Search all medical codes
Breast reconstruction with deep inferior epigastric perforator (diep) flap or superficial inferior epigastric artery (siea) flap, including harvesting of the flap, microvascular transfer, closure of donor site and shaping the flap into a breast, unilat...
HCPCS code
#### Name of the Procedure:
Breast Reconstruction with Deep Inferior Epigastric Perforator (DIEP) Flap or Superficial Inferior Epigastric Artery (SIEA) Flap
#### Summary
This procedure involves using tissue from the lower abdomen to reconstruct a breast mound. The tissue, comprising skin, fat, and blood vessels, is transferred to the chest to create a natural-looking breast. It includes harvesting of the flap, microvascular transfer, closure of the donor site, and shaping the flap into a breast.
#### Purpose
The procedure is primarily performed to reconstruct the breast following mastectomy due to breast cancer or other conditions. The goal is to restore the breast's appearance and symmetry, enhancing the patient's quality of life and body image.
#### Indications
- Previous mastectomy or lumpectomy.
- Congenital breast anomalies.
- Trauma resulting in significant breast tissue loss.
- Patient desires for breast reconstruction with natural tissue rather than implants.
#### Preparation
- Preoperative consultation and assessment.
- Possible imaging studies of the abdomen and chest.
- Fasting typically required from midnight before surgery.
- Medication adjustments as advised by the healthcare provider.
#### Procedure Description
1. **Anesthesia:** General anesthesia is administered.
2. **Harvesting the Flap:** An incision is made in the lower abdomen to harvest the DIEP or SIEA flap, which includes skin, fat, and blood vessels.
3. **Microvascular Transfer:** The harvested tissue's blood vessels are carefully detached and reconnected to the chest's blood vessels using microsurgery techniques.
4. **Shaping the Breast:** The flap is shaped to form a new breast mound.
5. **Closure of Donor Site:** The abdominal incision is closed, often resulting in a scar similar to that of a tummy tuck.
#### Duration
The procedure typically takes 6 to 8 hours, depending on the complexity and whether it's unilateral or bilateral.
#### Setting
Performed in a hospital operating room, requiring specialized surgical and microvascular equipment.
#### Personnel
- Plastic and reconstructive surgeon.
- Anesthesiologist.
- Surgical nurses and technicians.
- Microvascular specialist (if required).
#### Risks and Complications
- Infection.
- Blood clots.
- Flap failure (loss of the transferred tissue).
- Scarring and changes in abdominal contour.
- Seroma or hematoma (fluid or blood collection).
#### Benefits
- Natural-looking breast reconstruction.
- Use of the patient's tissue, reducing implant-related issues.
- Possible improved abdominal contour due to the flap harvest.
#### Recovery
- Hospital stay of 5 to 7 days.
- Postoperative instructions include wound care, activity restrictions, and pain management.
- Recovery period typically spans 6 to 8 weeks.
- Follow-up appointments for monitoring and possible adjustments.
#### Alternatives
- Breast implants (saline or silicone).
- TRAM flap (Transverse Rectus Abdominis Myocutaneous flap).
- Latissimus dorsi flap.
- **Pros and Cons:**
- **Implants:** Shorter surgery, less recovery time but potential for implant-related complications.
- **TRAM Flap:** Utilizes muscle which may affect abdominal function.
- **Latissimus Dorsi Flap:** Involves muscle movement which might affect back strength.
#### Patient Experience
- During the procedure under anesthesia, the patient will not experience pain.
- Postoperative pain and discomfort managed through medication.
- Experience of tightness and soreness in the donor site.
- Gradual improvement in breast appearance and symmetry over months.