Re: fat transfers ~ Diep ~ Siea ~ Sgap ~ Flap details..interesting.....

[Guest guest]

None of these flap procedures would be a feasible option for cosmetic

enhancement. They are only for those who have had a mastectomy, and

even then they are not always successful. When I was on Ilena's

list, I heard from some women who were suffering due to their tram

flap. Nix that idea!

Patty

>

> Yavon ~

> Wow, what an interesting proceedure ! This looks like another

option for

> many people ! ! Thank you for sharing this with me. I just had

to copy it and

> share it with the group ! Are you going to this gentleman to see

if you are

> a good candidate for this surgery ? ? Please keep us posted on

everything

> !

> Many blessings ~ Dede

>

>

>

>

> DIEP / SIEA / SGAP Flap Details

>

>

> HISTORY

> The most common method of breast reconstruction using a patient's

own

> tissues (as opposed to breast implants) has been TRAM flaps. A

TRAM flap involves

> the surgeon removing tissue (skin, underlying fatty tissues, and

muscle) from

> the abdomen and using it to create the new breast. The tissue

needs a blood

> supply to keep it viable, so the surgeon has to harvest the blood

vessels that

> run through the underlying muscle to the abdominal wall fat and

skin.

> Although what is really needed to form the new breast is the skin

and underlying

> fatty tissues, the blood vessels supplying those tissues go

through the muscle,

> and that is the reason the muscle is also taken. When this type of

procedure

> is done, patients are left with a long scar that is very similar

to the scar

> that is left when a cosmetic abdominoplasty ( " tummy tuck " ) is

performed,

> with the abdominal wall nicely recontoured.

>

>

> DISADVANTAGES OF A TRAM

>

> Although TRAMs are highly successful and still a very good option

for many

> patients, there are a few disadvantages to a TRAM flap. Because

the abdominal

> muscles are cut and a portion removed, patients are left with some

abdominal

> wall weakness. In addition, they are also at increased risk for

abdominal

> wall hernias. Also, much of the discomfort many patients feel

after the surgery

> is not in the area of the new breast but rather from the abdomen

where the

> muscles were cut. DESCRIPTION OF A DIEP A DIEP flap is a

microsurgical

> technique that many feel represents an improvement over the TRAM

flap. When a

> DIEP flap is harvested, the skin and underlying fatty tissues from

the abdomen

> are removed, but the muscle and abdominal wall fascia are

preserved and left

> in place.

> In a DIEP flap, what the surgeon does instead is to

microsurgically dissect

> out the major blood vessels (called perforator vessels). This

illustration

> represents the blood vessels being dissected from the surrounding

muscle which

> leaves the muscle intact. These vessels that run through the

muscle are

> called perforator vessels.

> ADVANTAGES OF A DIEP

> Because this approach leaves the muscle wall and its overlying

fascia

> intact, there is much less risk of abdominal wall weakness and

hernia. In addition,

> patients clearly have less discomfort following DIEP surgery as

compared to

> a free TRAM flap. Because of the reduced pain and fact that the

muscle wall

> remains intact, patients are often able to get back to their

normal daily

> routines more quickly than after a TRAM flap reconstruction.

Patients undergoing

> a DIEP flap have essentially the same scar as those undergoing a

TRAM flap,

> so their abdominal wall is nicely recontoured.

> CONTRAINDICATIONS OF A DIEP

> As with any surgical procedure, there are disadvantages to a DIEP

flap.

> Because it is a more complex procedure, the DIEP flap takes longer

so the

> patient's anesthetic is also longer. If a patient has previously

had abdominal

> surgery, or if the patient does not have enough extra skin and

underlying fatty

> tissues in the abdomen, the patient may not be a candidate for

this type of

> procedure. Also, because of the complexity of this procedure,

there are only a

> handful of surgeons in the country who are experienced at

performing a DIEP

> flap.

