Autologous Tissue flaps [TRAM, DIEP, SIEA, GAP]

  Autologous tissue (abdominal tissue reconstruction)- Just as above, there exists a paucity of both skin and volume which can be reconstructed using fat and skin from the abdomen. The typical incisions are the same as that of a tummy tuck, which is a side benefit of the procedure. There are several techniques usedto transfer this tissue up to the chest, depending on the amount of tissue needed and potential effects on the abdominal muscles. Dr. Gordley is facile in “free” microsurgical tissue transfers, and muscle sparing procedures (DIEP, SIEA and muscle sparing TRAM, GAP) will be used in select patients. The upside of this method is the natural appearing and natural feeling result, which requires no implant. An added benefit is the simultaneous tummy tuck. The downside is the longer recovery (6-8 weeks), the potential for abdominal hernia and muscle weakness, and a more complicated lengthy procedure.

Abdominal Tissue Reconstruction
 

Left Mastecomy and then Radiation, followed by free DIEP flap, and later Right breast lift

Bilateral Mastectomies with free DIEP flaps

Bilateral Nipple Sparing Mastectomies (for BRCA) and free DIEP flaps

Right Mastectomy with free DIEP flap, later with Bilateral implants and Left breast lift

Previous Right lumpectomy and radiation, now with new cancer, with Right mastectomy and free DIEP flap

 

Bilateral immediate reconstruction with free DIEP flaps, nipple reconstruction and areola tattoo

 

Right breast immediate reconstruction with ‘stacked’ DIEP flaps, nipple reconstruction and areola tattoo.

 

Right mastectomy with immediate free DIEP flap, followed by nipple reconstruction and areola tattoo.

Bilateral mastectomies with immediate free DIEP flap reconstruction, followed later by nipple reconstruction and areola tattoo.

Right mastectomy with immediate Tissue Expander placement, followed by radiation and chemotherapy, and ultimately followed with Right delayed reconstruction with free DIEP flap, and later nipple and areola reconstruction.

 

  Bilateral mastectomies with “buried” free DIEP flaps, one session of fat grafting,

followed by nipple reconstruction and areola tattoo

After original Rt. mastectomy and radiation, underwent Lt. prophylactic mastectomy,
with bilateral breast reconstruction with free DIEP Flaps, one session of fat grafting, and then nipple and areola reconstruction.

After previous bilateral mastectomy and implant based reconstruction by another surgeon,

revised with bilateral free DIEP flaps, then nipple and areola reconstruction.