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Perforator Flap Breast Reconstruction

One of the newer advances in autologous breast reconstruction is the development of perforator flaps. Perforator flaps allow our plastic surgeons at Florida Plastic Surgery Group to transfer fat and skin, recreating a natural-looking breast without sacrificing muscle. Since the muscles are spared, patients have less pain at the donor site, faster recovery, and a 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 blood vessels necessary to keep the flap alive are microsurgically dissected through the muscle. The rectus abdominus muscle is left intact and the blood vessels are 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

Insurance for Your Breast Reconstruction Surgery

Our plastic 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 Florida Plastic Surgery Group, our office staff will work with you and act as your advocate to the insurance company.

Our breast reconstruction team will help guide you through the process one step at a time. At the Florida Plastic Surgery Group, we believe that patients, their desires, and anatomy are all unique. Therefore, our doctors will explain all the options and listen to your particular wishes to create a personalized approach to your reconstruction. To learn more about perforator flap breast reconstruction, please contact a member of our staff today.

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