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 reconstruction. Autologous tissue is tissue used from a patient’s own body — most commonly, the fat, skin, and sometimes muscle. The tissue is taken in the form of a flap — a flap being that skin, fat, and muscle 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.
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 microsurgery 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.
What Is the SCIA Flap?
The abdomen is the preferred site to take tissue from to reconstruct the breast. The SCIA (Superficial Circumflex Iliac Artery) flap takes skin and fat from the abdomen and the superficial circumflex blood vessels. Like the DIEP (Deep Inferior Epigastric artery Perforator) flap, the SCIA Flap takes the skin and fat from the abdomen, much like a tummy tuck, but uses different blood supply. Unlike the blood supply to the DIEP Flap which “perforates” through the abdominal muscles, the SCIA Flap uses blood vessels (the superficial circumflex artery and vein) that run on top of the muscles and therefore, there is NO muscle disruption with the SCIA Flap.
The blood vessels for a SCIA are similar to those used in an SIEA Flap except that they are positioned more laterally (more toward the hips, away from the midline). There are fewer patients that actually have a superficial circumflex artery and vein that is of adequate size and that adequately supplies the skin and fat from the abdomen with blood flow. Because of this anatomic limitation, the decision to perform an SCIA Flap is usually made during surgery.
Other than the blood vessels used, every other aspect of the SCIA Flap is like the DIEP and SIEA flaps. The SCIA Flap is an elegant alternative to the DIEP Flap in those patients who have appropriate anatomy. It takes a high degree of skill to complete this, and there are only approximately 60 surgeons (less than 5% of all plastic surgeons) in the United States who perform this surgery. Dr Jeremy Williams and Dr Christopher Williams are passionate about helping educate the women in Colorado and across the United States and are proud to offer this procedure in partnership with Skyridge Medical Center.
Which Patients Benefit from an SCIA Flap?
There are several factors which help qualify a woman to undergo the SCIA 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 SCIA Flap.
Women who are the best candidates for the SCIA 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 SCIA Flap offers a lower risk of abdominal weakness or bulging, but that this “investment” will likely produce a more natural, longer-lasting result than other methods of reconstruction, including implant-based reconstruction. These women usually have few serious 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).
We have several women who have volunteered to be contacted by other patients to discuss any questions or concerns candidates may have — those lists are available at our office. These women have finished reconstruction and can offer personal insight, suggestions, and helpful tips to women starting the reconstruction process.
To schedule a consultation to learn more about these techniques, please call 720-457-4461 or schedule an appointment online.