Natural Tissue Flap (Autologous) Breast Reconstruction

Before undergoing mastectomy, Dr. Lerman will discuss several different breast reconstruction options to perform at the time of the mastectomy to recreate the breast mound. Those seeking the most natural-looking results can have their breasts reconstructed using their own living tissue. The most advanced method is the DIEP flap reconstruction. This operation is the latest technique that evolved from an older operation known as the transverse rectus abdominis myocutaneous (TRAM) flap which is still widely utilized by surgeons who dont perform microvascular surgery and DIEP flap reconstruction.  Fortunately, Dr. Oren Z. Lerman has the advanced skills and training required to perform perforator flap microvascular breast reconstruction like the DIEP flap. Dr. Lerman not only performs this surgery routinely (over one hundred times annually), he also runs the microvascular breast reconstruction fellowship training the next generation of breast reconstruction and DIEP flap experts. We can review the full advantages of natural tissue (autologous) breast reconstruction during a personal consultation at our Manhattan, NYC or Westchester, NY practice. Contact us today to schedule an appointment. 

Understanding Microvascular Breast Reconstruction

The traditional form of flap reconstruction, TRAM flap reconstruction, involves recreating the breast by harvesting tissue from an area of the body and tunneling it under the skin to the breast mound with its blood vessels still attached. However, advances in surgical techniques have led to the introduction of microvascular breast reconstruction, or free flap reconstruction. The procedure gets its name because it involves completely separating donor tissue from the original blood supply (creating a free flap) before transferring it to the breast mound and reattaching the blood vessels to the chest wall under a microscope. In order to perform this state-of-the-art procedure, Dr. Lerman had to undergo special training in microvascular surgery.

Benefits over Traditional Flap Techniques

Microvascular breast reconstruction can create a new breast with an incredibly natural look and feel. When compared to TRAM flap reconstruction, this procedure offers patients several unique benefits. With microvascular breast reconstruction, Dr. Lerman can maximize blood flow to the tissue flap and preserve the muscle of the abdominal wall, which is not possible during TRAM flap reconstruction. As a result, microvascular breast reconstruction patients have a significantly lower risk of abdominal muscle weakness and most experience less post-operative pain. Finally, women who undergo microvascular breast reconstruction with abdominal tissue can experience the added benefit of improved abdominal contours, similar to the results achieved with a tummy tuck.

Types of Microvascular Breast Reconstruction

Based on your unique needs and goals for surgery, Dr. Lerman can harvest tissue from several different areas of the body during your microvascular flap reconstruction procedure:

• The abdomen (deep inferior epigastric perforator or DIEP)
• The buttocks (gluteal artery perforator or GAP)
• The posterior thigh (profunda artery perforator or PAP)
• The inner thigh (transverse upper gracilis or TUG)
• Stacked Flaps (combining 2 flaps to make one breast)
• Restoring Sensation after Mastectomy with Nerve Grafts

In addition, Dr. Lerman can perform a type of reconstruction known as stacked flaps, where two flaps are combined (such as the DIEP and the PAP) to create one breast. We can review the details and advantages of each type of microvascular flap reconstruction to identify the technique that is right for you.

Contact Us to Learn More

As a specialist in reconstructive and cosmetic plastic surgery, Dr. Lerman strives to achieve the highest level of excellence and care when treating each patient. To discover if microvascular breast reconstruction is right for you, schedule a personal consultation with Dr. Lerman today.