UW Surgeons Specialize in Various Breast Reconstruction Options
The UW Health Breast Center offers a wide range of reconstructive options for women after mastectomy. Its team of plastic and reconstructive surgeons provides experience and expertise in both breast implants and tissue flap procedures including the deep inferior epigastric perforator (DIEP) flap procedure.
Ahmed Afifi, MD is a UW Health plastic and reconstructive surgeon and assistant professor of surgery at the University of Wisconsin School of Medicine and Public Health. According to him, "The type of reconstructive surgery a woman selects is a highly personal decision. Our team of physicians and providers works closely with each patient to help her make a decision that best fits her personal needs."
The most common procedure is breast reconstruction by permanent implants. This procedure provides a shorter, less complex surgery, and faster recovery and return to daily activities than a tissue flap procedure.
However, women who are seeking a more natural look and feel of the breast, and do not want an artificial substance such as silicone in their bodies, often choose DIEP flap reconstruction. This procedure uses fat and skin from the lower abdomen to reconstruct the resemblance of a natural breast, simultaneously providing a tummy tuck for the patient. The tissues and accompanying blood vessels are reattached using microsurgery at the new breast site. Unlike the transverse rectus abdominus myocutaneous (TRAM) flap reconstruction, in which the abdominal muscle is harvested with the fat, the DIEP procedure preserves the muscle. The DIEP reconstructive surgery generally lasts six to eight hours and requires a hospital stay of four to five days as well as a recovery period of six weeks.
DIEP procedure is preferred for bilateral reconstruction, as it preserves the abdominal muscles on both sides of the body. Dr. Afifi notes that women who are considering a prophylactic mastectomy due to risk factors or genetic testing results often find the decision easier to make when they have the option for reconstruction, including the DIEP.
If a patient has had previous abdominal surgery, does not have enough skin or fat in the belly or is not fit enough to withstand the longer surgery, she would not be a candidate for DIEP. The UW Breast Center also offers procedures to meet each patient's individual needs and body type, including:
- Latissimus dorsi flap reconstruction
- Superior gluteal artery perforator (SGAP) flap reconstruction
- Superficial inferior epigastric artery (SIEA) flap reconstruction
- Transverse upper gracilis (TUG) flap reconstruction
Dr. Afifi states that breast reconstructive options are available for patients of different ages, lifestyles, and expectations. He says, "The patient and physician will come to a decision together to best meet the patient's needs. We are fortunate to have past patients who are willing to speak with prospective patients to give them a first-hand perspective. Our goal is to provide compassion and understanding throughout the patient’s reconstruction and recovery, and to help them make the most informed decision possible."