Breast Reconstruction

Our Natural Tissue Breast Reconstruction Procedure Options

Welcome to Dr. Levine’s pioneering approach to natural tissue reconstruction, offering true muscle-sparing procedures without the need for implants.

Dr. Joshua L. Levine is a world-renowned, pioneer microsurgeon specializing solely in natural tissue breast reconstruction.

Unlocking Breast Reconstruction Possibilities: Understanding the Surgical Delay Phenomenon

Maximizing Tissue Potential Through Advanced Perforator Flap Techniques

In breast reconstruction, the Surgical Delay Phenomenon stands as a crucial mechanism in expanding the pool of candidates eligible for DIEP (Deep Inferior Epigastric Perforator) flap procedures. This phenomenon orchestrates a significant alteration in the vascular network’s responsiveness, ultimately amplifying tissue viability. By carefully planned actions before surgery, such as the surgical delay, we initiate a process where blood vessels become stronger, enhancing tissue resilience.

This innovative approach not only extends the available tissue for reconstruction but also supports the attainment of optimal surgical outcomes. When choosing your breast reconstruction surgeon, it’s crucial to assess their proficiency in this technique, as it reflects their expertise and the range of solutions they can provide.

The profound impact of the Surgical Delay Phenomenon cannot be overstated. Its implementation has rendered procedures previously considered unfeasible, feasible for numerous patients.

Dr. Levine’s Procedure Options

DIEP / SIEA

Diep/Superior Inferior Epigastric Perforator Free Flap

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DIEP/SIEA

The abdomen is the most common donor site in perforator flap breast reconstruction. Extra skin and fat is removed to reconstruct one or both breasts resulting in a flattened abdomen similar to that of a tummy tuck.

“STACKED” DIEP

Deep Inferior Epigastric Perforator Free Flaps

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STACKED DIEP - ABDOMEN

In a “stacked” DIEP, both halves of the abdomen are stacked together to reconstruct one breast when added volume is needed.

SHaEP

Stacked Hemiabdominal Extended Perforator Flaps

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SHaEP

By extending the DIEP, more tissue can be used from the hip in combination with abdominal tissue to get the volume needed to reconstruct both breasts.

PAP

Profunda Artery Perforator Free Flap

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PAP

The PAP flap uses available tissue from the back of the thigh at the buttock crease (“banana roll”.) This is a great option for those who are thin or have low body fat.

“STACKED” COMBINATION FLAPS

| ABDOMEN & THIGH |

“STACKED” COMBINATION FLAPS

Perforator flaps from different donor sites can be combined/stacked to obtain adequate volume in breast reconstruction. One example is a “stacked” DIEP and PAP combination.

IGAP

Inferior Gluteal Artery Perforator Free Flap

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IGAP

The IGAP, or “In-the-crease” IGAP, uses available tissue from the lower buttock just above the buttock crease. This option is great for those who are thin or have low body fat.

SGAP

Superior Gluteal Artery Perforator Free Flap

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SGAP

The SGAP flap uses available tissue from the upper buttock.

TDAP & ICAP

Thoracodorsal Artery & Intercostal Artery Island Perforator Flaps

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TDAP & ICAP

These flaps use available tissue from the chest wall underneath the arm and are particularly useful for partial breast reconstruction.

NSM

Nipple-sparing Mastectomy

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NSM

Some women are candidates for nipple preservation mastectomy. This dramatically enhances the overall cosmetic outcome.

BEFORE & AFTER GALLERY

Breast Reconstruction Photos

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BEFORE & AFTER GALLERY