> Determining whether a patient is a candidate for a DIEP is

something the

> doctor must do on a case-by-case basis. However, because this is a

lengthy

> surgery there are some conditions which may possibly prevent a

patient from being

> a candidate for a DIEP. These contraindications are things

like:

> * Insulin-dependent diabetes - affects wound healing after

surgery

> * Significant cardiac or pulmonary diseases/conditions - may

preclude

> a lengthy anesthetic

> * Significant obesity - affects wound healing after surgery

and may

> preclude a lengthy anesthetic

> * Age - as patients get older other health conditions are

more likely

> to preclude a lengthy surgery or anesthetic

> * Smoking - affects wound healing after surgery

> * Previous abdominoplasty ( " tummy tuck " ) - DIEP / SIEA cannot

be done

> if there has been a previous abdominoplasty

> * Liposuction - if a patient has previously had abdominal

liposuction

> it may preclude having a DIEP / SIEA

> As a general rule, most patients who qualify for a TRAM flap will

probably

> qualify for a TRAM flap, with some exceptions due to the increased

length of

> surgery. Previous c-sections, hysterectomies, and appendectomies

do not

> normally interfere with a patient qualifying for a DIEP flap.

>

> SIEA FLAP VARIATION

> An SIEA flap is essentially a variation on the DIEP flap. The

difference is

> in which blood vessels are utilized. The decision as to which

blood vessels

> will be used is one which is made intraoperatively by the surgeon,

based upon

> the patient's own anatomy. For the vast majority of patients, the

DIEP flap

> is the best alternative. However, in the hands of a surgeon who is

highly

> experienced with perforator flaps, it may be possible to do the

SIEA flap.

> Frederick J. Duffy, Jr., M.D.

> 7777 Forest Lane, Suite C504

> Dallas, Texas 75230

> Phone: 972-566-3939

> Fax: 972-566-3999

>

>

>

>

>

> **************Get trade secrets for amazing burgers. Watch " Cooking

with

> Tyler Florence " on AOL Food.

> (http://food.aol.com/tyler-florence?video=4 & ?

NCID=aolfod00030000000002)

>

[Guest guest]

trams are old news differant results diep are reliable

Re: fat transfers ~ Diep ~ Siea ~ Sgap ~ Flap details..interesting.....

None of these flap procedures would be a feasible option for cosmetic enhancement. They are only for those who have had a mastectomy, and even then they are not always successful. When I was on Ilena's list, I heard from some women who were suffering due to their tram flap. Nix that idea!Patty>> Yavon ~ > Wow, what an interesting proceedure ! This looks like another option for > many people ! ! Thank you for sharing this with me. I just had to copy it and > share it with the group ! Are you going to this gentleman to see if you are > a good candidate for this surgery ? ? Please keep us posted on everything > ! > Many blessings ~ Dede> > > >

> DIEP / SIEA / SGAP Flap Details > > > HISTORY > The most common method of breast reconstruction using a patient's own > tissues (as opposed to breast implants) has been TRAM flaps. A TRAM flap involves > the surgeon removing tissue (skin, underlying fatty tissues, and muscle) from > the abdomen and using it to create the new breast. The tissue needs a blood > supply to keep it viable, so the surgeon has to harvest the blood vessels that > run through the underlying muscle to the abdominal wall fat and skin. > Although what is really needed to form the new breast is the skin and underlying > fatty tissues, the blood vessels supplying those tissues go through the muscle, > and that is the reason the muscle is also taken. When this type of procedure > is done, patients are left with a long scar that is very similar to

the scar > that is left when a cosmetic abdominoplasty ("tummy tuck") is performed, > with the abdominal wall nicely recontoured. > > > DISADVANTAGES OF A TRAM > > Although TRAMs are highly successful and still a very good option for many > patients, there are a few disadvantages to a TRAM flap. Because the abdominal > muscles are cut and a portion removed, patients are left with some abdominal > wall weakness. In addition, they are also at increased risk for abdominal > wall hernias. Also, much of the discomfort many patients feel after the surgery > is not in the area of the new breast but rather from the abdomen where the > muscles were cut. DESCRIPTION OF A DIEP A DIEP flap is a microsurgical > technique that many feel represents an improvement over the TRAM flap. When a > DIEP flap is harvested, the skin and

