PRMA Plastic Surgery

The DIEP flap is the most advanced form of breast reconstruction available today because it completely preserves the patient's muscles.

The DIEP flap uses the patient's own abdominal skin and fat to reconstruct a natural, warm, soft breast after mastectomy. Unlike the TRAM flap, the DIEP preserves all the abdominal muscles. Only abdominal skin and fat are removed similar to a "tummy tuck". Saving the abdominal muscles means patients experience less pain, enjoy a faster recovery, maintain their core strength long-term, and have a lower risk of complications. LEARN MORE

The SIEA flap (also known as the SIEP flap) is very similar to the DIEP flap procedure. Both techniques use the lower abdominal skin and fatty tissue to reconstruct a natural, soft breast following mastectomy.

The main difference between the SIEA flap and the DIEP flap is the artery used to supply blood flow to the new breast. The SIEA blood vessels are found in the fatty tissue just below skin whereas the DIEP blood vessels run below and within the abdominal muscle. While the surgical preparation is slightly different, both procedures spare the abdominal muscles and only use the patient's skin and fat to reconstruct a warm, soft breast. LEARN MORE

The TUG/VUG flap procedure uses tissue from the inner portion of the upper thigh (just under the groin crease) to reconstruct a "natural", warm, soft breast.

The TUG/VUG flap is a very good option for women who have small to medium sized breasts, want to avoid an abdominal scar, or are not candidates for DIEP or SIEA flap breast reconstruction (e.g. have had previous abdominoplasty or do not have enough lower abdominal tissue). LEARN MORE

Some patients are candidates for direct-to-implant reconstruction (also known as single-stage or Alloderm one-step) whereby the permanent implant is inserted at the same time as the mastectomy.

The patient avoids the use of an expander and the whole expansion process. The breast implant is usually completely covered by the pectoralis muscle and Alloderm (a cadaveric acellular dermal graft). In some instances, the implant may be placed on top of the muscle and covered by Alloderm. LEARN MORE

The most common method of breast reconstruction currently performed in the US uses tissue expanders and breast implants, usually with Alloderm. This is usually performed as a multiple-step procedure starting with tissue expanders. LEARN MORE

Fat grafting is a fairly new technique in breast surgery. Fat is liposuctioned from one part of the patient's body, purified and then injected into the breast.

There are several fat grafting techniques that are used by plastic surgeons. There is no "set way" that has been shown to be the best in terms of long-term results. However, studies have shown that regardless of the technique used, the collection, storage, and transplantation of the fat cells (and the fat stem cells) must be optimized to obtain the best long-lasting results.LEARN MORE

Latissimus flap breast reconstruction uses skin, fat and muscle (latissimus dorsi) from the back, beneath the shoulder blade area. The tissue ("flap") is brought around to the chest to create a new breast. LEARN MORE

Women who do not have an adequate amount of abdominal tissue for reconstruction may be eligible for GAP (gluteal artery perforator) flap breast reconstruction. This procedure uses excess skin and fat from the gluteal (buttock) region and leaves all the gluteal muscle behind. Sparing the muscle preserves function and makes recovery easier. LEARN MORE

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