The most common free tissue transfer is the DIEP (Deep Inferior Epigastric Perforator). The reason for this is that it usually provides a good size tissue for breast reconstruction and larger/ more reliable vessels than other sites. It involves the movement of subcutaneous tissue and skin from the abdomen, effectively creating a ‘tummy tuck’ effect. The abdomen is closed and the belly button is repositioned. No muscle is sacrificed from the abdomen during this procedure, allowing for a relatively short recovery time.

A DIEP free tissue transfer is not always possible for reasons such as previous DIEP completed for the opposite breast, some previous abdominal surgeries or poor vessels on preoperative imaging. For these patients, your options will be discussed, with possible alternative free tissue transfers available to you.

Incision and scars

The abdominal incision spans from hip to hip along the pant line, with a separate incision surrounding the belly button. Breast incisions can vary depending on a number of factors - though commonly a circular incision surrounding where the nipple previously was or an ellipse shape horizontal through the centre of the breast and through the fold (IMF) of the breast.

The PAP (Profunda Artery Perforator) free tissue transfer is the movement of subcutaneous tissue (fat), skin and vessels from the back of your inner thighs, high up near your buttock. This movement of tissue creates a thigh lift effect for patients. The amount of tissue available from this area is often less volume than the DIEP and, therefore, would only allow for a smaller volume breast. Fat grafting during revision surgery can assist with increasing size if required. No muscle is sacrificed from the thighs during this procedure, allowing for a relatively short recovery time.

Incision and scar: The posterior thigh incision spans from the inner thigh to the outer thigh, up high close to the buttock.

The LAP (Lumbar Artery Perforator) free tissue transfer is the movement of subcutaneous tissue (fat), skin and vessels from your lower back and flank (side of the abdomen). This surgery provides some contouring to the waistline and abdomen, as well as providing a buttock lift. No muscle is sacrificed from the back during this procedure, allowing for a relatively short recovery time. In most cases, this area has a smaller volume of tissue in comparison to the DIEP and therefore would only allow for a smaller breast. Fat grafting during revision surgery can assist with increasing size if required.

Incision and scar

The incision is on the back and spans from the hip to the central bank for a unilateral reconstruction. This will be the same on the other side of the back for a bilateral reconstruction.

The LTP (Lateral Thigh Perforator) free tissue transfer is the movement of subcutaneous tissue (fat), skin and vessels from your outer thighs. This surgery provides some contouring to the upper thighs. No muscle is sacrificed from the thigh during this procedure, allowing for a relatively short recovery time. In most cases, this area has a smaller volume of tissue in comparison to the DIEP and therefore, would only allow for a smaller volume breast. Fat grafting during revision surgery can assist with increasing size if required.

Incision and scar

The incision is on the upper thigh and spans from the front of the thigh around the outside to the back of the thigh. One thigh for unilateral breast reconstruction and two thighs for bilateral breast reconstruction.

The SGAP (Superior Gluteal Artery Perforator) free tissue transfer is the movement of subcutaneous tissue (fat), skin and vessels from your mid to upper buttock region. No muscle is sacrificed from the buttock during this procedure, allowing for a relatively short recovery time. This can provide some abdominal contouring, predominantly on the sides of the abdomen, and in some women, a good volume of tissue to transfer.

Incision and scar

The incision for this procedure is on the upper part of the buttock and spans from the centre to the hip. One buttock for unilateral breast reconstruction and two buttocks for bilateral breast reconstruction.