Most patients have enough tissue in the front area of the abdomen to have breast reconstruction using only that tissue (DIEP flap). The SHAEP flap offers an abdominal-based natural tissue reconstruction option for those who do not. It uses tissue from both the front of the abdomen and sides of the abdomen. Using the “love handle area” on each side of the body gives surgeons the opportunity to use more tissue.
Lower abdominal and hip tissue blood supply varies person-to-person, which means that this procedure typically requires a preoperative CT angiogram. This type of scan helps surgeons identify a patient’s strongest perforator blood vessels to approriately plan the surgery.
Types of SHAEP Breast Reconstruction procedures
All SHAEP flaps combine a DIEP flap with a flap that transfers tissue from the hip area. The deep circumflex iliac artery (DCIA) is most commonly used to supply blood to the hip area component of the flap. Other arteries may be used instead, depending upon the patient’s blood flow in that area of the body.
- Surgeons order and review a CT angiogram to identify blood supply and plan the procedure before surgery
- During surgery, a surgeon elevates flaps of shit and fat from both the lower abdomen and the hip area beside it
- The surgeon uses microsurgical techniques to expose the perforator vessels that feed the flaps, as identified by preoperative testing
- The flaps are moved to the chest wall and combined to make two breasts
- With the use of an operating microscope, a surgeon connects blood vessels in the flap to those in the chest wall
- After the flap transfer is complete, the donor sites are repaired and closed.
Risks & Benefits
Free flap breast reconstruction procedures all carry a small risk of flap failure in the event that the blood flow to the flap is disrupted after surgery. Flap failure risks are largely dependent upon a surgeon’s experience performing microsurgery and perforator surgery.
The SHAEP flap tends to produce high quality breast contour. In many cases, it also result in improved abdominal contour.