At The Breast Center Park Meadows Cosmetic Surgery, we are proud to offer several types of breast reconstruction. Our ultimate goals are to help women restore their sense of self, well-being, sensuality and femininity during this difficult time while helping to maximize the aesthetic outcome as well.
Unique to the Rocky Mountain Region, Dr Jeremy Williams and Dr Christopher Williams offer the latest, state-of-the-art techniques in breast reconstruction, including Autologous Tissue Breast Reconstruction. Autologous tissue is tissue used from a patient’s own body — most commonly the muscle, fat, and skin. The tissue is taken in the form of a flap — a flap being that muscle, skin, and fat taken from one area of the body and relocated to another location on the body, carrying its own blood supply. There are two forms of flaps used today in breast reconstruction — Pedicled and Free Flaps.
A Pedicled Flap is a flap that has been rotated or moved from its original location to reconstruct a defect nearby, without losing that blood supply. These flaps were developed about 30 years ago and are still viable choices in breast reconstruction. A Free Flap is a flap whose blood supply is cut to move the tissue a longer distance for relocation. The blood supply (artery and vein) must be reconnected, using a microscope, once the flap is placed in its new location. Free flaps are newer techniques, developed about 20 years ago, and since have become frequently used in breast reconstruction.
How Does Flap Surgery Work?
Dr Jeremy Williams and Dr Christopher Williams use microsurgical techniques to move free flaps and reconnect the blood supply. They use a surgical microscope to help them reconnect the veins and arteries from the flap of the body with the relocated tissue on the chest. Without this connected blood supply, the tissue would not survive.
Perforator-Based Microsurgical Breast Reconstruction is the most current and state-of-the-art technique in breast reconstruction. It uses both muscle-sparing and nerve-sparing techniques in an effort to limit the damage to donor sites. At these donor sites, only the artery and veins (these are the blood vessels which “perforate” the muscles) are harvested. The muscles and nerves are left intact — this takes additional time and effort during surgery, but the surgeons at The Breast Center Park Meadows Cosmetic Surgery feel it is necessary to limit the damage to donor sites in breast reconstruction if possible.
Difference Between the DIEP Flap and Free TRAM Flap
The DIEP Flap is the preferred method for Autologous Breast Reconstruction performed by Dr Jeremy Williams and Dr Christopher Williams at The Breast Center Park Meadows Cosmetic Surgery. However, the Free TRAM (Transverse Rectus Abdominis Muscle) Flap is an older method of breast reconstruction, but still a viable option for some today.
While it is not a cosmetic procedure, women do enjoy many of the same benefits they would from a tummy tuck operation. The Free TRAM Flap is a Free Flap technique, similar to the TRAM Flap, which uses the skin, fat, and rectus abdominis (major abdominal) muscle and is relocated to the chest wall to reconstruct the breast. The difference between a TRAM Flap and a Free TRAM Flap is the Free TRAM Flap uses the Deep Inferior Epigastric Artery and Vein for the blood supply. Because the blood supply that is used with the Free TRAM comes up from the pelvis, the flap cannot be rotated to the chest and must be transferred to the chest where the flap is reconnected to a new blood supply in the chest using microsurgical techniques (free flap).
Unfortunately, even the Free TRAM Flap takes a very important muscle in the abdomen in an effort to protect and provide a blood supply to the tissue relocated in the breast. This can leave the patient with very weak abdominal muscles, and at a much higher risk for abdominal bulging and hernia formation. In some instances, a muscle-sparing free TRAM can be performed where a small piece of the rectus abdominis muscle is taken (the size of a postage stamp) rather than the entire muscle.
Some studies indicate that the muscle sparing free TRAM does not create as much abdominal weakness as the TRAM or free TRAM when used as a one sided (unilateral) procedure. However, for reconstruction of both breasts (bilateral), the muscle-sparing free TRAM appears to cause more abdominal weakness, especially when compared to procedures that take NO abdominal muscle such as the DIEP flap.
Candidates for Free TRAM Flap
Dr Jeremy Williams and Dr Christopher Williams are passionate about helping educate the women in Colorado and across the United States and offer this procedure in partnership with Skyridge Medical Center.
There are several factors which help qualify a woman to undergo the Free TRAM Flap method of breast reconstruction. Your surgeon will help go through the different options for you during your consultation at The Breast Center Park Meadows Cosmetic Surgery and ultimately determine if you are a candidate for the Free TRAM Flap.
Women who are the best candidates for the Free TRAM Flap are women who desire to have reconstruction and have extra tissue, skin, and fat in their lower abdomen for use as a donor site and desire a better abdominal contour, similar to that of a tummy tuck. These women understand the risks associated with all flap techniques and have determined that the TRAM Flap offers the best options for them personally and realize it will likely produce a more natural, longer-lasting result than other methods of reconstruction, including implant-based reconstruction. These women usually have few seriously medical problems and have enough emotional strength and support to be able to cope with the possible loss of a flap (less than 3% risk of flap loss).
To learn more about the Free TRAM Flap and other breast reconstruction options, please call 720-457-4461 or complete the form on this page to arrange a one-on-one consultation with our compassionate board-certified plastic surgeons at The Breast Center Park Meadows Cosmetic Surgery.