If you’ve undergone a mastectomy or are planning one as part of your breast cancer treatment, you may be exploring your options for breast reconstruction. One highly advanced technique that might be right for you is the SIEA flap procedure, a microsurgical approach that uses your own tissue to create a natural breast shape without compromising muscle strength. This is particularly appealing if you want to avoid implants and achieve a natural look and feel.
At the New York Group for Plastic Surgery, we specialize in breast reconstruction techniques, including the SIEA flap. Our board-certified plastic surgeons offer recommendations based on your anatomy, goals, and overall health. This guide will help you understand how the SIEA flap works, its benefits, who it’s right for, and what you can expect from the procedure.
What is the SIEA flap procedure?
The SIEA flap is often considered when you want to rebuild your breast using your own tissue, especially after a mastectomy. It’s a suitable option if you want to avoid implants and prefer a more natural reconstruction. Patients who qualify for the SIEA flap typically have enough soft tissue in the lower abdomen and want to preserve their abdominal muscle strength.
The SIEA flap (superficial inferior epigastric artery flap) uses skin and fat from the lower abdomen, much like the DIEP flap. However, instead of dissecting deeply to access blood vessels under the muscle, the SIEA flap utilizes superficial vessels located just beneath the skin. This means the abdominal muscles remain intact. The harvested tissue is microsurgically connected to blood vessels in the chest to reconstruct a natural-looking breast, all while preserving core strength and reducing the physical impact on the body.
Benefits of SIEA flap
Completely muscle-sparing approach
Unlike the TRAM or even the DIEP flap, the SIEA flap does not involve cutting or moving any abdominal muscle. This minimizes post-operative pain, preserves your core strength, and avoids the risk of abdominal hernias or bulging.
Faster recovery time
Because it’s less invasive, the SIEA flap typically involves a shorter hospital stay and a quicker return to daily activities. Many patients report feeling more mobile and less restricted during the initial healing phase, especially when compared to muscle-involving procedures.
Natural breast appearance and feel
The use of your own soft tissue allows the reconstructed breast to look and feel more natural than implants. Over time, your new breast will settle and move more like natural breast tissue, which can be especially comforting after a mastectomy.
Long-term durability
SIEA flap reconstructions are autologous, meaning they use your own tissue, which eliminates concerns about implant rupture or replacement. This makes the SIEA flap a durable, low-maintenance solution for many patients seeking long-term peace of mind.
Candidacy for the SIEA flap
Not every patient is a candidate for the SIEA flap, as it depends on factors like vascular anatomy, tissue availability, and overall health. Because the success of this procedure depends on the presence of strong superficial blood vessels in the abdomen, a thorough pre-surgical evaluation is essential. You may be a candidate for the SIEA flap if:
- You have adequate superficial abdominal blood vessels
- You have sufficient soft tissue in your lower abdomen
- You are in overall good health to undergo surgery
- You have not had extensive prior abdominal surgeries
- You are looking for a natural alternative to implants
At NGPS, our board-certified plastic surgeons conduct a comprehensive assessment to determine if the SIEA flap is right for you. This includes reviewing your medical history, surgical history, and desired goals. We also use Vectra XT 3D imaging, a cutting-edge tool that allows us to visualize and simulate your potential results with extreme precision. If the SIEA vessels are not viable, we may recommend other breast reconstruction options like the DIEP, PAP, or TUG flaps.
What to expect during the SIEA flap procedure?
During the SIEA flap procedure, you’ll be placed under general anesthesia. Your surgeon will begin by making a carefully planned incision in your lower abdomen to access the fatty tissue and superficial blood vessels. The SIEA artery and vein are meticulously preserved, and no muscle is cut or moved during this process.
Once the tissue is harvested, it is transferred to the chest, where microsurgery is used to connect the flap’s blood vessels to vessels in the chest wall. This reestablishes blood flow, allowing the tissue to survive in its new location. The tissue is then sculpted to create a breast mound that mimics the look and feel of a natural breast. Both the abdominal and chest incisions are then closed, and surgical drains may be placed temporarily to support healing.
Patients typically remain in the hospital for 2 to 3 days after surgery. The initial results can typically be seen immediately after surgery, but the final shape may develop over the following weeks. Because the procedure uses your own tissue, the results are long-lasting, soft, and natural, often with better long-term satisfaction than implant-based reconstruction.
Explore your candidacy for the SIEA flap procedure
The SIEA flap is a remarkable option for women seeking a natural, muscle-sparing breast reconstruction. While it’s not suitable for everyone, it offers distinct advantages, including quicker recovery and preserved abdominal strength, for the right candidates.
At the New York Group for Plastic Surgery, our experienced team specializes in advanced autologous breast reconstruction and uses cutting-edge tools like Vectra XT 3D imaging to ensure the best possible outcomes. If you’re considering breast reconstruction, we invite you to schedule a consultation to learn if the SIEA flap or another technique is right for you.
