Perforator FLAP Breast Reconstruction
Perforator Flap breast reconstruction is a type of reconstructive surgery that uses a patient’s own tissue to reconstruct the breast mound. Although there are several surgical approaches, whose variations are depending on the patient’s donor site, the two most popular are DIEP Flap breast reconstruction and PAP Flap breast reconstruction.
Deciding which micro-surgical breast reconstruction technique is right for you depends on your body type and your personal preferences. Dr. Kari Colen or Dr. Steven Colen can help you decide which perforator Flap breast reconstruction technique is right for your during your consultation in either our Manhattan or Hackensack New Jersey office.
DIEP Flap Reconstruction
What is a DIEP Flap Reconstruction Procedure?
The deep inferior epigastric artery perforator (DIEP) flap is an evolution of the free TRAM flap surgical technique. As with the free TRAM flap, tummy fat and skin are transferred to re-create the breast mound. Using fat to reconstruct the breast gives a natural feel to the new breast and, in most people there is sufficient tissue available to create a moderate to large volume breast. Removing this skin and fat from the abdomen results in a ‘tummy-tuck‘ as part of the procedure.
The deep inferior epigastric artery is the blood vessel which supplies blood to the Rectus Abdominis muscle. It also gives off side branches, which travel through or around the muscle to the overlying fat.
The DIEP flap uses these side branches or ‘perforators‘ as its blood supply with the result that the Rectus Abdominis muscle is entirely uncut during the operation. This reduces the risk of abdominal weakness compared to the free TRAM. Although the muscle is untouched during this reconstruction, the thick fibrous tissue overlying the muscle (fascia) is cut to ensure that the perforators have sufficient length and diameter to supply blood to the reconstructed breast tissue. After the abdominal fat and skin are transferred to the breast, this cut is closed with a very strong suture to minimize the risk of abdominal wall weakness.
Am I a Candidate for DIEP Flap Reconstruction?
Because perforators are used rather than the main deep inferior epigastric artery and vein, this operation is not suitable for all women. Perforators are generally smaller in diameter than the main vessel, and vary in size between different people.
If the perforators are too small, this type of reconstruction may not be an ideal option. In fact, it is often not possible to predict the size of these vessels until surgery is underway, so your surgeon may offer you a DIEP flap reconstruction with the proviso that the operation may be changed to a free TRAM flap reconstruction on the table.
PAP Flap Reconstruction
What is PAP Flap Breast Reconstruction?
PAP Flap, or profunda artery perforator Flap, breast reconstruction is a surgical technique where a section of fat, skin, and blood vessels is removed from the back of your upper thigh (just below the buttocks) without any muscle removed to recreate a breast mound. Using this micro-surgical technique, Dr. Kari Colen or Dr. Stephen Colen of Colen MD will carefully reattach the blood vessels from the PAP with the blood vessels in the chest.
Another benefit of PAP Flap breast reconstruction is that because the flap is using the patient’s own skin and fat, the resulting breast mound feels very natural. Recovery from PAP flap reconstruction is also faster than other breast reconstruction techniques and there is less pain.
Am I A Candidate for PAP Flap Breast Reconstruction?
Women who have had earlier abdominal surgery or a very thin and therefore are not ideal candidates for TRAM or DIEP flap surgery, may find that PAP flap breast reconstruction is their ideal option. Dr. Kari Colen or Dr. Stephen Colen can discuss if PAP Flap breast reconstruction is ideal during your consultation at their Park Avenue Suite in Manhattan or Hackensack, New Jersey office.
