What to Expect

Flap-based breast reconstruction moves fatty tissue from elsewhere on your body to the breast site. This procedure allows for the reconstructed breasts to seem more like normal breasts when compared to a breast reconstructed with an implant. In addition, the flap-based reconstructed breast will adjust with changes in weight. Flap surgery is a longer and more complicated procedure than an implant procedure and can add approximately three to eight hours to the procedure. Microsurgery is used to connect the blood vessels from the transferred tissue to the existing blood vessels on your chest. The recovery time is longer for flap surgery due to multiple surgery sites.

Despite the longer operative time, the operation does not alter vital functions in a major way. The level of invasiveness of the procedure is akin to a “tummy tuck” with hernia repair, but because of the need for flap monitoring, the patient will stay in the hospital for at least five days.


Risks & Complications

There is a possibility for additional procedures following your flap reconstruction. There is a possible impact on the area of tissue retrieval, such as loss of sensation or increased risk for a hernia. Tissue death (necrosis) may occur due to insufficient blood supply. However, a surgeon can trim this area if it is small enough. Loss of sensation may occur at the tissue donor site. There is also a risk of lumps forming due to firm scar tissue replacing fat tissue that had its circulation cut off, which can also be removed.

As with any surgical procedure, medical risks, bleeding, and wound complications may occur. These wounds however hardly ever require re-operations. The scars are frequently touched up during the revisional symmetry procedures.

Because of the underlying abdominal skin, the lower abdomen may have some areas with decreased sensation. While hernias or bulges are incredibly uncommon, a mesh may be used to reinforce the donor site.

Despite the hardship of postoperative recovery, breast free flap reconstructions (DIEP flaps) carry high long-term patient satisfaction rates.

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Types of Flap Surgery

Palm Aesthetics Plastic Surgery - TRAM Flap- Breast Reconstruction Sarasota, Bradenton, Lakewood Ranch


TRAM (transverse rectus abdominis myocutaneous) uses skin, fat, blood vessels and muscle in the lower abdomen, between the waist and pubic bone to rebuild the breast. TRAM flap tissue is very similar to breast tissue, making it a good substitute and the most commonly performed flap surgery. The risk of TRAM flap surgery is that abdominal function may be compromised by cutting through the muscle.

Palm Aesthetics Plastic Surgery - DIEP Flap - Breast Reconstruction - Lakewood Ranch, Sarasota, Bradenton, Florida


DIEP (inferior epigastric perforators) utilizes blood vessels that run through the abdomen, along with the skin and fat connected to them, to reconstruct the breast while sparing any muscle. The blood vessels are harvested and grow with the autologous tissue.

Stacked DIEP Flap

Stacked DIEP flap is a newer procedure that is ideal for women who do not have enough abdominal tissue for a standard DIEP flap. The entire or continuous flap from the lower abdomen is either stacked or folded in half for the breast reconstruction. It is also muscle-sparing as no muscle is removed or cut.

Palm Aesthetics Plastic Surgery - SIEA Flap - Breast Reconstruction - Lakewood Ranch, Sarasota, Bradenton


SIEA (superficial inferior epigastric artery), is also a muscle-sparing flap surgery and utilizes the blood vessel that runs just under the lower abdomen for breast reconstruction. It is also sometimes called SIEP (superficial inferior epigastric perforator). SIEA flap differs from the DIEP flap as it uses a different section of abdominal blood vessels. SIEA Flap requires no incision, but DIEP flap requires a small incision in the fascia, the layer covering the rectus abdominis muscle.

Palm Aesthetics Plastic Surgery - Latissimus Flap - Breast Reconstruction - Lakewood Ranch, Sarasota, Bradenton

Latissimus Dorsi Flap

Latissimus dorsi flap uses the muscle on your upper back, along with the skin, fat and blood vessels attached for breast reconstruction. It is closer to the chest than the abdominal flaps, and is a good choice for women that cannot have TRAM, DIEP, or SIEA flaps due to reasons such as a lack of tissue.

Palm Aesthetics Plastic Surgery - Latissimus Flap - Breast Reconstruction - Lakewood Ranch, Sarasota, Bradenton

TUG Flap

TUG (transverse upper gracilis) uses the muscle, skin, fat and blood vessels located in the upper inner thigh to reconstruct a breast. TUG flap is a good flap surgery for women who do not have enough abdominal tissue, or want to achieve a desired breast size.

Palm Aesthetics Plastic Surgery - SGAP Flap - Breast Reconstruction - Lakewood Ranch, Sarasota, Bradenton

SGAP/Hip Flap

SGAP/hip (superior gluteal artery perforator) is a muscle-sparing breast reconstruction that utilizes the blood vessels, skin, and fat from the upper buttocks or hip. It is an ideal flap surgery for women that are having the procedure done on both breasts and do not have enough abdominal tissue. Your buttocks will be smaller and tighter due to the removal of skin and fat.


IGAP (inferior gluteal artery perforator) also utilizes blood vessels from the buttocks, but IGAP uses the tissue on the bottom of the buttocks, near the buttock crease.

Stacked GAP Flap

Stacked GAP flap takes a flap of skin from each upper buttock to recreate a single breast and takes longer than TRAM, DIEP, or SIEA flap surgery. It is recommended to those who do not have enough tissue in the other areas.

PAP Flap

PAP (profunda artery perforator) flap, utilizes a blood vessel that runs through your thigh, along with skin and fat for breast reconstruction. PAP flap is a muscle-sparing flap surgery.

Body Lift Perforator Flap

Body lift perforator flap reconstruction combines DIEP flap and SGAP/Hip flap reconstruction, ideal for slim women with medium-to-large breasts who are having both of their breasts reconstructed but do not have enough abdominal or buttocks tissue to recreate the size of their breasts. It is also a great option for women who want to replace their breast implants for a more natural flap reconstruction.

Consultation Request

Are you ready to begin your transformation and have the plastic surgery procedures performed by a comprehensively trained and experienced plastic surgeon? Request a consultation by submitting the form below or by calling Palm Aesthetics Plastic Surgery Center at 941-822-8955 today. You will receive a confidential, in-depth, personalized consultation with our plastic surgeons on your selected procedure.

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