At The Breast Center Park Meadows Cosmetic Surgery, our Board-certified plastic surgeons are proud to offer several types of reconstructive breast surgery. 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 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.
Pedicled Flap vs. Free Flap
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.
State-of-the-Art Breast Reconstruction Techniques
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, which 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 SIEA Flap?
Because many women have extra tissue in their abdomen, the abdominal flaps (DIEP, SIEA and SCIA) are the preferred methods for autologous breast reconstruction performed by Dr Jeremy Williams and Dr Christopher Williams.
Dr Jeremy Williams and Dr Christopher Williams were two of the first surgeons to offer the SIEA Flap in the Rocky Mountain region. The Superficial Inferior Epigastric Artery (SIEA) Flap is a state-of-the-art technique to reconstruct a woman’s breast using her own tissue, while limiting damage to the donor site.
The SIEA Flap is almost identical to the DIEP Flap, with the exception being that the abdominal muscle is not even entered because the artery runs superficial to the muscle. Usually, it’s not even determined until during surgery whether or not this specific type of procedure is possible — it starts as a DIEP Flap, and after the artery has been located, it’s then determined that the SIEA Flap is even a possibility.
Only 10-20% of women have this anatomy, and our surgeons do their best to utilize this anatomy and spare the muscle completely. The SIEA Flap is a perforator-based microsurgical method of breast reconstruction and spares both the nerves and the muscles from the abdomen — the same tissue removed in a standard tummy tuck.
Benefits of the SIEA Flap
While it is not a cosmetic procedure, women do enjoy many of the same benefits they would from a tummy tuck operation — and, as in a cosmetic tummy tuck, the muscle is left unharmed in the SIEA Flap. The skin and fat removed from the abdomen are relocated to the chest wall to reconstruct the breast.
This procedure is slightly longer than other flap methods of reconstruction because the blood vessels must be dissected from the muscle — 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.
Is the SIEA Flap Right for Me?
There are several factors which help qualify a woman to undergo the SIEA 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 SIEA Flap.
Women who are the best candidates for the SIEA Flap 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 SIEA 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.