Answers to Common SIEA Flap Questions

As a breast reconstruction surgeon located in the New York Metro area, I get a lot of questions from women from all walks of life who want to learn more about their reconstructive options following mastectomy. Many women come to me from all parts of New York and across the country to learn more about SIEA flap reconstruction. On this page I have put together a few of the more common questions I get about this technique. For more detailed questions or to find out if you are a candidate for this procedure, request a phone consultation with me or call the practice at 516-482-1100 to schedule an appointment.

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FAQ's about SIEA Flap

The SIEA flap seems like the best of all the abdominal flap reconstructions. Why can't my doctor just do that and not touch my muscles?

The SIEA flap is dependent upon tiny blood vessels that supply the fat and skin of the lower abdomen. In the majority of patients these vessels are just too small to either find or utilize. If they are large or the dominant blood supply to your abdomen, then these are the blood vessels that should be utilized. Unfortunately, this determination is not made until you are asleep in the operating room. One of the first steps in my procedure is to look for these vessels to see if these vessels exist and are large enough to nourish and drain the flap.

Is the post operative course any different for a patient who has had a SIEA flap any different than a patient who has had a DIEP flap?

While no muscle is utilized or has been touched in a SIEA flap I think the majority of the discomfort comes from pulling the abdominal skin together for the closure. I cannot detect any difference in the healing between patients who have had a SIEA flap and a DIEP flap.

Are their any technical issues that might make a surgeon reluctant to perform the SIEA flap?

While the blood vessels to the SIEA flap are small in size they generally are easier to dissect when large enough than the vessels to a DIEP flap. These vessels are also shorter in length which can make the shaping of the breast more difficult because of the shorter leash of the blood supply. When these vessels are present and large enough, this should not be a deterrent to a well-trained microsurgeon to perform this procedure.