SIEA Breast Reconstruction

John C. Lincoln Center for Reconstructive and Plastic Surgery
9250 N. Third St., Suite 1003
Phoenix, AZ 85020
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In SIEA flap breast reconstruction, a breast mound is formed from transplanted skin, fatty tissue and the superficial inferior epigastric perforator (SIEA) blood vessels within the tissue.

In many ways, SIEA flap surgery is similar to DIEP breast reconstruction. Both procedures remove a flap of tissue from the lower abdomen. In turn, this flap is used to reconstruct a breast. The abdominal muscles are left intact, and muscle function is preserved. A plastic surgeon uses microsurgery — delicate surgery that uses a microscope to operate on blood vessels that are 1 millimeter wide, or less — to reconnect the harvested blood vessels to the chest wall.

The key differentiator between SIEA and DIEP is the artery that is harvested along with skin and fatty tissue, to supply blood flow to the new breast.

  • In DIEP flap surgery, an incision is made through the abdominal muscle — the so-called "sixpack" — to harvest the deep inferior epigastric vessels.
  • By contrast, SIEA flap surgery does not cut through the abdomen, because the superficial inferior epigastric perforator vessels are located nearer to the skin.

Because fatty tissue is removed from the abdomen, women who undergo SIEA flap surgery often experience a flatter abdomen, just as one would after a "tummy tuck" procedure.

SIEA Flap Reconstruction Limited by Blood Vessel Size

Unfortunately, comparatively few patients are good candidates for SIEA flap reconstruction. The primary reason is because the superficial blood vessels are tiny. This limits the size of the abdominal area that can be used for a flap procedure. Superficial blood vessels may not be present for patients who have had past abdominal surgery, surgery such as Caesarean-section or hysterectomy.

If a patient is not a candidate for SIEA flap surgery, a microsurgery specialist may choose to perform a DIEP flap reconstruction instead.