Autologous or “free-flap” breast reconstruction makes use of your individual tissue to reconstruct your breast after a mastectomy. Tissue is usually taken from areas with further pores and skin and fats, and our most well-liked donor website is the decrease stomach.
Plastic surgeons usually carry out DIEP (deep inferior epigastric artery perforator) flap reconstruction for the overwhelming majority of our sufferers. The operation includes rigorously dissecting out the flap blood vessels alongside their course via your stomach muscle (your “six-pack” muscle).
To protect your stomach perform and core energy, we keep away from taking any muscle with the flap and spare the motor nerves. The DIEP blood vessels are then disconnected and the flap is transferred to your chest. Utilizing high-powered magnification and really small stitches, we restore blood provide to the stomach tissue by connecting the DIEP flap blood vessels to the interior mammary vessels subsequent to your sternum. The flap is then put in place and secured to supply a pure breast form tailor-made to your particular person chest.
Evaluating implant-based vs. free flap breast reconstruction
Benefits of free-flap breast reconstruction embody:
• Sufferers usually have greater satisfaction over time with a extra pure end result.
• Borrowing extra decrease stomach tissue additionally flattens your stomach.
• Higher tolerates radiation if wanted for therapy of breast most cancers.
• Considerably much less long-term “upkeep,” corresponding to extra imaging and the potential threat of an implant rupture.
• Doesn’t require tissue enlargement, which includes weekly clinic visits for 2 to a few months with a purpose to stretch the pores and skin sufficient for everlasting silicone implant placement.
• Avoids any threat of breast implant-associated lymphoma (though the lymphoma threat with implants is extraordinarily low).
• Decrease long-term upkeep and fewer postoperative clinic visits imply fewer visits to the physician, which is particularly necessary for sufferers who dwell additional away from their reconstructive surgeon.
Disadvantages of free-flap breast reconstruction embody:
• A extra concerned preliminary process. It usually takes about 4 to 6 hours for a free-flap development of 1 breast and 6 to eight hours for free-flap reconstruction of each breasts, in contrast with three to 4 hours an for implant-based reconstruction.
• Longer restoration time. Sufferers usually keep within the hospital for 2 to a few days after flap surgical procedure with an extended general restoration time of six to eight weeks, in contrast with an in a single day keep and three to 5 weeks of restoration time with implants.
• Extra scarring. You should have scars in your breast(s) and likewise throughout your decrease stomach.
• There’s a very small likelihood of flap failure (1 to 2%), which can contain re-operation if this had been to happen.
DIEP flaps are an amazing possibility for breast reconstruction normally, however, sadly, not all ladies are candidates. Intensive prior stomach surgical procedure, vital power ailments or different components could restrict our capability to supply free-flap breast reconstruction.
There isn’t a one proper reply for breast reconstruction, and it’ll depend upon many particular person components. Due to this fact, you need to focus on your objectives and circumstances together with your surgeons to determine the most suitable choice for you. Breast reconstruction is a staff effort, and we’re right here to assist information you thru the method.
Dr. JT Stranix is a plastic surgeon at UVa Well being System.