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What Is Flap Reconstruction?

Flap reconstruction (also called tissue-based reconstruction) is a procedure that involves moving healthy, live tissue from one location on your body to another. Usually this live tissue is moved to areas that have lost skin, fat, muscle movement, and/or skeletal support.

Flap surgery can be used for procedures, such as breast reconstruction or trunk and extremity reconstruction. Doctors may also use flap surgery to help them reconstruct facial features or nerves.

Types of Flap Reconstruction

There are several different types of flap reconstruction surgery. These include the following:

  • Local flap—A local flap is located next to a wound; the skin tissue remains attached at one end so that the blood supply can keep flowing through that piece of skin.
  • Regional flap—This uses a section of tissue that is attached by a specific blood vessel.
  • Bone/soft tissue flap—This type of flap is often used when bone and the overlying skin are moved to a new location.
  • Musculocutaneous flap (muscle and skin flap)—This type of flap is often used when the area to be covered needs more bulk and an increased blood supply. This type of flap is often used to rebuild a breast after a mastectomy (breast removal surgery).
  • Microvascular free flap—This involves detaching and reattaching skin and blood vessels from one area of the body to another area. Doctors use microsurgery to reattach the blood vessels.

Latissimus Flap Reconstruction 

This flap is taken from the back and is made up of fat and muscle with or without skin. These types of flaps stay attached to their blood supply. Surgeons tunnel the flap under the skin from the back to the chest. Surgeons make an incision (cut) along the bra line on the back.

These types of flaps are often used along with a tissue expander or an implant. In some cases, these flaps can be used by themselves to create a small volume breast.

TRAM Flaps & DIEP Flaps: Abdominal Free Flap Reconstruction

There are two types of abdominal flaps:

  1. DIEP flap (deep inferior epigastric perforator flap), and
  2. TRAM flap (transverse rectus abdominus myocutaneous flap).

An abdominal flap is tissue that’s taken from your abdomen. Abdominal flaps use skin, fat, and sometimes muscle. Surgeons can use an abdominal flap to reconstruct a breast in women who have extra abdominal tissue.

Abdominal flaps are often used as a free flap. This means the flap is transferred along with its blood supply (a small artery and vein) from the abdomen to the chest. The flap will then be reattached to a small artery and vein.

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