MUSC Advanced Breast Reconstruction program

Perforator Flaps

Using flaps of a woman’s natural tissue for breast reconstruction can be done without transferring muscle tissue when the flap includes a perforating blood vessel. Perforator flaps promise optimal cosmetic results without the loss of muscle strength.  While procedures vary based on where the perforator flap originates, the general approach usually is the same. A flap of skin, fat and blood vessels is carefully detached from one part of your body, then reattached and shaped into a new breast at the mastectomy site.  At MUSC, two surgeons accomplished in complex microsurgery will work together to reconnect the blood vessels, shortening the time of the operation.

One of the most successful perforator flap procedures uses a DIEP flap, which is taken from the abdominal region, where many women have fat and skin to spare. In some cases, though, using the DIEP flap is not always possible, or there may be better options. The decision about which type of flap to use is based on many factors including the amount of tissue available at the donor site, desired breast size, expected scarring and the patient’s surgical history. We will help you to determine the solution that works best for your situation.

You may not be a flap candidate if:

  • you do not have enough body fat to make the size breast that you desire.
  • you wish to avoid a donor site scar.
  • you have had previous surgeries that have injured perforating vessels.
  • you have a medical condition that limits your ability to withstand general anesthesia for an extended period of time.
  • you require systemic anticoagulation (blood thinners).

Perforator Flap Procedures

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