When you meet with our board-certified Plastic and Reconstructive Surgeon Dr. Ned Snyder IV you will quickly learn that there are many different options for breast reconstruction. The SIEA (superficial inferior epigastric artery) flap is a surgical technique comparable to the popular DIEP (deep inferior epigastric perforator) flap breast reconstruction. Both reconstructions allow for tissue removal in the lower abdomen. While the DIEP is the more preferred breast reconstruction for autologous tissue, the SIEA can be considered when the superficial blood vessels are the right size and length. Dr. Snyder will not be able to tell if you qualify for this type of reconstruction until the day of surgery. The SIEA blood vessels are found in the fatty tissue just below skin whereas the DIEP blood vessels run below and within the abdominal muscle (making the surgery more technically challenging). While the surgical preparation is slightly different, both procedures spare the abdominal muscle and only use the patient’s skin and fat to reconstruct the breast. The good news about the SIEA flap is that it can be performed with a less invasive technique than the DIEP flap, which may translate into a speedier recovery period.
Though the SIEA is similar to the DIEP, it is used less frequently since the arteries required are generally too small to sustain the flap in most patients. Less than 20% of patients have the anatomy required to allow this procedure. The decision as to which type of reconstruction to perform is therefore made intra-operatively by Dr. Snyder based on your anatomy. All of this can be discussed in a private and compassionate consultation in our office in Round Rock or Austin, TX.
On the day of your surgery, you will be checked in as a patient at a local hospital for your SIEA flap breast reconstruction. This will be a lengthy surgery (4 – 6 hours) and a general anesthetic will be used. If you are having a mastectomy performed at the same time, your general surgeon will remove your breast tissue while Dr. Snyder prepares to harvest the tissues in your lower abdomen. The incision made in the abdominal wall is just like an abdominoplasty (tummy tuck). One the incision is open, Dr. Snyder will be able to tell if you should have the SIEA or the DIEP flap surgery. The tissue will be collected, purified, and relocated to the chest. The blood vessels will be redirected and connected as well. Dr. Snyder will sculpt the new breast layer-by-layer until the desired size and shape are achieved.
After your surgery, you will wake up in our recovery area where our dedicated nursing staff will provide you with excellent post-op care. You will be staying for at least 4 – 6 days. During this time, your breasts will be monitored very carefully so that the flap does not fail. You will have drains on your abdomen and one on each breast. Our nurses will manage the drains for your while you are in the hospital and will show you how to empty them before you are discharged. Dr. Snyder will also prescribe a pain medication for you to fill at the pharmacy when you are ready to leave the hospital. You will have a follow-up visit 7 days after the surgery.
Your normal everyday tasks will need to be drastically reduced or eliminated as your body will need to take the time to heal. A caregiver, family member, or a home-health nurse will need to be with you for several weeks until you can be independent (bathe, use the toilet, dress, and care for incisions on your own). It may be challenging to get around, but be patient with your body. You may find it arduous to get out of bed, bend over, or perform any movement that requires you to use your ab muscles or arms. Standing up may be very frustrating and painful for a while, but it is important to try to move around to avoid a blood clot. Remember to watch for signs of fever and infection. Contact our team at Breast and Body Center of Austin if you have any questions or concerns about your recovery.
Plan Your Procedure
- Recovery Time
- 4 – 6 Weeks
- Average Procedure Time
- 4 – 6 Hours
- Post-op Follow-up
- 7 Days
- Procedure Recovery Location
SIEA Flap FAQs
When Can I have the Surgery?
Tissue flaps are typically performed at the same time as a mastectomy (immediate) or are an option for women that have already had a mastectomy in the past (delayed). We will work with your general surgeon on scheduling the reconstruction at the same time as the mastectomy if you want this option. Your health will be the ultimate factor in when you can have the surgery.
Will I need In-Home Care?
Someone will need to be there to help care for you in the weeks following your surgeries. This person will be helping you with bathing, toileting, dressing, emptying your surgical drains, moving around, and more for the first couple of weeks post-operation. This person will need to be someone you trust with your health and is physically able to help move you around if needed. You may wish to hire professional in-home care.
Will You work with my Surgeon?
Yes. Dr. Snyder will not be removing your breast in the mastectomy procedure. You will have a general surgeon to perform the mastectomy. We can work in tandem with your general surgeon to make the process as seamless as possible. Your treatment planning session is your time to ask questions, express concerns, and get more information on what you can and cannot do to reconstruct your breasts.