Superficial Inferior Epigastric Artery (SIEA) Flap
Division of Plastic and Reconstructive Surgery
Wang Ambulatory Care Center, Suite 435
55 Fruit Street
Boston, MA 02114
We are also located at:
Mass General/North Shore Center for Outpatient Care
102 Endicott Street
Danvers, MA 01923
Parking is available in the Parkman St. and nearby Fruit St. and Yawkey Center garages. Please note that some GPS systems do not recognize the 15 Parkman St. address. If you use a GPS system to drive to Mass General, enter Blossom St. as your destination, and then turn onto Parkman directly from Blossom.
Explore This Procedure
About the Procedure
If you have a mastectomy to treat or prevent cancer, breast reconstruction can surgically recreate a natural-looking breast. One option for breast reconstruction is a superficial inferior epigastric artery (SIEA) flap procedure.
In a SIEA flap, the surgeon first excises skin and fat from the lower abdomen. This process does not require removing any of the rectus abdominus muscle, which houses the artery and vein that serve as the primary blood supply to skin and fat of the lower abdomen.
The excised abdominal tissue, or "flap," is then transferred to the mastectomy area. There, blood flow is restored by reconnecting the artery and vein to a set of vessels in the chest wall. The surgeon then shapes the flap to form a new breast.
Unlike the DIEP flap, the SIEA flap does not require making an incision in the abdominal muscle (incisions are made only in the skin and fat). SIEA flaps thus generally involve less postoperative pain than DIEP flaps—and no increased risk for hernia formation.
Note: A SIEA flap leaves a scar that extends along the lower abdomen, from one hip to the other. As a result, the recovery period may be longer than with breast construction with implants or tissue expanders.
Breast Reconstruction at Massachusetts General Hospital
Our plastic surgeons have extensive experience in all types of breast reconstructive techniques, including the newest and most innovative procedures. When appropriate, we combine techniques, using flaps, implants and nipple tattooing to achieve the most natural-looking outcome.
All forms of breast reconstruction after mastectomy have inherent risks, which will be fully discussed during your consultation.
Qualities of Candidates
You may be a good candidate for SIEA flap reconstruction if you:
- Are not a candidate for implant reconstruction
- Have had failed reconstruction using a breast implant
- Have had radiation administered to your chest wall
- Have sufficient tissues in your lower abdomen to create one or both breasts
- Have never had surgery on your abdomen
- Prefer to reconstruct one or both breasts using your own tissue
You may not be a good candidate for SIEA flap reconstruction if you:
- Are obese
- Cannot tolerate prolonged general anesthesia
- Have an overly large abdominal pannus (hanging flap of tissue)
- Have diabetes
- Have had abdominal surgery (e.g. an abdominoplasty)
- Have had a Cesarean section or hysterectomy (because these procedures may eliminate vessels that must be present for the SIEA flap to be successful)
- Lack sufficient lower abdominal tissue to create acceptable breast volume
- Smoke (or quit smoking only recently)
Other Reconstruction Options
Depending on your particular situation, other flap options to create the new breast may include:
- Deep inferior epigastric perforator (DIEP) flap: Uses tissue from the lower abdomen
- Latissimus dorsi flap: Uses tissue from the upper back
- Superior or inferior gluteal artery perforator (SGAP/IGAP) flap: Uses tissue from the buttocks
- Transverse rectus abdominus myocutaneous (TRAM) flap: Uses tissue from the lower abdomen
- Transverse upper gracilis (TUG) flap: Uses tissue from the inner thigh and underlying gracilis muscle
The TUG flap and SGAP/IGAP flaps are generally used with patients who lack enough abdominal tissue for the DIEP or SIEA flap.
The Division of Plastic and Reconstructive Surgery is home to Harvard-affiliated plastic surgeons who have pioneered many plastic surgery techniques and are members of major academic and medical societies.