Which flap revision is for me? (Photo)
Doctor Answers 3
DIEP flap reconstruction
I am sorry about your experience post mastectomy. You would get better results with autologous tissue breast reconstruction. The best option is using your lower abdominal tissue without using the muscle( Deep Inferior Perforator Flap) to avoid wreaking the abdominal muscle. The other option is to use the tissue from inner thigh (PAP) flap.
You have options!
I agree with Dr Whitfield, but I would add a few more options. You could have another attempt at implant reconstruction if you have not had radiation, but it would be risky and the outcome might not be so good. You could undergo bilateral latissimus dorsi flaps and if you didn't have enough tissue you could place an expander or implant under the flap. There are a variety of abdominal flaps (pedicle TRAM, free TRAM, muscle-sparing TRAM, DIEP, SIEA) that would work if you have enough abdominal tissue, and then there are a variety of "secondary" flaps from the buttocks and thigh. You should seek consultation with someone experienced in all of these techniques, so they can assess your body and determine the best plan. Good luck!
Breast reconstruction revision with DIEP flap or PAP flap
Given your history of infection you are being referred for reconstruction with your own tissues. The most common source is your lower abdomen. The concern of a lower abdominal bulge does exist but is low (0.7% to 5%). The next most common procedure uses the inner thigh tissue in the form of a PAP or TUG flap. After that the upper buttock tissue can be used in the form of an SGAP flap.
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