SIEA Flap Breast Reconstruction

Another technique in breast reconstruction, the SIEA, is very similar to DIEP technique in type of abdominal tissue that we transplanted to reconstruct the breast.

However, this technique that employs superficial (surface) vessels to provide blood supply for the abdominal tissue, is possible in one out of three patients as the superficial (surface) vessels have a good size only in 30% of cases.

Thus, women who can benefit from this new technique can have the same breast reconstruction as the DIEP but without opening the muscle fascia, therefore, operative time and patients' morbidity are reduced.

Through the preoperative planning developed in 2003 by Dr. Jaume Masià, we can know exactly, even before the surgery, whether our patient is a candidate for either a DIEP or SIEA.

The domain of the surgical technique and the knowledge of the anatomy make these techniques very reliable and successful, reducing the possibilities of complications to less than 1% with optimal selection of patients and the adequacy of the technique performed.

Unlike the TRAM flap reconstructions, performing a perforator flap technique avoids the sacrifice of abdominal muscles, avoiding the risk of hernias and abdominal wall weakness, abdominal wall bulges and the loss of muscle function which frequently occurred in women who were subjected to this type of aggressive intervention.

In fact, the use of surface vessels in the SIEA can completely avoid injuires to abdominal muscles since the vessels used are located above the muscle and do not pass through it. The deep vessel that feeds the lower abdominal tissue is preserved while transferred skin and fat are transformed into a new breast.

Like DIEP technique, the removal of tissue from the abdomen achieves an aesthetic outcome similar to a cosmetic abdominoplasty.

The duration of this intervention is shorter, about 4 or 5 hours, and the postoperative recovery lasts 3-4 days. Two weeks after surgery patients can return to their normal daily activities.

Restoration of nipple and areola is the next step. The scar gradually improves in appearance overtime. When patients contralateral breast is too large or saggy, surgical techniques of breast reduction and/or mastopexy are performed in order to obtain breast symmetry (lift and breast reduction), usually in the same operation when reconstruction is performed. In this way the patient avoids undergoing two surgeries under general anesthesia.

Deadlines

  • Surgery: 5 hours
  • Hospitalization: 3-5 days
  • Daily activity: 2-3 weeks
  • Sports: 1 month
  • Recreation of the nipple and areola: 4-6 months

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