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DIEP FLAP
Deep Inferior Epigastric Perforator Flap
Perforator flaps represent the state of the art in breast reconstruction.
Replacing the skin and soft tissue removed at mastectomy with soft,
warm, living tissue is accomplished by borrowing skin and fatty tissue
from the abdomen.
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SGAP FLAP (bilateral simultaneous)
Gluteal Artery Perforator Flap
For the thin woman or those with otherwise inadequate tummy
tissue, the breast may be reconstructed with tissue borrowed from
the gluteal area. Skin, fat, and the tiny feeding blood vessels are
taken using a fine incision along the panty line.
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I-GAP FLAP (bilateral
simultaneous)
Inferior Gluteal Artery Perforator Flap
Our newest development, the In-The-Crease IGAP is an excellent
option for many women. Excess skin and fat are borrowed from the inferior
buttock, leaving an improvement in buttock shape, and a scar that
is completely hidden.
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SIEA FLAP
Superficial Inferior Epigastric Artery Flap
For some women the blood vessels just under the skin in the lower
abdomen may be chosen as the feeding vessels for the required tissue.
The procedure is otherwise the same as the SIEA flap.
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Autologous
Augmentation
Breast Augmentation with Patients’ own Tissue
The skin and fat on the lateral chest wall can be used to augment
the breast. This tissue is taken from under the arm, next to the breast.
The tissue used is named according to the blood vessels which supply
it. The blood supply to this tissue is either from perforators through
the muscle between the ribs (intercostal perforator artery or
ICAP flap), from the blood vessels in the armpit (axilla),
or from perforators through the latissimus dorsi muscle (thoracodorsal
artery perforator or TDAP flap). The living tissue
is turned over and secured under the breast.
ICAP FLAP: Before
and After Pictures |
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“Skin-Sparing” Mastectomy with Reconstruction
We now offer mastectomy and reconstruction with no scars
on the breast. For some patients, all breast skin including
the nipple and areola can be preserved. The
mastectomy is performed via an incision under the arm. The reconstruction
is done using a perforator flap (DIEP,SIEA or GAP flap) placed through
the same incision. The result is a natural, normal appearance with
no scars on the breast.
This new technique is being offered in selected cases for prophylactic
mastectomy, for patients with the BRCA gene mutation, for patients
with DCIS and for patients with invasive cancer.
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