SIEA Flap
This is the best but least frequently used of the the flaps for breast reconstruction from lower abdomen. SIEA stands for Superficial Inferior Epigastric Artery flap. The vessels used for this flap run in the subcutaneous fat of the lower abdomen. They are very small and not present in at least half of the patients who present for breast reconstruction. But when they are present they can be used and provide for a completely natural breast mound without any incision into the muscle of the abdominal wall. This is a commonly used flap in cases where natural tissue flaps are used for both breast mound reconstructions. It is used in this case to make the recovery better in the short term and long term.
The advantage to using the lower abdominal tissue for surgery is that women get a flatter midsection, like a "tummy tuck". In cases where women have excess lower abdominal tissue, this is a very good operation, because the reconstructed breast mound is natural feeling and projecting, and ages with you despite your body type. Sensation will never be normal as your breast has been removed, but the flap will gain protective (temperature and pain) sensation over time. Because it is made of your own tissue, it is a very natural type of reconstruction.
Dr Vega performs this operation frequently and successfully, which is very important. Because the caliber of these vessels is very small (half the size or smaller than the DIEP), it is a higher risk operation, but in the right hands success rate for this flap should be close to, if not exactly that of the other lower abdominal flaps.