Autologous Reconstruction in New Orleans, LA
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Contact UsWhat is Autologous Reconstruction?
Reconstructive surgery of the breast is performed using a patient's own natural tissue after a lumpectomy or mastectomy. These techniques are nuanced, sophisticated microsurgical procedures that help patients achieve natural-looking breasts after they have been removed. At Stalder Plastic Surgery in New Orleans, LA, we offer our breast reconstruction patients comprehensive autologous surgical options. Microsurgical tissue transfer is a primary focus of Dr. Stalder's practice, with years of experience, allowing him to adopt a patient-specific approach to developing each surgical plan. While the abdominal DIEP flap is the gold standard for most patients, there are many circumstances in which we may suggest taking tissue from other donor sites on the body or employing stacked flap techniques. Contact our office to learn more about your tissue reconstruction options.
What Are the Benefits of Autologous Reconstruction?
Autologous breast reconstruction represents a significant advancement in the field of reconstructive surgery, offering women undergoing mastectomy in New Orleans, LA a way to regain breast contour using their own tissue. This approach at Stalder Plastic Surgery offers several key benefits that enhance the overall reconstructive experience, including:
- Promotes a natural look and feel
- Reduces risk of rejection
- Provides long-lasting results
- Elimination of implant-related concerns
- Improved body image and better quality of life
- Possibility for sensation recovery over time
- Less long-term cosmetic maintenance
Am I A Candidate for Autologous Reconstruction?
For autologous reconstruction to work, you must have enough tissue on your body for Dr. Stalder to transfer to the breasts. While donor tissue is usually taken from the abdomen, Dr. Stalder can adjust his approach to harvest from the thighs, buttocks, or elsewhere. You also need to be in good overall health to minimize potential complications. During your consultation, Dr. Stalder can go over what to expect and how your treatment can be customized for your needs and goals.
What Can I Expect After Autologous Reconstruction?
The recovery period after autologous reconstruction varies depending on the specific procedure and your overall health. Initially, there will be some discomfort and swelling at both the donor site (where the tissue was taken from) and the reconstruction site. Dr. Stalder will provide pain management options to help alleviate any discomfort. You will also be given specific instructions on how to care for your surgical sites, including guidelines on activity restrictions to ensure proper healing. It's essential to follow these instructions closely and attend all follow-up appointments to monitor your progress and address any concerns as soon as possible.
Learn More About Flap Reconstruction
Please call our New Orleans, LA plastic surgery office today to learn more about the various types of autologous techniques for reconstructive breast surgery. Even if you have just received a breast cancer diagnosis, we would like to join your medical team while you are on your way to recovery. We will schedule your appointment for a complete evaluation and a personal consultation with Dr. Stalder at your earliest convenience.
Deep Inferior Epigastric Perforator (DIEP)
Deep Inferior Epigastric Perforator (DIEP): The DIEP flap is widely recognized as the gold standard in breast reconstruction. This procedure employs transferring abdominal tissue and blood vessels while still preserving function of the underlying muscles. This technique has the popular added benefit of aesthetic contouring of the abdomen, similar to a tummy tuck. Microsurgery techniques are used to reattach blood vessels, resulting in a breast reconstruction that is both enduring and natural in appearance.
Superficial Inferior Epigastric Artery (SIEA)
Superficial Inferior Epigastric Artery (SIEA): Named after the superficial inferior epigastric artery in the lower abdomen, the SIEA flap is comparable to the DIEP flap. But unlike DIEP flap surgery, which involves deeper tissue, this procedure utilizes blood vessels that bypass the abdominal musculature. The SIEA flap stands out by eliminating the need for any incision in the fascia layer covering the rectus abdominis muscle. This innovation avoids nerve, muscle, or fascial injury to the abdominal wall. The suitability for this type of flap surgery is limited, as successful reconstruction requires an adequate SIEA, found in only 10 – 15 percent of patients identified using CT scan imaging.
Abdominal Perforator Exchange (APEX)
Abdominal Perforator Exchange (APEX): This procedure uses the same tissue as a DIEP flap for breast reconstruction, however an APEX is performed when the positioning of the perforators in relation to the muscle is less than optimal. The small vessels used to transfer the tissue are cut and then reattached rather than cutting through muscle to obtain the proper blood supply. This allows for enhanced volume recruitment while ensuring a lower incision for a more pleasing aesthetic outcome.
Profunda Artery Perforator (PAP)
Profunda Artery Perforator (PAP): An alternative for patients not eligible for abdominal-based flap surgery due to previous surgery or insufficient volume. This procedure utilizes excess tissue from the inner thigh to restore the breast. To optimize the contour of the inner thigh, we incorporate the principles of medial thigh lift. Depending on the location of the best blood vessels that provide vascularity to the inner thigh, skin, and fat, two major orientations of the flap can be utilized: transverse PAP (t-PAP) and vertical PAP (v-PAP). The t-PAP aims to conceal the incision in the gluteal crease, while the v-PAP places the incision at the transition between the front and back of the leg.
Gluteal Artery Perforator (GAP)
Gluteal Artery Perforator (GAP): Uses excess tissue from the buttocks to reconstruct the breast tissue. When patients are not eligible for abdominal-based flap surgery due to previous procedures or lack of available tissue, buttock flaps offer a viable alternative. An IGAP or SGAP flap can be utilized depending on the donor tissue's location. The SGAP flap, our preferred choice, not only restores the breast but also enhances the contour of the gluteal area, similar to a buttock lift. Moreover, it effectively hides the incision within the panty line area.