underlying fatty tissues from the abdomen > are removed, but the muscle and abdominal wall fascia are preserved and left > in place. > In a DIEP flap, what the surgeon does instead is to microsurgically dissect > out the major blood vessels (called perforator vessels). This illustration > represents the blood vessels being dissected from the surrounding muscle which > leaves the muscle intact. These vessels that run through the muscle are > called perforator vessels. > ADVANTAGES OF A DIEP > Because this approach leaves the muscle wall and its overlying fascia > intact, there is much less risk of abdominal wall weakness and hernia. In addition, > patients clearly have less discomfort following DIEP surgery as compared to > a free TRAM flap. Because of the reduced pain and fact that the muscle wall > remains intact, patients

are often able to get back to their normal daily > routines more quickly than after a TRAM flap reconstruction. Patients undergoing > a DIEP flap have essentially the same scar as those undergoing a TRAM flap, > so their abdominal wall is nicely recontoured. > CONTRAINDICATIONS OF A DIEP > As with any surgical procedure, there are disadvantages to a DIEP flap. > Because it is a more complex procedure, the DIEP flap takes longer so the > patient's anesthetic is also longer. If a patient has previously had abdominal > surgery, or if the patient does not have enough extra skin and underlying fatty > tissues in the abdomen, the patient may not be a candidate for this type of > procedure. Also, because of the complexity of this procedure, there are only a > handful of surgeons in the country who are experienced at performing a DIEP >

flap. > Determining whether a patient is a candidate for a DIEP is something the > doctor must do on a case-by-case basis. However, because this is a lengthy > surgery there are some conditions which may possibly prevent a patient from being > a candidate for a DIEP. These contraindications are things like: > * Insulin-dependent diabetes - affects wound healing after surgery > * Significant cardiac or pulmonary diseases/conditions - may preclude > a lengthy anesthetic > * Significant obesity - affects wound healing after surgery and may > preclude a lengthy anesthetic > * Age - as patients get older other health conditions are more likely > to preclude a lengthy surgery or anesthetic > * Smoking - affects wound healing after surgery > * Previous abdominoplasty ("tummy tuck") - DIEP / SIEA cannot be done > if there has

been a previous abdominoplasty > * Liposuction - if a patient has previously had abdominal liposuction > it may preclude having a DIEP / SIEA > As a general rule, most patients who qualify for a TRAM flap will probably > qualify for a TRAM flap, with some exceptions due to the increased length of > surgery. Previous c-sections, hysterectomies, and appendectomies do not > normally interfere with a patient qualifying for a DIEP flap. > > SIEA FLAP VARIATION > An SIEA flap is essentially a variation on the DIEP flap. The difference is > in which blood vessels are utilized. The decision as to which blood vessels > will be used is one which is made intraoperatively by the surgeon, based upon > the patient's own anatomy. For the vast majority of patients, the DIEP flap > is the best alternative. However, in the hands of a surgeon who is

highly > experienced with perforator flaps, it may be possible to do the SIEA flap. > Frederick J. Duffy, Jr., M.D. > 7777 Forest Lane, Suite C504 > Dallas, Texas 75230 > Phone: 972-566-3939 > Fax: 972-566-3999 > > > > > > ************ **Get trade secrets for amazing burgers. Watch "Cooking with > Tyler Florence" on AOL Food. > (http://food. aol.com/tyler- florence? video=4 & ?NCID=aolfod00030000 000002)>

[Guest guest]

I am going to try first I will pray about it

fat transfers ~ Diep ~ Siea ~ Sgap ~ Flap details..interesting.....

Yavon ~

Wow, what an interesting proceedure ! This looks like another option for many people ! ! Thank you for sharing this with me. I just had to copy it and share it with the group ! Are you going to this gentleman to see if you are a good candidate for this surgery ? ? Please keep us posted on everything !

Many blessings ~ Dede

DIEP / SIEA / SGAP Flap Details

HISTORY

The most common method of breast reconstruction using a patient's own tissues (as opposed to breast implants) has been TRAM flaps. A TRAM flap involves the surgeon removing tissue (skin, underlying fatty tissues, and muscle) from the abdomen and using it to create the new breast. The tissue needs a blood supply to keep it viable, so the surgeon has to harvest the blood vessels that run through the underlying muscle to the abdominal wall fat and skin. Although what is really needed to form the new breast is the skin and underlying fatty tissues, the blood vessels supplying those tissues go through the muscle, and that is the reason the muscle is also taken. When this type of procedure is done, patients are left with a long scar that is very similar to the scar that is left when a cosmetic abdominoplasty ("tummy tuck") is performed, with the abdominal wall nicely recontoured.

