Flap surgery is a type of breast reconstruction that takes a flap of skin and tissue from one area of your body for use in creating a new breast following mastectomy. This is a complex procedure that can be started at the time of your mastectomy, followed by a subsequent procedure or procedures to correctly position and shape the breast mound and perform nipple reconstruction if desired. In some cases, women may choose to have both flap surgery and a breast implant or implants added for additional breast volume.
Dr. Savalia will speak with you and your breast cancer surgeon to determine the best approach for your reconstruction. Flap reconstruction may be right for you if you are not interested in implant-based reconstruction and/or are not right for oncoplastic breast reconstruction. This reconstructive procedure uses your body’s natural tissue to create a renewed breast shape and contour following a mastectomy.
Currently, Dr. Savalia’s reconstruction focus is on oncoplastic breast surgery and very rarely performs any type of flap surgery. He is, however, able to refer women who want or need a flap reconstruction technique to surgeons who specialize in this reconstructive approach.
DIEP flap reconstruction uses the skin and fat from your abdominal area to rebuild your breast. None of the abdominal muscle tissue is used during this procedure, which means that it does not compromise abdominal strength and recovery following this technique can be shorter and more comfortable. In addition, the technique can give patients the additional cosmetic benefit of a more slimmed-down abdominal area. To perform DIEP flap surgery, the surgeon removes a section of skin and fat from the abdomen, along with the blood vessels that supply it, and relocates this tissue to the breast that has been affected by cancer.
MS TRAM stands for muscle-sparing transverse rectus abdominis myocutaneous. This technique removes a portion of the patient’s abdominal skin and fat along with an area of muscle surrounding the blood vessels that supply the tissue. The tissue flap is then relocated to the chest and attached to blood vessels on the chest wall using a microsurgery technique. The flap is molded into the appearance of a new breast once blood flow is reestablished.
When the use of abdominal tissue for reconstruction of the breast is not the best option for medical or personal reasons, a latissimus dorsi myocutaneous flap procedure may be performed instead. This technique removes a flap of tissue from the patient’s mid-back area to create the new breast. A portion of the latissimus dorsi muscle is removed but modern techniques minimize the amount of muscle tissue needed to achieve a healthy and viable flap.
The TAP (thoracodorsal artery perforator) flap is a more complicated reconstructive procedure than the Lat flap that involves transferring a smaller segment of skin and fat from the back without removing any muscle tissue. A surgeon may use this flap to correct smaller defects caused by lumpectomy and subsequent radiation. The technique also can provide additional tissue to cover or hide a breast implant.
Gluteal Flap or GAP (gluteal artery perforator) surgery uses the tissues of the buttocks/hip to reconstruct the breast. This type of flap reconstruction is a strong option for women needing to reconstruct both breasts, but who are unable to use abdominal tissue (due to previous surgery such as a tummy tuck).
Gracilis Flap or TUG (transverse upper gracilis) surgery uses the gracilis muscle and tissue of the upper inner thigh to rebuild the breast. This type of flap reconstruction may be right for women who lack donor tissue in the belly area. Women with smaller-sized breasts may also be a good candidate for this reconstruction method.
If you have questions about breast reconstruction, my staff and I are happy to help. By working with a team of Southern California's most experienced breast reconstruction surgeons, radiologists, and nurses, we are able to provide women with the best possible options for one of the most life-changing and rewarding surgeries. Please contact us online or call (949) 759-0980 for more information.
Dr. Savalia is known for the most innovative, advanced breast reconstruction techniques. He is a board certified plastic surgeon and artist who creates the most natural, elegant, personalized aesthetic results. He is as renown for his care and compassion as he is for extraordinary outcomes. This is why he was named one of Orange County’s Physicians of Excellence by his peers.
Dr. Savalia’s Breast Health Center team includes the finest oncologists, radiation specialists, geneticists, and nurse navigators. Being cared for by an established team is a great advantage for patients.
"I prefer a light-handed approach that leaves my patients looking visibly rejuvenated, not surgically enhanced."