Abdominal Flap Reconstruction

This surgery is ideal for women who have excess abdominal tissue below the level of their belly button. The skin, fat and sometimes a small portion of muscle in the lower abdomen are used to reconstruct the breast. Most commonly, the tissue is removed along with it’s blood vessels and then reconnected to new blood vessels near the breast. Poor candidates for this procedure include thin patient’s who do not have enough excess abdominal tissue, patient’s who smoke, patient’s with a history of a blood clotting disorder and those with multiple abdominal scars.

The Abdominal Flap Procedure

The steps below outline the surgical procedure in detail. Surgery is typically 6-8 hours for reconstruction of one breast and 10-12 hours for reconstruction of both breasts.

Step 1.
The excess tissue to be taken from the abdomen is marked.

Step 2.
The abdominal flap is raised off of the underlying abdominal wall.

Step 3.
The blood vessels supplying the abdominal tissue are identified and traced down to their origin in the groin.

Step 4.
The tissue along with it’s blood vessels are then freed to be transferred to the chest.

Step 5. The new blood vessels that the abdominal tissue will be connected to are located either in the armpit (Image A) or beside the breastbone (Image B), in which case a small portion of a rib is removed to reach them.

Image a.

Image b.

Step 6.
The blood vessels of the flap tissue are then connected to blood vessels in the chest and the flap is sewn into place.

Step 7.
The abdominal wound is closed. Scars will vary from patient to patient depending on many factors.

Recovery after the Abdominal Flap

Following surgery, the patient is admitted to hospital for 4 days and will require frequent check-ups by our nursing staff to ensure that the flap has adequate blood supply. Drainage tubes will be inserted in the abdomen and breast and will be removed by Dr. Yau when the drainage has decreased sufficiently, usually by post-operative day 10-14. Scars will be located on the operated breast around the skin paddle as well as across the abdomen spanning from hip to hip. Patients typically resume regular activities in 2 weeks and full strenuous exercise in 6 weeks. Nipple reconstruction typically occurs 3 months after surgery.

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