DISADVANTAGES OF A TRAM

Although TRAMs are highly successful and still a very good option for many patients, there are a few disadvantages to a TRAM flap. Because the abdominal muscles are cut and a portion removed, patients are left with some abdominal wall weakness. In addition, they are also at increased risk for abdominal wall hernias. Also, much of the discomfort many patients feel after the surgery is not in the area of the new breast but rather from the abdomen where the muscles were cut.

DESCRIPTION OF A DIEP

A DIEP flap is a microsurgical technique that many feel represents an improvement over the TRAM flap. When a DIEP flap is harvested, the skin and underlying fatty tissues from the abdomen are removed, but the muscle and abdominal wall fascia are preserved and left in place.

In a DIEP flap, what the surgeon does instead is to microsurgically dissect out the major blood vessels (called perforator vessels). This illustration represents the blood vessels being dissected from the surrounding muscle which leaves the muscle intact. These vessels that run through the muscle are called perforator vessels.

ADVANTAGES OF A DIEP

Because this approach leaves the muscle wall and its overlying fascia intact, there is much less risk of abdominal wall weakness and hernia. In addition, patients clearly have less discomfort following DIEP surgery as compared to a free TRAM flap. Because of the reduced pain and fact that the muscle wall remains intact, patients are often able to get back to their normal daily routines more quickly than after a TRAM flap reconstruction. Patients undergoing a DIEP flap have essentially the same scar as those undergoing a TRAM flap, so their abdominal wall is nicely recontoured.

CONTRAINDICATIONS OF A DIEP

As with any surgical procedure, there are disadvantages to a DIEP flap. Because it is a more complex procedure, the DIEP flap takes longer so the patient's anesthetic is also longer. If a patient has previously had abdominal surgery, or if the patient does not have enough extra skin and underlying fatty tissues in the abdomen, the patient may not be a candidate for this type of procedure. Also, because of the complexity of this procedure, there are only a handful of surgeons in the country who are experienced at performing a DIEP flap.

Determining whether a patient is a candidate for a DIEP is something the doctor must do on a case-by-case basis. However, because this is a lengthy surgery there are some conditions which may possibly prevent a patient from being a candidate for a DIEP. These contraindications are things like:

Insulin-dependent diabetes - affects wound healing after surgery Significant cardiac or pulmonary diseases/conditions - may preclude a lengthy anesthetic Significant obesity - affects wound healing after surgery and may preclude a lengthy anesthetic Age - as patients get older other health conditions are more likely to preclude a lengthy surgery or anesthetic Smoking - affects wound healing after surgery Previous abdominoplasty ("tummy tuck") - DIEP / SIEA cannot be done if there has been a previous abdominoplasty Liposuction - if a patient has previously had abdominal liposuction it may preclude having a DIEP / SIEA

As a general rule, most patients who qualify for a TRAM flap will probably qualify for a TRAM flap, with some exceptions due to the increased length of surgery. Previous c-sections, hysterectomies, and appendectomies do not normally interfere with a patient qualifying for a DIEP flap.

SIEA FLAP VARIATION

An SIEA flap is essentially a variation on the DIEP flap. The difference is in which blood vessels are utilized. The decision as to which blood vessels will be used is one which is made intraoperatively by the surgeon, based upon the patient's own anatomy. For the vast majority of patients, the DIEP flap is the best alternative. However, in the hands of a surgeon who is highly experienced with perforator flaps, it may be possible to do the SIEA flap.

Frederick J. Duffy, Jr., M.D.

7777 Forest Lane, Suite C504 Dallas, Texas 75230 Phone: 972-566-3939 Fax: 972-566-3999

Get trade secrets for amazing burgers. Watch "Cooking with Tyler Florence" on AOL Food.