Breast Reconstruction

Breast Reconstruction: Microsurgery

SIEA (Superficial Inferior Epigastric Artery) Flap Breast Reconstruction

The SIEA flap is very similar to the DIEP flap procedure. Both techniques use the lower abdominal skin and fatty tissue to reconstruct a natural, soft breast following mastectomy.

The main difference between the SIEA flap and the DIEP flap is the artery used to supply blood flow to the new breast. The SIEA blood vessels are found in the fatty tissue just below skin whereas the DIEP blood vessels run below and within the abdominal muscle. While the surgical preparation is slightly different, both procedures spare the abdominal muscle and only use the patient's skin and fat to reconstruct the breast.

Though the SIEA is similar to the DIEP, it is used less frequently since the arteries required are generally too small to sustain the flap in most patients. Less than 10% of patients have the anatomy required to allow this procedure, sometimes gastic bypass patients are good candidates for this procedure as the vessels are more likely to be adequate. Unfortunately, there are no reliable pre-operative tests to show which patients have the appropriate anatomy. The decision as to which type of reconstruction to perform is therefore made intra-operatively by the plastic surgeon based on the patient's anatomy. Dr. Williams always inspects the vessels to determine if an SIEA flap is appropriate.

As with the DIEP procedure, patients receive an abdominoplasty (tummy tuck) at the same time as an added benefit to SIEA flap breast reconstruction.