Like a DIEP flap, a superficial inferior epigastric artery SIEA flap is an advanced breast reconstruction technique in which your surgeon uses your own living tissue instead of an implant to create your new breast. The advantages are a natural looking and feeling breast made of healthy, soft, living tissue that, unlike an implant, will not need to be replaced.
In this technique, Dr. Fisher removes a flap of skin and fat from your abdominal area without opening the underlying fascia and muscle or disrupting your motor nerves. The incision is placed low, much like a tummy tuck, with a secondary benefit of a flatter postoperative stomach. They then carefully shape the flap and transfer it to your chest. The blood vessels are connected to those in your chest wall or under your arm. It is this part of the procedure in particular, severing the very small blood vessels and reconnecting them using a microscope, that requires advanced technical skills, experience and microsurgery training.
The type of artery and vein used to supply blood to the newly reconstructed breast is the primary difference between a SIEA flap, which uses the blood vessels found in the fatty tissue just below the skin, and a DIEP flap, which uses deeper vessels under the rectus abdominis muscle. This difference makes a SIEA flap a more technically demanding procedure. Less than 20% of patients have the appropriate anatomy to sustain a SIEA flap. Your surgeon will make a preliminary determination that this flap is appropriate based on a preoperative vascular CT scan; it is only on examining the blood vessels in the operating room that your surgeon can make a final determination.
The SIEA flap technique requires more initial operating time than an implant reconstruction, but the reconstruction is complete in one surgery. Your recovery requires several days of rest in the hospital to monitor the flap before you are sent home. Most patients can expect to be sore and have less energy for the first couple of weeks after surgery, can resume light activity such as walks and driving after two weeks of rest, and should avoid heavy lifting or strenuous exercise for at least six weeks.
In many cases, the nipple can be reconstructed at the time of your first breast reconstruction surgery. Otherwise, three months after your initial surgery the nipple will be reconstructed as part of a second touch-up surgery. Three dimensional areola tattooing is also available in the office to add color to the areola and the appearance of texture to the reconstructed nipple. The end result is a breast that looks, feels and moves like a natural part of your body — because it is.
To find out more about a SIEA flap, or any other breast reconstruction option, call our office to schedule a consultation.