Perforator Flap Frequently Asked Questions
1. Am I a candidate for an abdominal perforator flap breast reconstruction?2. If I am not a candidate for an abdominal perforator flap (DIEP or SIEA), then what other options do I have?
3. Can I have a DIEP flap at the same time as my mastectomy operation?
4. Can I have a DIEP flap if I already had a mastectomy?
5. Can I have a DIEP flap if I have an implant breast reconstruction?
6. What should I bring with me to my consultation with Dr. Vasile?
7. What will the consultation be like?
8. How long will the surgery last?
9. Who will be in the surgery?
10. How long do I need to stay in the hospital?
11. Will I be able to walk after the surgery?
12. Are there any physical limitations after the surgery?
1. Am I a candidate for an abdominal perforator flap breast reconstruction?
If you do not smoke and you have not had a tummy tuck (abdominoplasty) or liposuction procedure to the abdomen, then most likely you are a candidate for the procedure. A MRA (magnetic resonance angiography) study, that Dr. Vasile developed with Drs. Prince and Newman, will also help make that determination.
2. If I am not a candidate for an abdominal perforator flap (DIEP or SIEA), then what other options do I have?
Other donor sites may be an option. For example, the upper and lower buttock (SGAP, IGAP, or DFAP flap), the inner thigh (TUG or TUT flap), and the lateral chest (lateral thoracic flap). Dr. Vasile worked with Drs. Prince and Newman to also develop MRA protocols for all these other donor sites. The hospitalization and recovery time is the same for the other donor sites that require microsurgery (buttock and thigh). The lateral thoracic flap only requires an overnight stay in the hospital.
3. Can I have a DIEP flap at the same time as my mastectomy operation?
Yes, the most common scenario is breast reconstruction during the same operation as when the mastectomy is done (immediate reconstruction).
4. Can I have a DIEP flap if I already had a mastectomy?
Yes, many patients have a DIEP flap breast reconstruction during a separate operation after the mastectomy (delayed reconstruction). This can range from months to years after their initial mastectomy operation.
5. Can I have a DIEP flap if I have an implant breast reconstruction?
Yes, many patients have a DIEP flap breast reconstruction after a failed implant breast reconstruction from capsular contracture, pain, etc. The implant is removed at the time of the DIEP flap and the capsule scar contracture is cut and partially removed.
6. What should I bring with me to my consultation with Dr. Vasile?
You should bring your records regarding the type and staging of your breast cancer, the treatment of your breast cancer, and your most recent imaging study results of your breasts.
7. What will the consultation be like?
You will have a very informative meeting with Dr. Vasile. The beginning of the consultation will be information gathering for Dr. Vasile. The middle portion of the consultation will be understanding your goals. The last portion of the consultation will be educating you on the procedures. You will then be examined by Dr. Vasile. At the end of the examination, medical photographs will be taken.
8. How long does the surgery last?
The length of time depends on whether a mastectomy is done at the same time, whether one breast or both breasts are being reconstructed, and which donor site is being used. In general, the average surgical time can range from 4 to 8 hours.
9. Who will be in the surgery?
The surgery will be performed by Dr. Vasile and another surgeon, who has extensive training in perforator flap microsurgical breast reconstruction. Other members of the surgical team, such as nurses, physician assistants, and anesthesia staff help take care of you.
10. How long do I need to stay in the hospital?
You will need to stay in the hospital until the fourth postoperative day so that we can make sure the reconstructed breast is well.
11. Will I be able to walk after the surgery?
Yes, you should be walking the day after surgery.
12. Are there any physical limitations after the surgery?
You are encouraged to be active. However, you may not lift heavy weights (over 10 lbs) and you may not run for one month after the surgery. Thereafter, you may resume your full exercise routine.