Microsurgical Breast Reconstruction

Name: Microsurgery
Brand: Plastic Surgery Group at City Centre
Rating: 4.1 (46 reviews)

Restore breast shape using your body’s own tissue through advanced microsurgical reconstruction techniques.

Microsurgical Breast Reconstruction in Surrey, BC

Microsurgical breast reconstruction is an advanced technique that uses a patient’s own tissue to recreate a natural breast mound following mastectomy. During this procedure, a reconstructive microsurgeon transfers skin and fat from another area of the body—known as a donor site—to the chest, where it is shaped to form a new breast.

This approach allows surgeons to rebuild the breast using healthy tissue while minimizing damage to the donor area. Because the transferred tissue maintains its own blood supply through microsurgical vessel connections, the reconstructed breast can achieve a natural look and feel that evolves with the body over time.

Several donor sites can be used for microsurgical breast reconstruction, though the most common involves tissue from the lower abdomen using a DIEP or SIEA flap. In some cases, a free TRAM flap may also be considered.

Microsurgical Breast Reconstruction at a Glance

Length of Surgery

5+ hours

Hospital Stay

2-3 days

Recovery

8-12 weeks, 6-12 months for final results

What Is Microsurgical Breast Reconstruction?

Microsurgical breast reconstruction most commonly uses tissue from the lower abdomen to recreate the breast. The two primary techniques are the DIEP (Deep Inferior Epigastric Artery Perforator) flap and the SIEA (Superficial Inferior Epigastric Artery) flap. Both procedures transfer skin and fat from the abdomen while preserving the abdominal muscles. This helps maintain core strength and reduces the risk of long-term abdominal weakness compared with older techniques.

The final decision between a DIEP flap and an SIEA flap is often made during surgery and depends on the size and reliability of the blood vessels supplying the tissue.

When possible, an SIEA flap may be chosen because it avoids deeper dissection within the abdominal wall. However, if those vessels are too small or inconsistent, a DIEP flap is performed because the DIEP vessels are typically more robust and reliable.

The abdomen is commonly selected as the donor site because:

Many patients have adequate skin and fat in the lower abdomen
The resulting scar is typically well concealed beneath clothing
Removal of excess tissue often creates a contour similar to a tummy tuck

Your surgeon will discuss the advantages and limitations of each reconstructive option during consultation.

Testimonials Words From Our Patients

N.G.

Had a breast reduction done by Dr Adrian Lee. Amazing surgeon - very kind, explains things well and paid close attention to detail. The staff in the office are very kind too. I am ...

R.M.

I have had two surgeries at the Plastic Surgery Group at City Centre. I have only had interaction with Laurie in reception and Dr. Prince. Dr. Prince is second to none. She takes t...

S.W.

Dr. Oxley has done two procedures removing cancer for me. The first visit I had with him was in the surgery suite. He was professional, punctual and had just the right amount of hu...

K.G.

Dr. Imran Ratanshi performed my breast reduction surgery a month ago and I feel amazing. The recovery time was unbelievable and his staff has continually checked up on me to make s...

R.M.

My highest recommendation for an outstanding doctor and person: Dr. Rizwan Mian. Dr. Mian has surgically removed cancer from my skin a number of times in recent years - all basal-c...

J.H.

Can’t recommend Dr Genoway enough! I was looking for a reconstructive surgeon for 5 years, had several consultations with other doctors. As soon as I met Dr Genoway, I knew I...

M.Y.

I had my breast surgery in Plastic Surgery Group. Well organized safe and the best care during my surgery. Thank you guys and wish you all the best.

G.M.

I was a novice to surgery and the staff here were amazing - very friendly and helpful. Dr. Lee was very calm and knowledgeable and answered my questions. Breast reduction surgery w...

T.W.

Highly recommend Dr. Prince. Had a breast reduction Oct.20....best decision Ive ever made. Dr. Prince was so professional and helpful. Great bedside manner. If you're on the fence ...

J.P.

Dr.Oxley has been patient and very kind throughout my procedure making my experience less stressful and much more manageable. Also his office staff are a pleasure to work with. Alw...

J.H.

I am a breast cancer survivor. After my reconstruction surgery failed I was referred to Dr Imran Ratanshi. His kind demeanor and great sense of humor put me at ease immediately. I ...

J.C.

Absolutely amazing Suman is amazing at her job a big thank you. Dr R Mian so professional and made me feel so comfortable. A true artist in his field. I had a breast reduction Best...

C.A.

I had an exceptional experience with Dr. Genoway and their team. From the initial consultation to the surgery day, I felt an unwavering sense of compassion and support. The effort ...