Stacked Hemi Abdominal Extended Perforator (SHaEP):
Stacked Hemi Abdominal Extended Perforator (SHaEP): For patients previously considered too thin for a DIEP abdominal flap or for patients with large breasts at risk of size reduction, the SHaEP flap is an excellent option. The SHaEP flap is an extended version of the DIEP flap, utilizing perforator blood vessels from the hip area to enhance the flap and recruit more healthy tissue for transfer. For this intricate and delicate procedure, engaging a highly experienced and rigorously trained surgeon like Dr. Stalder is imperative.
Stacked Flaps
Stacked Flaps: "Stacked" refers to using multiple flaps to restore the breast, especially when a single donor site lacks adequate volume or skin. This method enables total autologous breast reconstruction, even in thinner patients. In the case of single breast reconstruction, the two flaps utilized are usually from the same donor area, such as stacked DIEPs, stacked PAPs, or stacked GAPs. By adopting this approach, the symmetry in the targeted body area is optimized.
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Autologous DIEP Reconstruction
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View PhotosAutologous DIEP Reconstruction after radiation
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About UsAutologous Reconstruction FAQs
How long does recovery take after autologous breast reconstruction?
Recovery time varies, but typically, patients can expect to spend 4-6 weeks for initial healing. During this time, Stalder Plastic Surgery provides comprehensive post-operative care and guidelines to ensure a smooth recovery. Full recovery and the final shape of the breast can take several months.
Are there any risks associated with this type of breast reconstruction?
As with any surgical procedure, there are risks, including infection, bleeding, and issues with anesthesia. Specific to autologous reconstruction, there may be additional concerns such as tissue failure. The team at Stalder Plastic Surgery discusses all potential risks in detail during consultation.
How does autologous reconstruction compare to implant-based reconstruction?
Autologous reconstruction uses the patient's own tissue, offering a more natural look and feel compared to implants. While implant-based reconstruction might have a shorter initial recovery, autologous reconstruction typically results in more natural movement and sensation. The choice depends on individual circumstances and preferences, which Dr. Stalder can guide you through in your consultation.
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Stalder Plastic Surgery Reviews
Great Team, great work. I would recommend them to anyone or should I say everyone. Great job DR. STALDER, keep up the great work.
I cannot speak highly enough about my experience with the team at Stalder Plastic Surgery. They are sensitive, caring, professional, comforting and smart. They walked me through a life changing surgery and I felt that they were a constant source of support.
Dr. Stalder and his office staff are beyond amazing. They make you feel so comfortable and welcome. They made my reconstruction journey so pleasant and calming.
On August 1, 2023 at the age of 69 I was diagnosed with breast cancer in my right breast. So many things go through your mind at this time and so many choices to make. Within a week I had a team that consisted of an oncologist, radiologist, breast surgeon and plastic surgeon. All amazing doctors, but my plastic surgeon Dr. Mark Stalder, of Stalder Plastic Surgery hit it out the ballpark. My spouse and I went into our first visit with so many questions, we had a list, and each question was patiently answered. During a few consultations with Dr. Stalder I decided that I would do a double mastectomy with DIEP Flap reconstruction. Even though my cancer was only in my right breast I didn’t want the concern of it occurring in my left breast at a later date. Jess, Dr. Stalder’s patient rep had recently been diagnosed with breast cancer. She had gone through the same surgery I was about to undergo. I spoke to her at length about my decision and what was to come. Jess was so very so helpful and supportive and really put my mind at ease with my decision. Abby, Dr. Stalder’s PA is the best, such a sweetheart. She was there for every visit from pre-op to all of my follow ups. When she went out on maternity leave, Alexa stepped in, once again another fabulous person. She made me feel as if she had been there from day one as well. I can’t leave Angie out either. On a few occasions when I called with a question and staff was with other patients she always answered my questions or made sure I got my question answered. The surgery I chose consisted of two surgeries, the first the Masectomy and DIEP flap and then a few months later there was the “tweaking” surgery. The second one was to even out my breasts and move the scar from the DIEP flap and tighten up my belly. The first surgery was September 19, 2023 and the second was on February 19, 2024. All through these surgeries Dr. Stalder and his amazing team have been right there along for the ride with me. Always patient and kind when I came in for follow-ups with my list of questions. Dr. Stalder always walks in with the biggest smile and makes you feel so comfortable. And let me tell you how important that is considering you are completely naked during those follow up visits. It’s been almost a year since my first surgery and I can’t thank Dr. Stalder, Jess, Abby, Alexa and Angie enough for their professionalism, kindness, compassion, making me feel like a person, not just a patient, and for giving my spouse piece of mind during this ordeal as well. You guys rock!
Dr. Stalder and his staff are deserving of more than 5 stars. They are truly the best - doctor, physician's assistant , Abby and office staff, Jess. My mastectomy and reconstruction surgeries were very difficult and had many unforeseen complications. Dr. Stalder was so caring and encouraging. He and his staff were never more than a phone call away. They were always patient and kind. The end results are amazing; he has made me feel whole again. I am forever grateful for Dr. Stalder and staff.
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