What is the SIEA flap?
The superficial inferior epigastric artery (SIEA) flap reconstruction is similar to the deep inferior epigastric perforator (DIEP) flap reconstruction in that the skin and fat from the lower abdomen is used to create a natural looking breast reconstruction. The only difference between these two flaps is in the blood supply for the flaps. The blood vessels for the SIEA flap are superficial (closer to the skin). Since the vessels are very superficial, the muscle is not touched. This results in a quick recovery and zero chance of hernia.
Who makes a good candidate?
The major limitation for the SIEA flap is that not everyone has large enough superficial inferior epigastric vessels for the operation to be successful. Preoperative imaging can help determine if a patient is a candidate, but the ultimate determination is made in the operating room with visualization of the vessel size.
What are the drawbacks
Similar to the DIEP flap, the SIEA flap can only be done once. Additionally, many patients are not candidates for a SIEA flap reconstruction.
How is the procedure performed?
The SIEA flap technique uses different perforator vessels so that no muscle manipulation is required, leaving the muscle completely intact. These superficial vessels can be found through incisions made in the lower abdominal skin and fat layer without touching the muscle layer.
Similar to the DIEP flap, the SIEA flap tissue will then be inserted into the empty breast envelope to reconstruct a natural-looking breast. Although this procedure may seem more appealing than a DIEP flap reconstruction, it is only in the operating room, at the time of surgery, when it can be confirmed that a woman is a candidate for this flap.