ADVANTAGES AND DISADVANTAGES OF MICROSURGICAL FLAPS

TummyMicrovascular flaps (also known as free flaps) like the DIEP, SIEA, and more recently the TUG flap, can improve the outcome of reconstruction by improving the aesthetics of the reconstructed breast and by reducing complications such as fat necrosis (hardening of the reconstructed breast) and flap loss (loss of the reconstruction). The donor tissue scarring is more acceptable and cannot be perceived through clothing like the latissimus reconstruction can. But microsurgical restoration can be surgically more complex and requires an increased operating time, and is not widely available.

Microsurgical reconstruction is not perfect. There are risks, benefits, alternatives and there can be complications. The final result will not be exactly like the original breast appeared. Sensation, although it will improve with time, will not return to normal. There are scars and microsurgeons cannot perfectly copy the original breast. But, in optimal circumstances the new breast is soft, the contour of the body is restored, and the appearance and feel are superior to mastectomy alone or after reconstruction with implants.

Advantages of the microsurgical flaps include:

  • No use of silicone or implants

  • Soft, permanent reconstruction

  • Tummy tuck or inner thigh lift of the donor area

  • High chance of success and low incidence of flap loss

  • No loss of abdominal muscles

  • Can be used after radiation

Disadvantages of microsurgical flaps include:

  • Not as widely available

  • Performed by only a few surgeons and requires experienced microsurgical center

  • Longer anesthetic time

  • Longer hospital stay than implant reconstruction

  • Longer recovery period than implants

  • Another area of your body requires surgery in addition to the breast