DIEP, MS-TRAM and TRAM FLAP Advantages: The ‘Gold Standard’ in breast reconstruction. Uses the patients’ own tummy tissue and transplants it to the breast to restore breast volume and shape with some of the benefits of a tummy tuck. Will move, feel and age in a more natural way than an implant reconstruction and withstand […]
Advantages: Lumbar flap or Latissimus Dorsi (LD) flap is another more recent secondary option after the DIEP flap. May be used in those who do not have enough tummy tissue available. Disadvantages: Donor site tends to produce drain a lot of fluid post-operatively, similar to the LD flap. Only a short blood vessel can be taken […]
Advantages: For those of slimmer build with no tummy but smaller breasts then this may be a good secondary surgery option, producing quite a ‘perky’ breast reconstruction. Disadvantages: Wound healing of the inner thigh donor site can be an issue. Limited volume achievable. More complex microsurgery as vessels smaller. Recovery: 4 – 6 hours of […]
Advantages: Can recruit some of the upper (S-GAP) or lower (I-GAP) buttock tissue and were initially popular as an alternative to the DIEP flap. Disadvantages: ‘In the crease’ scar of the I-GAP flaps means that the patient sits on the scar which can delay wound healing and be painful in the long term. Buttock tissue […]
Advantages No donor site. Good for smaller non-droopy breasts. Better for bilateral cases as symmetry improved. Quick recovery. Disadvantages Radiotherapy will tend to cause a very high rate of complications. Tends to be firmer and colder. Implants do not last for ever. Hard to match fuller, more droopy breast. Will need to be placed under […]
Advantages: In order to improve the soft tissues a more recent innovation is to cover the lower part of the implant with a piece of organic mesh derived from pig or cow skin. Removes the need for a donor site such as in the back flap operation. Disadvantages: Notorious for producing an inflammatory response and […]
Advantages A very reliable, classic option since the 70s. No microsurgery service required. Disadvantages Combines the disadvantages of an implant with the downside of a donor site on the back. Collection of tissue fluid (seroma) is a common complication. In plastic surgery units, the LD flap is only used in salvage situations. Recovery 3 – […]
Symmetrisation: Despite the best efforts of the surgeon, if a patient has very large or droopy breasts then it may just not be possible to match the other side and an uplift (mastopexy) or reduction may be required to achieve optimum symmetry. Best left until 3-6 months after the initial reconstruction. This tends to be a […]