Microsurgical Breast Reconstruction After Mastectomy with Perforator Flaps (DIEP Flap, SIEA Flap & GAP Flap)

Pioneered in the early 1990's, perforator flap breast reconstruction represents the state of the art in breast reconstruction surgery after mastectomy. The tissue removed at the time of mastectomy may be replaced with the patient's own warm, soft, living tissue to recreate a "natural" breast.

Skin, fatty tissue, and the tiny blood vessels that supply nutrients to the tissue ("perforators") can be taken from the patient's abdomen (SIEA flap and DIEP flap procedures) or buttocks (GAP flap procedure).

Unlike conventional tissue reconstruction techniques (like the TRAM flap), these microsurgical perforator flap techniques (SIEA, DIEP and GAP flaps) carefully preserve the patient's underlying musculature. The tissue is then transplanted to the patient's chest and reconnected using microsurgery.

Preserving underlying muscles lessens postoperative discomfort making the recovery easier and shorter, and also enables the patient to maintain muscle strength long-term. This is particularly important for active women.

While microsurgical breast reconstruction offers many advantages to the patient, perforator flap surgeries are very complex and time-consuming and specialized training and experience in these specific procedures is required.

Before choosing a surgeon ensure that he/she is a plastic surgeon certified by the American Board of Plastic Surgery and has extensive experience with perforator flap breast reconstruction. Ask about the success rate of the procedure in their hands (most specialists boast a flap survival rate of at least 97%) and how many they have performed.

Insurance companies are federally mandated to pay for the cost of breast reconstruction. Unfortunately, some patients will still face difficulties in gaining access to perforator flap specialists. Here again it pays to seek out plastic surgeons who specialize in DIEP flap, SIEA flap and GAP flap breast reconstruction as typically an insurance specialist is available to help patients with insurance issues.