Breast Reconstruction
Beth Israel Deaconess Medical Center (BIDMC) provides state-of-the-art techniques in breast reconstruction after mastectomy. There are many choices and options, from breast implants to advanced muscle-sparing procedures that use the body’s own abdominal tissue, such as DIEP flap and SIEA flap. These perforator flap procedures transfer skin, fat and blood vessels from the abdomen to the mastectomy site to reconstruct the breast. Breast reconstruction can be done at the same time as mastectomy or even in a delayed fashion, several years later.
Patients benefit from our dedicated (specialized) breast and reconstructive surgeons, and nursing and operating room staff. Proficient, skilled and experienced in microsurgical techniques, the team specializes in muscle-sparing perforator flap procedures.
Muscle-Sparing Procedures
If you decide on breast reconstructive surgery, our surgeons will help you decide which option is best for you based on your medical history and personal preferences. There are many choices, from silicone and saline implants, to reconstructive surgery.
In recent years, surgeons have focused on advanced muscle-sparing reconstructive procedures. These include:
Deep Inferior Epigastric Perforator (DIEP) Flap
DIEP flap is an innovative technique in breast reconstruction. BIDMC has performed more than 750 DIEP flaps, more than any other hospital in Boston. This perforator flap procedure transfers skin, fat and blood vessels from the abdomen to the mastectomy site to form a new breast. But unlike traditional procedures, DIEP flap spares the abdominal muscle. Leaving the muscle intact promotes a faster recovery and quicker return to a physically active lifestyle.
The DIEP procedure is different from the more traditional TRAM (transverse rectus abdominus myocutaneous) flap procedure. The TRAM flap uses the rectus muscle in reconstruction (the muscle that allows you to do sit-ups). TRAM flap procedures carry a higher risk for abdominal weakness and hernia.
Superficial Inferior Epigastric Artery (SIEA) Flap
Like the DIEP flap procedure, SIEA flap also preserves abdominal muscle. The procedures differ only in the choice of blood vessels the surgeon uses to nourish the flap tissue, which is based on patient anatomy and can only be determined once the operation is underway. In both procedures, surgeons transfer the abdominal flap to the mastectomy site, and use a microscope to reconnect the blood vessels and complete the reconstruction.
Superior Gluteal Artery Perforator (SGAP) Flap
SGAP flap is another muscle-sparing reconstructive procedure. But SGAP flap uses tissue from the upper buttock for breast reconstruction. This procedure is an option for women who do not have enough abdominal tissue for reconstruction.
For More Information
For more information about whether you are a candidate for perforator flap or other reconstructive procedures, talk with your doctor or contact the reconstructive breast surgeons at BIDMC at 617-632-7369.