Read All Testimonials

Am I a Good Candidate for a DIEP/SIEA flap?

Microsurgical breast reconstruction using a DIEP flap is one of the most commonly performed flap procedures at PSG. However, the most appropriate reconstruction method depends on several individual factors, including patient anatomy, health history, cancer treatment plan, and personal preference.

You may be a candidate if you have adequate lower abdominal skin and fat to form a new breast and are otherwise in good health.

Certain factors may make microsurgical reconstruction less appropriate, including:

Significant previous abdominal surgery
Personal or family history of blood-clotting disorders
Insufficient abdominal tissue
Smoking
Diabetes or severe obesity
Other major medical conditions

If radiation therapy is required as part of cancer treatment, it is typically completed before flap reconstruction because radiation can affect tissue healing and final cosmetic outcomes. If the abdomen cannot be used as a donor site, other areas may be considered, such as the upper inner thigh (TUG flap) or buttocks (SGAP or IGAP flaps).

Advantages

Uses your own tissue
Creates soft and natural-looking breast
Rejuvenates the abdomen (a tummy tuck)
Conceals donor scars
Brings healthy, new skin to the chest which may be necessary in patients who have skin damage from multiple previous surgery scars, radiation, or failed implant reconstruction
More easily matches the shape of the opposite breast than implant reconstruction would.
Has a very low chance of needing future revisional surgeries
Has less risk of abdominal weakness, bulge, or hernia after surgery than a pedicled TRAM
Has less risk of partial fat necrosis (scar lumps in breast) than a pedicled TRAM

Disadvantages

Requires longer hospitalization (4-5 days) than implant reconstruction would
Abdomen needs to recover as well (requiring 6-8 weeks of limited physical activity)
Longer surgery time
Technically more difficult and requires the surgeon to have additional training; not all centers and surgeons are comfortable with performing microsurgery

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Preparing for DIEP Flap Surgery

Prior to surgery, patients typically undergo a CT angiogram (CTA) of the abdomen. This specialized scan maps the blood vessels supplying the abdominal tissue and helps the surgical team identify the best vessels for microsurgical transfer. Additional preparation generally includes routine blood tests and a preoperative evaluation with anesthesia.

Patients are asked to stop taking blood thinners, anti-inflammatory medications (except Tylenol), and certain supplements two weeks before surgery. Herbal products such as ginkgo biloba, St. John’s Wort, fish oil, flaxseed oil, and high-dose vitamin E may increase bleeding risk and should also be discontinued.

If possible, hormone medications such as Tamoxifen may be paused approximately one month before surgery to reduce clotting risk, though this decision is coordinated carefully with your oncology team.

Smoking or nicotine use prevents patients from undergoing microsurgical reconstruction because nicotine significantly increases the risk of blood clots in the delicate vessels supplying the transferred tissue. Smoking also increases the risk of infection, wound healing problems, and respiratory complications after surgery.

Contact Us

To learn more about how you may benefit from DIEP flap reconstruction or to schedule a consultation with one of our board-certified plastic surgeons, please contact our Surrey office today.

Recovery After DIEP Flap Breast Reconstruction

Recovery after microsurgical breast reconstruction varies depending on overall health, the extent of surgery, and whether reconstruction was performed immediately or at a later stage. Most patients resume many normal daily activities within about eight weeks, though complete recovery may take six to twelve months. Some patients are able to return to work after approximately six weeks, while others require a longer recovery period depending on the demands of their job and the broader context of cancer treatment.

Secondary procedures such as nipple reconstruction and areola tattooing are commonly performed three to six months after the initial surgery under local anesthesia. Swelling gradually resolves over several months, and final breast shape and scar maturation typically continue to improve for up to a year following surgery.

Possible Complications

As in any surgery, risks include anesthetic reaction, infection, scarring, poor wound healing, bleeding or seroma (fluid collection), and deep vein thrombosis or pulmonary embolus (very rare). Complications specific to this surgery are mastectomy flap necrosis (skin slough), partial flap loss, fat necrosis (firm scar lumps in the breast or abdomen), lymphedema (arm swelling), anastomotic failure (failure of blood vessel connection), abdominal hernia or bulges, need for reoperation, umbilical slough (belly button loss), numb skin, and breast asymmetry.

There is a 1-2% risk of the reconstruction failing (total flap loss). This is usually due to a problem with the blood vessels, which are connected under the microscope. Various measures are taken, and special postoperative monitoring equipment is used in the first few days after surgery to help prevent this.