SIEA Flap Breast Reconstruction in Houston(Superficial
Inferior Epigastric Artery)
With recent advances in microsurgery, there are now a
variety of new and enhanced procedures available to women facing breast
reconstruction after mastectomy. While the pedicled TRAM Flap technique
is still widely used in the US, surgeons like Dr. Spiegel who possess advanced
training in microsurgical techniques are leading the way in providing breast
cancer survivors with new, sophisticated breast restoration options. New
techniques like the SIEA Flap (superficial inferior epigastric artery) facilitate improved aesthetic results
with fewer donor site complications and provide the patient with a new breast
created from her own soft, living tissue.
Very similar to the DIEP Flap procedure,
the SIEA Flap utilizes skin and
tissue from the lower abdominal region to reconstruct the new breast mound. The
main difference between these two breast reconstruction techniques lies in the
artery used to supply blood flow to the reconstructed breast. The blood vessels
utilized in the DIEP Flap generally run below and within the abdominal muscle,
while blood vessels for the SIEA Flap are
typically found in the fatty tissue located just below the skin. Since the SIEA
Flap does not use the deep inferior epigastric vessels, it does not require an
incision to be made into the abdominal muscle as in the DIEP Flap procedure.
In the SIEA Flap, incisions are
instead made in the skin and fat only. For this reason, recovery time from the
SIEA Flap is less painful than that of the DIEP Flap, and there is no risk of
hernia.
Unfortunately, only
about 30% of women are actually eligible for this surgery. The superficial
vessels are quite small and in the majority of women, these vessels are
simply too small to utilize or even find during surgery. If the superficial vessles are large or dominant blood supply to the patient’s abdomen however,
and are visible during surgery, then this would be the ideal blood supply to
utilize. However, this decision is not made until the time of surgery based on
the anatomy found, as it cannot be easily tested preoperatively. There are however
exams that can be helpful in predicting vessel presence prior to the operation.
Women who have had Cesarean sections or previous stomach surgeries are less
likely to have intact SIEA vessels.
While these
superficial vessels are typically smaller and more difficult to detect, they
are usually easier to dissect when large enough. This is because the SIEA Flap
procedure does not require dissection of the muscle and fascia. The DIEP Flap
is generally a longer and more technically demanding procedure since the
surgeon must locate and dissect the perforating vessels from the muscle. Both
of these microsurgical techniques minimize the risk of abdominal bulging and
hernia. Like the DIEP Flap, the SIEA
Flap uses the patient’s lower abdominal skin and fat and therefore provides
the added benefit of a tummy tuck procedure as well.
Despite the
advantages of these microsurgical techniques, there are still many plastic
surgeons that consistently rely on the TRAM Flap procedure as the
reconstructive procedure of choice. In fact, there are very few centers in the
US at present that routinely perform sophisticated muscle preserving techniques
like the DIEP and SIEA Flap. Very
few surgeons possess the technical training and experience required to perform
these complex microsurgical procedures. For this reason, many patients wishing
to have these less invasive, muscle-sparing techniques have to travel for their
procedures. Each year, numerous women make the journey to The Center for Breast
Restoration to undergo the DIEP or SIEA
Flap in Houston, TX at the hands of thoroughly trained and specialized Houston breast
reconstruction surgeon, Dr. Aldona Spiegel. Dr. Spiegel also offers routine
re-innervations in which nerves are carefully connected to facilitate gradual
return breast sensation.
For more information on these and other breast
reconstruction procedures, please contact us or visit us at our
Houston office. |
