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Are there different types of free flap breast reconstructions?

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Last Modified: May 8, 2009

Dear OncoLink "Ask The Experts,"

Are there different types of free flap breast reconstructions?

Rachel McKenna, MSN, CRNP, Nurse Practitioner in the Division of Plastic Surgery at the University of Pennsylvania Hospital, responds:

Yes, there are several different types of free flap breast reconstruction.

Usually the tissue is taken from your lower abdomen. There are 3 possible types of free flap reconstruction from the lower abdomen. As discussed previously, the decision of which of these three is best for you is not finalized until the surgery is started and we can look at the anatomy of your abdominal wall.

1. Free TRAM flap = Free Transverse Rectus Abdominus Myocutaneous Flap, in this surgery skin, fat, blood vessels and a small piece of muscle are taken
2. DIEP flap = Deep Inferior Epigastric Perforator flap, in this surgery the abdominal muscle is cut in order to get the vessels but no muscle is taken.
3. SIEA flap = Superficial Inferior Epigastric Artery flap, in this surgery no incisions are made to the abdominal muscle, all vessels taken are from on top of the muscle.

If you have had a previous major abdominal surgery such as an abdominoplasty (tummy tuck) or if you do not have enough tissue on your lower abdomen to reconstruct your breast we can also use tissue from your buttocks or inner thighs. Many abdominal operations, such as Cesarean sections, do not limit our ability to use the tissue of the lower abdomen.