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Breast Reconstruction with Free Flaps

Jacobs Medical Center

Free-flap surgeries are performed at Jacobs Medical Center in La Jolla, which offers a dedicated recovery unit with specialized care that can shorten a patient's stay and decrease the need for opioid pain medication.

A flap procedure is an alternative to breast implants that uses your own tissue, usually from the abdomen, to form the shape of a breast.

This creates a more natural looking breast than with implants. Because it is your own tissue, it will age and change naturally.

If you are receiving treatment for breast cancer at UC San Diego Health, our plastic surgeons work with the Comprehensive Breast Health Center to coordinate reconstructive surgery with mastectomies. We also regularly treat patients who have had mastectomies or breast cancer treatment at other medical centers, patients who are seeking an alternative to a previous reconstruction with implants, or those who need breast reconstruction for other reasons.

Compared to other medical centers in the region, UC San Diego Health offers more surgical options for breast reconstruction, including free-flap procedures such as the DIEP flap and the PAP flap. These are considered to be muscle-sparing flaps because no muscle is used in the transfer of tissue.


A Patient's Perspective

"I feel better about myself and I'm grateful for my surgeon. After going through this procedure, I wouldn’t change a thing,” says patient Annette Whalen after free flap surgery. More about her story.

In a DIEP flap, blood vessels called deep inferior epigastric perforators (DIEP), as well as the skin and fat connected to them, are removed from the lower abdomen and transferred to the chest to reconstruct a breast after mastectomy. This procedure only removes the skin and fat, sparing the abdominal muscles. A DIEP flap also leaves the belly looking flatter and tighter, much like a tummy tuck.

PAP Flap

The PAP (profunda artery perforator) is a blood vessel that runs through your thigh. A PAP flap uses a section of skin and fat from the back of your upper thigh to reconstruct the breast. This also gives the effect of a thigh lift.

hallway inside Jacobs Medical CenterRecovery from Flap Surgery

Both the DIEP and PAP flap are types of microsurgery that leave you with two surgical wounds: in the chest and at the site where tissue was removed. 

When needed, microsurgery patients have access to a specialized recovery unit at Jacobs Medical Center in La Jolla and UC San Diego Medical Center in Hillcrest. Care is provided by a sub-specialty trained group of nurses who closely and continuously monitor tissue reconstruction, as well as overall well-being.

The team also includes anesthesiology pain management experts who have specialized training to prevent pain, both before and after surgery. These types of pain management regimens have been shown to decrease pain, shorten hospital stays, and reduce the need for opioid pain medication.