We specialize in state-of-the-art breast reconstruction techniques using your body’s own tissue without sacrificing important functional muscles.

Considered the most advanced in the world today, our procedures result in a breast that closely matches your own in shape and softness.

DIEP and SIEA – Breast Reconstruction using Your Lower Abdominal

Many tissues from the body can be used to rebuild the breast after mastectomy.  The best spot to get the tissue from depends on your body type. The lower abdomen is the first choice for most women at it provides the needed fat and skin while placing the scar in a spot that is less visible. It also provides a cosmetic tummy tuck that is appreciated by most women.

DIEP and SIEA Flap Procedures

Both the DIEP and SIEA flaps use abdominal skin and fat from the lower part of the abdomen. The difference between the two is the choice of blood vessels that nourish the flap tissue.

In the DIEP flap, only the skin and fat tissue are taken from the donor site.  Blood vessels that travel underneath and then through the Rectus abdominus muscles are carefully dissected out, leaving them attached to the overlying fat and skin of the lower abdomen. The muscle itself is not used and therefore this procedure is significantly less invasive than earlier methods of breast reconstruction which removed the entire rectus abdominus muscle(s).

The blood vessels of the SIEA flap are more superficial, and do not travel within any muscles of the abdominal wall. Therefore, less dissection is required than in the DIEP flap, resulting in less pain and potentially a quicker recovery.   The decision as to which flap is performed is based on whether or not a patient has these vessels of adequate size and length. This is not known the surgery is underway.

Once the abdominal tissue is safely detached from the abdomen, the abdomen donor site is closed, and the abdomen tissue blood vessels are re-attached to the small blood vessels in the breast area, resulting in a microsurgical tissue transfer. A small piece of cartilage on the third or fourth rib is removed to allow access to the blood vessels on your chest that the abdominal flap will be connected to. The tiny blood vessels are connected together using microsurgery techniques.  Once this is complete, the blood flow to the tissue is restored.  Next, the tissue is shaped to fit the mastectomy defect.

Due to the complex nature of the surgery, the procedure can be lengthy – often close to four hours for one breast. However the efforts are rewarded by excellent cosmetic results and a life-long reconstruction that only uses the patient’s own body tissue.  While this technique is longer and surgically difficult, the procedure is much less invasive then earlier techniques, so recovery is faster.  The operation leaves a horizontal scar on the lower abdomen, similar to that created in a cosmetic tummy tuck, resulting in a slimmer abdominal contour that is appreciated by most women.