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SIEA Flap Breast Reconstruction

SIEA (superficial inferior epigastric artery) flap breast reconstruction is a type of breast reconstruction surgery that uses tissue from the lower abdomen to rebuild the breast. Unlike other types of flap reconstruction such as the TRAM flap which uses muscle and tissue from the abdomen, the SIEA flap technique only uses the skin and fat from the lower abdomen. An SIEA flap is similar to a DIEP flap for breast reconstruction but there are no incisions in the abdominal wall fascia or muscle.

Benefits of SIEA Flap Breast Reconstruction

There are several benefits to undergoing SIEA flap breast reconstruction over other types of flap reconstruction:

  • Minimally invasive: Because the surgery only uses skin and fat from the lower abdomen, it is less invasive than other types of flap reconstruction that require muscle to be removed or the fascia to be incised..
  • Natural-looking results: SIEA flap breast reconstruction can provide natural-looking results that are similar in shape, size, and texture to the natural breast.
  • Shorter recovery time: Because the surgery is less invasive, the recovery time is often shorter than other types of flap reconstruction. Patients may be able to return to their normal activities more quickly.
  • Reduced risk of complications: Because the muscle and fascia of the abdomen are left intact, there is a reduced risk of complications such as abdominal weakness and bulge.
  • Improved abdominal contour: The removal of excess skin and fat from the lower abdomen results in a flatter, more toned abdominal contour, similar to a tummy tuck.

SIEA Flap vs DIEP Flap

It is often difficult to know before surgery if a patient is an ideal candidate for an SIEA flap. The plan is usually made for a DIEP flap and then based on the findings during surgery, an SIEA flap will be performed if possible. Both flaps harvest the same tissue of the lower abdomen and transplant the tissue into the breast. However, if the superficial vessels that are needed for the SIEA flap are found to be too small during surgery, an SIEA flap can not be performed. The procedure will then default to a DIEP flap.

SIEA Flap Surgery

Many patients find the SIEA flap breast reconstruction procedure to be a positive experience that helps restore their confidence and sense of femininity after breast cancer. The procedure provides a natural-looking result, and the flap of tissue from the lower abdomen can also help contour and flatten the abdomen for a more aesthetically pleasing appearance.

The SIEA flap breast reconstruction process typically involves the following steps:

  1. Consultation: During your initial consultation, Dr. Jandali will evaluate your medical history and perform a physical exam to determine if you are a good candidate for the procedure. They will also discuss the details of the procedure and what you can expect during the recovery period. 
  2. Imaging: Before the procedure, Dr. Jandali will order a CT angiogram to assess and map out the deep perforators (small blood vessels) and also the superficial vessels in the abdominal area. This helps determine which vessels are the best to use for the surgery and their location.
  3. Surgery: The SIEA flap breast reconstruction procedure is performed under general anesthesia. The anesthesia team also performs nerve blocks in both the breast area and the abdomen to help with postoperative pain control. Dr. Jandali and his team will harvest the flap of tissue from your lower abdomen and transfer it to the chest area. The blood supply to the tissue will be reestablished and then the tissue will then be sculpted into the shape of a breast. 
  4. Recovery: After the procedure, patients are monitored in the ICU or the intermediate care unit where the nursing staff can monitor the blood flow to the flap every hour. Patients are usually discharged home after 48 hours. Dr. Jandali will provide detailed instructions for post-operative care, including wound care and pain management. 
  5. Follow-up: Dr. Jandali will schedule follow-up appointments to monitor your progress and ensure that you are healing properly. You may also need to undergo additional revision procedures, including nipple reconstruction or breast lift, to achieve the best end result.

It’s important to keep in mind that every patient is different, and the exact treatment process and timeline may vary based on your individual needs and goals. Dr. Jandali will provide a personalized plan for your SIEA flap breast reconstruction procedure to ensure the best possible outcome.

Ideal Candidates for SIEA Flap

SIEA flap breast reconstruction may be right for you if you:

  • Have enough excess abdominal tissue to use for reconstruction.
  • Do not have a history of abdominoplasty or large hernia repair with mesh
  • Do not smoke or have other medical conditions that may compromise healing
  • Are seeking a natural-looking result without the use of an implant

Frequently Asked Questions

How long does SIEA flap reconstruction take?

The length of the surgery will depend on the complexity of the procedure and the patient’s individual case. Generally, SIEA flap breast reconstruction can take anywhere from 4 to 6 hours for one breast and 8-9 hours for both breasts.

What is the recovery time like after SIEA flap breast reconstruction?

The recovery time for SIEA flap breast reconstruction is typically a bit shorter than other types of flap reconstruction. Most patients have all drains removed within two weeks. Most patients can drive and return to work within 2-3 weeks. Patients may be able to return to their normal activities and exercise within 6-8 weeks after the surgery. However, it is important to follow all post-operative instructions to ensure proper healing.

Will there be scars after SIEA flaps?

Yes, there will be scars after the surgery. However, the scars will be on the breasts and hidden in the lower abdominal area and can be easily covered with clothing. Over time, the scars will fade and become less noticeable.

Are there any risks or complications associated with SIEA flap breast reconstruction?

Like any surgery, there are risks and complications associated with SIEA flap breast reconstruction, such as bleeding, infection, blood clots, fat necrosis, and issues with wound healing. However, the risks are generally low and can be minimized with proper surgical technique and post-operative care.

Will the reconstructed breasts look and feel natural after SIEA flaps?

Yes, the reconstructed breasts can look and feel very natural after SIEA flaps. It often looks like patients have only undergone a breast lift after surgery. However, it is important to discuss your expectations with Dr. Jandali to ensure that they can be met.

Why Choose Jandali Plastic Surgery for Your SIEA Flap Breast Reconstruction?

At Jandali Plastic Surgery, located in Fairfield County, Connecticut, our team of experts are dedicated to providing the highest quality of care for our patients. We use the latest techniques and technologies to deliver beautiful and natural-looking results, and our team of experienced professionals is committed to ensuring that you are fully informed and comfortable throughout every step of your journey.

If you are considering SIEA flap breast reconstruction, we invite you to schedule a consultation with us. During your consultation, we will listen to your concerns, answer your questions, and help you determine if this procedure is right for you.

At Jandali Plastic Surgery, we are committed to helping women feel confident and beautiful after breast cancer. Contact us today to learn more about SIEA flap breast reconstruction and how we can help you achieve your goals.

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