What is Stacked FlapSM Breast Reconstruction?
Pioneered at our Center in 2007, the Stacked FlapSM breast reconstruction procedure provides a solution for thin women who need reconstruction of a single breast. The Stacked FlapSM allows excess living fat to be transplanted from the tummy for recreation of a new breast after mastectomy. The fat is collected from the donor site much like a tummy tuck procedure. In women with less fat to give, the Stacked FlapSM allows layering, or “stacking” the available amount of fat for more size and projection in the new breast. The Stacked FlapSM gives women with a thin abdomen a new option to restore the breast after mastectomy.
Other options for thin women, or those with otherwise inadequate abdominal tissue, are the Hybrid, SGAP & BODY LIFT breast reconstruction procedures.
When is Stacked FlapSM Breast Reconstruction Used?
Stacked FlapSM breast reconstruction is used to recreate a soft, natural breast for women facing mastectomy. It is used when the tummy tissue is too thin for an ordinary DIEP or APEX FlapSM procedure. This produces a larger breast and allows the incision in the tummy to be kept lower in the bikini line.
In most circumstances, the Stacked FlapSM procedure can be done on the same day as mastectomy; this is known as “immediate reconstruction.” For women with previous mastectomy, the Stacked FlapSM may be performed after treatment. This is known as “delayed reconstruction.” Almost ALL women are candidates for immediate reconstruction, so speaking with your team prior to mastectomy about reconstruction is important. Occasionally, a “bridging implant” reconstruction is used before DIEP breast reconstruction to allow women with more advanced disease requiring radiation treatment to benefit from skin sparing or nipple sparing mastectomy as well.
What are the Benefits of Stacked FlapSM Breast Reconstruction?
There are several benefits of the Stacked FlapSM breast reconstruction technique. The recreation of the breast with soft, warm, living fat is permanent and doesn’t require maintenance imaging or repeat surgeries. For women who’ve undergone mastectomy in the past, the Stacked FlapSM procedure allows for the avoidance of tissue expanders.
There are several benefits of the Stacked FlapSM breast reconstruction technique. The recreation of the breast with soft, warm, living fat is permanent and doesn’t require maintenance or repeat surgery over time. For women who’ve undergone mastectomy in the past, the Stacked FlapSM procedure also allows for the avoidance of tissue expanders.
An important benefit of the Stacked FlapSM over the TRAM flap, or other outdated procedures, is that the muscle of the abdominal wall is protected and core strength is preserved. This allows for the avoidance of placing artificial mesh into the abdomen, and prevents hernias and long term abdominal weakness.
Women who undergo the Stacked FlapSM breast reconstruction also benefit from improved abdominal shape, much like a “tummy tuck.” Taking less fat from each side and using this layering technique also allows the donor incision to be kept lower than is otherwise possible. This produces an associated flatter, tighter abdomen, which is a nice compliment to the newly reconstructed breast.
What are the Risks Associated with Stacked FlapSM Breast Reconstruction?
As with any surgery, the risks can be minimized by carefully following your pre-surgical instructions. If you have other medical problems or factors that increase your risk, we will work with you to educate you on proper preparation and arrange your clinical care regimen to maximize your safety and ensure a successful recovery.
What to Expect Throughout the Stacked FlapSM Procedure Process
Pre-Surgery Office Visit
In most cases, you will be seen in our office 1-2 days prior to your surgery. At that time, we will go over the planned procedure, review consents, answer any questions you may have, and apply any surgical planning markings as may be required.
When you arrive at the hospital, you will be escorted to the preoperative holding area where you will change into a gown and be given foot coverings. The nurse or anesthesiologist will start an IV so that fluids and necessary medications may be given to you. Family members will be allowed to visit with you in the preoperative area once you are prepared for surgery.
After your surgery is complete, you will awaken in the recovery room under warm blankets with a dedicated nursing attendant at your side. You will be carefully monitored and kept comfortable. You will then be transferred to a private inpatient room that is prepared to allow you to rest and recover under the supervision of your attending physician and nurses. One adult caregiver may stay with you overnight during your hospitalization. A fold-out Murphy bed has been integrated into your room for their individualized comfort.
Your procedure will be performed in a state-of-the-art operating suite that is part of a fully accredited hospital that has been recognized by the American College of Surgeons for Excellence in care quality. Highly trained professionals using the most modern equipment and techniques will attend to you. In addition to your surgeons, the surgical team includes anesthesiologists, operating room technicians, nurses, and physician assistants.
What to Expect Post-Operation
You will experience some changes that are quite common after surgery and may include:
Some mild swelling and bruising is to be expected after surgery and will gradually subside after a few weeks.
Some soreness is normal after surgery, but we will provide medications to maximize your comfort and help speed up your recovery. Intermittent muscle spaSMs and feelings of tightness are normal and will subside as your swelling resolves.
Scar lines tend to improve in appearance for up to a year and are usually faded by 12-18 months.
Some numbness in the skin is normal after surgery. Occasionally the recovery of sensory nerves can result in tingling, itching, or mild electrical sensations that come and go. These sensations will resolve over time and are usually accompanied by some return of feeling in the skin.
You may resume your normal activities as recommended by your surgeon. In most cases, avoidance of strenuous activity is recommended for 4-6 weeks. As a general rule, most patients can drive between 2-3 weeks after surgery if you are no longer using pain medication and your doctor has cleared you. It is recommended to perform gentle stretches for the shoulders beginning in the early weeks after your procedure. Your clinic team can provide specific instruction for post-mastectomy range of motion exercises as applicable. You should maintain full range of motion within the early weeks post-operation. Patients are generally released to return to full activities and work schedule between 4-6 weeks after surgery. Your clinic team will provide any necessary documentation for your employer.
Returning Home Post-Operation
If you are traveling from out of state or internationally for care with us, your caregiver will need to be with you throughout your stay post-discharge and on the same flight home to assist you in the airport. Your caregiver’s education will be provided by our nursing staff during your time with us and our team is available to you and your assistant 24 hours/day should any questions arise after you are released from the hospital. Your arrangements for assistance after surgery should include an estimated seven to ten days of availability from your caregiver.
We Are Here For You
Be reassured that you are being attended to by some of the most highly skilled and dedicated healthcare providers in the world. Do your best to relax knowing that we are going to take excellent care of you from the moment you enter our facility. Do not hesitate to ask for any special needs you may have.