So what are "perforator flaps"?

Pioneered in the early 1990's, perforator flap breast reconstruction represents the state of the art in breast reconstruction surgery after mastectomy. The tissue removed at the time of mastectomy may be replaced with the patient's own warm, soft, living tissue to recreate a "natural" breast.

Skin, fatty tissue, and the tiny blood vessels that supply nutrients to the tissue ("perforators") can be taken from the patient's abdomen (SIEA flap and DIEP flap procedures) or buttocks (GAP flap procedure).

Unlike conventional tissue reconstruction techniques (like the TRAM flap), these microsurgical perforator flap techniques carefully preserve the patient's underlying musculature. The tissue is then transplanted to the patient's chest and reconnected using microsurgery.

Preserving underlying muscles lessens postoperative discomfort making the recovery easier and shorter, and also enables the patient to maintain muscle strength long-term. This is particularly important for active women.

As with all types of breast reconstruction, 2 or 3 procedures performed a few months apart are often required to complete the reconstruction process and to obtain the best cosmetic result.

While perforator flap breast reconstruction offers many advantages to the patient, the surgeries are very complex and time-consuming and specialized training is required.

Unfortunately, due to this complexity very few centers in the US offer these techniques so many patients will have to travel for the procedure. The good news is that many of these centers will accommodate out-of-state and even international patients.

Before choosing a plastic surgeon ensure that he/she is certified by the American Board of Plastic Surgery and has extensive experience with perforator flap surgery. Ask about the success rate of the procedure in their hands (most specialists boast a flap survival rate of at least 97%) and how many of these types of reconstructions they have performed.

Insurance companies are federally mandated to pay for the cost of breast reconstruction. Unfortunately, some patients will still face difficulties in gaining access to a perforator flap surgeon and the procedure. Here again it pays to seek out plastic surgeons who specialize in microsurgery (and perforator flap techniques in particular) as typically insurance specialists are available to help patients with insurance issues.

To learn more about each of these perforator flap techniques please click on the following links:

DIEP flap
SIEA flap
GAP flap

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Minas T Chrysopoulo, MD
Plastic, Reconstructive & Microsurgical Associates (PRMA)
9635 Huebner Road
San Antonio, TX 78240
Tel: (210) 692-1181
Toll Free: (800) 692-5565
www.prma-enhance.com
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