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in the operating theatre:

MeThodS of ReconSTRUcTIon

Implant-based reconstruction is a popu- lar choice that uses an implant to rebuild the is a popu- lar choice that uses an implant to rebuild the

breast. A deflated, expandable implant is placed under the chest muscle and small amounts of a salt water solution are injected every few weeks until the desired breast size is reached. A second surgery removes the expandable implant and replaces it with a permanent one, either silicone or saline. Small-breasted women with little abdomi- nal fat are the best candidates for this type of recon- struction. Women who have had radiation therapy on their chest are usually not good candidates, as the skin can be too damaged to stretch.

good candidates, as the skin can be too damaged to stretch. Autologous reconstruction uses skin, fat
good candidates, as the skin can be too damaged to stretch. Autologous reconstruction uses skin, fat

Autologous reconstruction uses skin, fat and muscle from the body; includes DIEP, SGAP, TRAM and TUG uses skin, fat and muscle from the body; includes DIEP, SGAP, TRAM and TUG

dIeP flap The Deep Interior Epigastric Perforator flap is microsurgery suitable for patients with sufficient stomach fat

suitable for patients with sufficient stomach fat 1. Skin, fat and blood vessels removed from the

1. Skin, fat and blood vessels removed from the abdomen, leaving the muscle in place to preserve abdominal strength and speed up recovery time.

3. New skin flap is attached to internal mammary vessels, which will nourish the flap.
3. New skin flap is attached
to internal mammary vessels,
which will nourish the flap.

2. The DIEP flap transports the deeper blood vessels that run below and within the abdomi- nal muscle.

New nipple and areola created at a later stage

nal muscle. New nipple and areola created at a later stage SGAP or IGAP flap spare

SGAP or IGAP flap spare the muscle, using only skin, fat and blood vessels from the upper or lower buttock to build a new breast. A sur- geon uses a microscope to reconnect even the tiniest blood vessels. SGAP uses tissue from the upper part of the buttock, while IGAP uses tissue from the lower buttock.

TUG flap is micro- surgery which uses skin, fat, blood ves- sels and some mus- cle from the patient’s inner thigh to create a new breast.

TRAM flap surgery uses muscle, skin, fat and blood vessels from the abdomen. The procedure can either be a pedicled flap, where the tissue is tunnelled under the abdominal skin to the chest and keeps its original blood supply, or a free flap, where the tissue is completely removed and reconnected through micro- surgery.