What is a Microsurgery?

Microsurgery is a very intricate, specialized type of plastic surgery performed using delicate instruments, sutures finer than human hair and high powered magnification provided by either a microscope or high-powered loupes. Microsurgeons can repair and reconnect very small blood vessels and nerves less than 1mm in diameter.

Microsurgery has allowed significant advances in many surgical fields. Breast reconstruction has been transformed completely.

We can now replace tissue removed by a mastectomy with the patient's own tissue transplanted from another part of their body. Unlike conventional tissue reconstruction techniques (like the TRAM flap), the latest microsurgical techniques ("perforator flaps") carefully preserve the patient's underlying muscles. The tissue is disconnected from the body, transplanted to the patient's chest and reconnected using microsurgery.

Preserving underlying muscles lessens postoperative discomfort making the recovery easier and shorter. It also helps the patient maintain muscle strength long-term which is particularly important for active women.

Below is a video of microsurgery performed during a DIEP flap breast reconstruction. Here we are connecting the DIEP flap artery to the internal mammary artery in the chest under the microscope:

I hope this info helps!

Dr C

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Dr Chrysopoulo is a board certified plastic surgeon in San Antonio, Texas and an active member of the American Society for Reconstructive Microsurgery. He specializes in DIEP flap breast reconstruction and other state-of-the-art breast reconstruction procedures. He is in-network for most US insurance plans. Patients are welcomed from across and outside the US. Please call (800) 692-5565 or email patientadvocate@PRMAplasticsurgery.com to schedule a consultation.

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Microsurgical Breast Reconstruction With Perforator Flaps

So what are "perforator flaps"?

Pioneered in the early 1990's, perforator flap breast reconstruction represents the state of the art in breast reconstruction surgery after mastectomy. The tissue removed at the time of mastectomy may be replaced with the patient's own warm, soft, living tissue to recreate a "natural" breast.

Skin, fatty tissue, and the tiny blood vessels that supply nutrients to the tissue ("perforators") can be taken from the patient's abdomen (SIEA flap and DIEP flap procedures) or buttocks (GAP flap procedure).

Unlike conventional tissue reconstruction techniques (like the TRAM flap), these microsurgical perforator flap techniques carefully preserve the patient's underlying musculature. The tissue is then transplanted to the patient's chest and reconnected using microsurgery.

Preserving underlying muscles lessens postoperative discomfort making the recovery easier and shorter, and also enables the patient to maintain muscle strength long-term. This is particularly important for active women.

While microsurgical breast reconstruction offers many advantages to the patient, the surgeries are very complex and time-consuming and specialized training is required. Our surgeons perform of hundreds of microsurgical breast procedures per year making PRMA Plastic Surgery one of the busiest breast reconstruction centers in and beyond the USA.

To learn more about each of the perforator flap techniques offered at PRMA please click on the following links:

DIEP flap
SIEA flap
GAP flap

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Dr Chrysopoulo is board certified in Plastic and Reconstructive Surgery and specializes in breast reconstruction surgery after mastectomy for breast cancer. He and his partners at PRMA Plastic Surgery perform hundreds of microsurgical breast reconstructions with perforator flaps each year. To schedule a consultation, please call Toll Free on (800) 692-5565.

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