Flap Breast Reconstruction Surgery Explained

There are different options for breast reconstruction to choose from after a mastectomy. One of the options in breast reconstruction is using your own tissues to reconstruct or reshape your breast or breasts. This is also known as tissue flap procedure or autologous tissue reconstruction.

Flap breast reconstruction uses tissue from other parts of your body, such as your back, tummy, thighs and buttocks to rebuild the breast shape. Tissue flaps tend to look and behave more natural than breast implants. They may enlarge and shrink as you gain or lose weight. Although tissue flaps are often used by themselves to rebuild the breast, in some cases they may be used alongside a breast implant.

There are some things to consider before undergoing flap breast reconstruction surgery in Dubai such as:

• Flap surgery requires more time and a longer recovery period than breast implant procedures.

• The procedure leaves 2 surgical sites and scars – where the donor tissue was taken from and on the reconstructed breast.

• Not all women have viable donor sites

• Flap procedures are not the best option for smokers, or women who have uncontrolled diabetes, vascular disease or connective tissue diseases because healthy blood vessels are needed for the tissue’s blood supply.

Types Of Tissue Flap Surgery

The two techniques of flap breast reconstruction surgery are:

• Pedicle Flap. This technique involves the flap of tissue from the belly or the back being moved to the chest without cutting its original blood supply. The tissue is then pulled under the skin up to the chest area and attached.

• Free Flap. In this technique, the tissue and blood vessels are cut. Once the flap is in place, the blood vessels in the flap are reconnected microscopically to the blood vessels in the chest area by the surgeon.

There are different types of tissue flap surgery which are named after the body area where the tissue was taken.

• Latissimus Dorsi (LD) Flap. This is a type of pedicle flap surgery. It uses fat, muscle and skin from the upper back that is pulled under the skin to the chest area. The scar is usually placed on the bra line to make it less visible. An implant may sometimes be placed during the same surgery to make the breast larger.

• TRAM (Transverse Rectus Abdominis Muscle) Flap. This is one of the most common types of flap surgery. The surgeon takes tissue and muscle from the lower belly and moves it to the chest area. This results is a tummy tuck as it reduces the amount of skin and fat in the lower belly. TRAM can be done either as a pedicle flap or a free flap.

• DIEP (Deep Inferior Epigastric Artery Perforator) Flap. This is similar to TRAM and the free flap technique is used. The surgeon only takes skin and fat from the lower belly but does not use the muscle. Lower belly weakness is avoided by saving the muscle. Just like TRAM this also results in a tummy tuck.

• SIEA (Superficial Inferior Epigastric Artery) Flap. This is similar to the DIEP flap but the surgeon does not cut through the belly muscles to get to the artery used for the new breast. This also results in a tummy tuck.

• Gluteal Free Flap. This type of surgery involves the use of muscle, fat and skin from the buttocks to create a new breast.

• TUG (Transverse Upper Gracilis) Flap. This is a free flap technique and it uses tissue from the inner upper thigh to create a new breast. The scars are usually hidden on the groin and inside the thigh.

What To Expect After Surgery

Flap breast reconstruction surgery is done using general anesthesia and it may take several hours to complete depending on the technique used.

You will have bandages over the surgery sites when you wake up and you may be required to wear a special bra to hold the bandages in place and control the swelling. Drainage tubes may also be placed to collect fluid from the surgery sites.

You will stay in hospital for a few days (3 to 5) so the surgeon can be sure there is good blood supply to the skin over the reconstruction. You may experience soreness, redness and swelling on the area where the tissue was taken and in the new breast. This may last for several weeks but pain medication will be provided as well as antibiotics to prevent infection.

Strenuous activities should be avoided for several weeks and most women go back to work or their normal routine in about 6-9 weeks with clearance from their doctors.

Risks

Risks associated with breast reconstruction are the same as those of any other surgery: poor wound healing, bleeding, infection or a reaction to the anesthesia used in surgery.
Other risks associated with flap breast reconstruction surgery include:

• Collection of clear fluid or blood in the wound

• Death of tissue due to lack of blood supply

• Fat necrosis in the reconstructed breast causing discomfort

• Muscle weakness in the area where the muscle was removed

• Abnormal scarring

It is important to note that your new breasts will look different after surgery and they may feel firmer and look rounder or flatter than your previous breasts. Breast reconstruction is a long process and it may take several months to heal and even a year before you see the final results.

Book Your Appointment For A Consultation

Would you like to understand what options are available for breast reconstruction in the Dubai? Meet one of our experts at Al Shunnar Plastic Surgery for a personal consultation to develop a tailor-made plan for you. Contact us or Book an appointment and our patient care coordinators will identify the most suitable expert for you.