“Body Lift Breast Reconstruction” uses four flaps in total to reconstruct two breasts. With this approach, it is possible to reconstruct both breasts and achieve a larger breast size than could be achieved with a single DIEP flap for each breast. Body Lift Breast Reconstruction uses a DIEP flap from each side of the abdomen in combination with a second flap prepared from the tissue of the flank or “love handle” area. (A) The blood vessels that supply each of the four individual flaps used in this technique are meticulously separated from muscle, thus leaving muscle intact and functioning. (Inset) The blood vessels of two individual flaps are shown interconnected to one another in preparation for transfer to the chest. This procedure is performed on both sides of the abdomen to create two sets of stacked flaps. (B) The two sets of stacked flaps are transferred to the chest and, using microsurgical techniques, connected to blood vessels that will nourish the newly reconstructed breasts. (C) As is the case with body lift surgery, Body Lift Breast Reconstruction sculpts the waistline, flanks, and in some cases, outer thighs.
For women whose tummy tissue is not adequate or sufficient enough for ordinary DIEP flap reconstruction, “Body Lift Breast Reconstruction,” or “extended DIEP” flap breast reconstruction, can be a solution for restoring both breasts with natural living tissue. Just as stacked DIEP flaps can provide the necessary tissue to restore one breast when a single DIEP flap is not enough, Body Lift Breast Reconstruction is an option when one DIEP flap for each breast is just not enough. Using two flaps for each breast—four flaps in total—with the flaps folded, layered or “stacked” upon each other, gives added size and projection to the new breasts, especially for women who would not have enough tissue to be a candidate for traditional DIEP flap reconstruction, and/or have been told that they “do not have enough tissue” for a natural-tissue breast reconstruction.
Double-stacked breast reconstruction is most commonly done using a “body lift” technique. We design the perforator flaps used in this surgery much the same way that cosmetic plastic surgeons design a body lift. By combining DIEP flaps from the front of the abdomen with perforator flaps taken from the flank or “love handle” area (typically Deep Circumflex Iliac Artery or DCIA flaps), the extended DIEP flap technique reshapes the tummy and waist to produce an hourglass silhouette. Less frequently, we combine DIEP flaps from the abdomen with flaps taken from the thighs, in what is sometimes called a “four-flap” breast reconstruction. Regardless of which approach we use, our goal is to maximize the aesthetic results at the breasts as well as at the site of the “donated” tissue.
Blood vessels that are used for “Body Lift Breast Reconstruction” or “Four Flap Breast Reconstruction” are meticulously dissected without removing or destroying muscle. Because muscle is preserved, postoperative pain and discomfort are minimized, and strength and function are preserved. After the tissue that will form each new breast is transferred to the chest, the blood vessels that will nourish each flap are connected to blood vessels at the mastectomy site using delicate microsurgical techniques. When possible, sensory nerves may be connected to facilitate recovery of sensation in a reconstructed breast. Finally, the tissue is shaped into a new breast.
Because the lower abdominal tissue used for “Body Lift Breast Reconstruction” or “Four Flap Breast Reconstruction,” is similar to that removed during a tummy-tuck, or body-lift cosmetic procedure, women who undergo this procedure generally benefit from an improvement in the contour of their abdomen and waist. While typically not as low as the scar of a tummy-tuck, the scar that results from this type of surgery can typically be concealed in most clothing and in a once-piece bathing suit.
Approximately three months after the initial stage of breast reconstruction surgery, refinement of breast shape and procedures to produce overall symmetry can be completed. These optional additional procedures are performed on an outpatient basis and are referred to as Stage II.
Contact us if you would like more information about body lift breast reconstruction or for information about other options for breast reconstruction including DIEP flap surgery after mastectomy or breast reconstruction using breast implants. Our practice has offices in New York and Fairfield County, Greenwich Connecticut, and on the campus of Vassar Brothers Medical Center, in the Hudson Valley.