Are You A DIEP Flap Candidate? July 08, 2020 Share on Facebook Twitter Linkedin Am I a DIEP flap breast reconstruction candidate? The DIEP flap procedure has rapidly become the “gold standard” in breast reconstruction. While not every woman is a DIEP flap candidate, many are turned away when in fact they needn’t be. Typical […]

Read More

too thin for diep flap prma plastic surgery

“Too Thin” For A DIEP Flap?

“Too Thin” For A DIEP Flap? You May Still Be A Candidate! July 08, 2020 Share on Facebook Twitter Linkedin Can you be too thin for DIEP flap breast reconstruction?  I’ve spoken to several ladies recently who have had the same misconception about DIEP flap surgery. They were scared they were “too skinny”, especially if […]

Read More

breast reconstruction cost

How Much Does Breast Reconstruction Cost?

How Much Does Breast Reconstruction Cost? July 08, 2020 Share on Facebook Twitter Linkedin How much does breast reconstruction cost?  The two most common questions among breast cancer patients considering breast reconstruction are “how much does breast reconstruction cost?” and “will my insurance cover it?” The good news is that even though breast reconstruction is […]

Read More

Tammy’s Breast Reconstruction Journey. Part 2 – Finding My Surgeon

Tammy’s Breast Reconstruction Journey. Part 2 – Finding My Surgeon July 08, 2020 Share on Facebook Twitter Linkedin How did you find a breast reconstruction surgeon? After deciding to pursue immediate breast reconstruction I went online and requested information from the PRMA website on a Saturday. By Monday morning Mistie (the nurse) called me back to […]

Read More

Breast Reconstruction_ Reconstructive Options After Mastectomy

Breast Reconstruction: Reconstructive Options After Mastectomy

Breast Reconstruction: Reconstructive Options After Mastectomy July 08, 2020 Share on Facebook Twitter Linkedin What are the breast reconstruction options after a mastectomy?  Every woman has a right to breast reconstruction surgery after breast cancer. This has been a federal mandate for some time and insurance companies have to pay for breast reconstruction surgery by […]

Read More

post-img
Prev post

Traveling for Breast Reconstruction Just Got a Lot Cheaper

Next post

New Bill Would Mandate Breast Reconstruction Discussion Before Breast Cancer Surgery

post-img
Subscribe Newsletter