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So what is a "perforator flap"?

Pioneered in the early 1990's, perforator flap breast reconstruction represents the state of the art in breast reconstruction surgery after mastectomy. The tissue removed at the time of mastectomy may be replaced with the patient's own warm, soft, living tissue to recreate a "natural" breast.

Skin, fatty tissue, and the tiny blood vessels that supply nutrients to the tissue ("perforators") can be taken from the patient's abdomen (SIEA flap or DIEP flap procedures) or buttocks (GAP flap).

Unlike conventional tissue reconstruction techniques (like the TRAM flap), these perforator flap techniques carefully preserve the patient's underlying musculature. The tissue is then transplanted to the patient's chest and reconnected using microsurgery.

Preserving underlying muscles lessens postoperative discomfort making the recovery easier and shorter, and also enables the patient to maintain muscle strength long-term. This is particularly important for active women.

While these procedures offer many advantages to the patient, the surgeries are very complex and time-consuming and specialized training is required. Before choosing a surgeon ensure that he/she is a plastic surgeon certified by the American Board of Plastic Surgery and has extensive experience with microsurgery and perforator flap breast reconstruction. Ask about the success rate of the procedure in their hands (most specialists boast a flap survival rate of at least 97%) and how many they have performed.

Insurance companies are federally mandated to pay for the cost of breast reconstruction. Unfortunately, some patients will still face difficulties in gaining access to microsurgeons specializing in procedures. Here again it pays to seek out plastic surgeons who specialize in these techniques as typically an insurance specialist is available to help patients with insurance issues.