Tissue Based Breast Reconstruction Houston


Individual results may vary

Tissue Reconstruction is another option available to women seeking breast reconstruction after mastectomy in Houston, The Woodlands, and Conroe, Texas. There are several options available to the patient in terms of autologous tissue reconstruction:

  1. DIEP Flap: This is the most popular method of tissue reconstruction in my practice. This technique utilizes one’s skin and soft tissue from the abdomen with the markings of a tummy tuck.
  2. GAP flap: this utilizes tissue from the upper or lower buttocks area to reconstruct the breasts.
  3. TUG flap: this technique utilizes the soft tissue from the inner thigh and the underlying gracilis muscle to reconstruct a breast.
  4. Latissimus Dorsi myocutaneous flap. This involves utilizing the skin and muscle of the upper back/bra line area to reconstruct the breast. With this flap technique, a small implant is often added to help achieve desired size.
“From my first visit Dr. Gill explained what I will be looking at and I felt very confident in Dr. Gill after my first visit. I am still in Stage 1 of my procedures but I am amazed at how well everything turned out. I have had several nurses and Dr’s see Dr. Gill’s work and they were very impressed.
The staff is great; they are always so cheerful and genuinely concerned about how you are doing.
Reasons to choose Dr. Gill:
• Dr. Gill is always a pleasure to be around. Cheerful and always is concerned about if you are in pain or not.
• I like that they come to Conroe once a week, that is so nice since I live and work in Conroe.
• When in the hospital he came in and explained the procedure again to me before surgery and checked on me several times after the surgery.
• That he had worked with my surgeon before.
• Makes you feel like a person and not just a patient.
I have already recommended him to my primary Dr. and friends that I meet.”

- C.D.

Individual results may vary

What is a DIEP Flap?

Deep Inferior Epigastric Perforator flap is a state-of-the-art breast reconstruction that has become the gold standard for autologous/tissue reconstruction in Houston, The Woodlands, and Conroe, Texas area. It involves utilizing one skin and fat from the abdomen to reconstructive the breast. Abdominal tissue is the most natural and closest tissue match to breast tissue. The technique preserves the abdominal musculature by identifying the blood supply to the overlying skin and fat and then dissecting this blood supply carefully through the six pack/rectus muscle. This leads to a main trunk or blood supply that can be harvested and connected to the chest wall. The advantage of this technique is that it preserves the rectus muscle since the muscle is simply open like a book, the blood supply removed, and then closed like a book. The old way of doing this, known as the TRAM flap, used to involve taking the whole six pack/rectus muscle to maintain blood supply to the overlying tissues. In this TRAM flap technique over 11% of patients developed hernias or abdominal wall weakness. Utilizing the state-of-the-art DIEP Flap technique, we are able to reduce the risk of hernia or bulge to less than 0.6%. Hence it allows us to utilize one’s own tissue without the risk and morbidity of the older TRAM techniques in terms of morbidity to the abdominal wall.

What is the recovery from a DIEP flap?

With this method of reconstruction, Dr. Gill usually monitor the patient in the hospital for a period of four days. This is because we have to be certain that the blood supply going into the tissue and going out of the tissue is healthy and safe. In addition it typically takes 3 to 4 hours to reconstruct one breast with this technique and 5 to 7 hours for both breast to be reconstructed utilizing the DIEP flap. Therefore, utilizing one’s own tissue does add to anesthesia time and hospital stay. We do find the patients require a longer recovery compared the implant reconstruction. Generally, most patients are off the pain medication and the drains are out by two weeks. Therefore, utilizing these techniques patients have a higher short-term risk in terms of longer surgery and longer healing, but we find that patients have much less long-term risk with the tissue flaps in comparison to implants. In fact many national plastic surgery surveys demonstrated a much higher level of patient satisfaction with tissue flaps in terms of their body self image.

How does the reconstructive process work after the initial DIEP flap?

After the initial reconstruction is complete, we typically will wait a period of 3 months to allow swelling/bruising to decrease and the breast tissue to settle. We will then perform a 2nd stage procedure as an outpatient, a shaping and symmetry procedure. This is the time where we further fine-tune the reconstructed breast and then perform any symmetry procedure, such as a lift/reduction or augmentation, to the contralateral breast. There are several options to reshape the tissue flaps. This can involve removal of flat tissue removal or mastectomy skin. We also use fat grafting to add volume to the flap itself or into areas around the flap to help further shape or contour the overall result. This can allow for a more natural reconstructed breast.

What are the advantages of Tissue Breast Reconstruction?

Tissue Reconstruction has a very high patient satisfaction rating in the long-term surveys. Once a patient heals, there is very little risk of problems such as scar tissue or infection. Many patients commend that the tissue looks and feels similar to their pre-existing breast tissue.

What are the disadvantages of Tissue Breast Reconstruction?

There is more short term risk with tissue reconstruction. There is a longer anesthesia time and longer hospital stay. We do find that the recovery typically takes 1-2 more weeks than an implant reconstruction. In addition, there are added risks of wound healing and infection associated with the donor site incision.