Dr Griffin offers the broad spectrum of breast reconstruction options, including Advanced Microsurgical Breast Reconstruction. He is fellowship trained in Microsurgery, and has extensive and ongoing experience in breast reconstruction. Although the newer microsurgical options are excellent for many patients, it is important that all patients be presented with the full spectrum of options. For many patients, Autologous Reconstruction, which is the use of the patient's own tissues to make a new breast, is best. For other patients, Tissue Expander and Breast Implant reconstructions are better. Ultimately, patient choice is one of the most important factors in the decision for breast reconstruction. Dr. Griffin works closely with each patient to determine the individualized reconstructive plan.
The DIEP and SIEA Flaps - Deep Inferior Epigastric Perforator and Superficial
inferior Epigastric Artery Flaps
The DIEP and SIEA flaps are advanced methods of breast reconstruction.
Using microsurgery, healthy skin and tissue from the patient's abdomen is
used to restore a natural appearing, soft and living breast.
These flaps, as well as other microsurgical flaps, have an additional advantage of preservation of the abdominal wall muscles: the Rectus Muscles, or rather, the patient's sit-up muscles. There is significantly less risk of abdominal muscle weakness and hernias when muscle-sparing options, such as the DIEP, are used, when compared to the TRAM flap.
Gluteal Perforator Flaps and Medial Thigh/Gracilis Flaps for Breast Reconstruction
Select patients, who are good candidates for, and desire microsurgical
breast reconstruction, may choose alternatives to the DIEP and SIEA
flaps. Some patients have had a prior abdominoplasty, TRAM flap, or
DIEP. These patients may desire autologous breast reconstruction, and
not be able to use the lower abdominal tissue for breast reconstruction.
In these cases, use of the tissue from the upper buttock (the SGAP
Flap) may be a good option. Alternatively, the patient may be able
to use the tissue from the medial thigh (the Gracilis Flap) to reconstruct
a living breast.
In some cases, depending on a patient's individual anatomy, there may
not be enough lower abdominal tissue available to create an optimal
breast. These patients may choose Gracilis or Gluteal flaps instead
of DIEP or SIEA for breast reconstruction. All of the microsurgical
options have pros and cons. Patient preference, patient anatomy, and
Dr. Griffin's recommendations all play a part in choosing the best
reconstructive option for each patient.
Latissimus Flap
The latissimus flap is the transfer of muscle, skin and fat from the
patient's back to make a new breast. The latissimus flap is used most commonly
on top of a breast implant. Sometimes the latissimus flap can be used by
itself to fashion a breast.
This flap is an excellent way to add a more beautiful and natural shape to a breast implant reconstruction. It is also very useful in cases where the patient was treated with radiation after breast cancer.
Tissue Expanders and Implants
When implant reconstruction is chosen, it is usually preceded by tissue expansion.
In select patients, implants may be placed at the time of mastectomy, without
needing tissue expansion: Immediate Implant Reconstruction. The patient and
Dr Griffin may choose from a large variety of shapes and sizes of silicone
and saline implants.