Innervated flap reconstruction refers to a type of autologous (own tissue) breast reconstruction procedure that can restore feeling in the reconstructed tissue.
There are many types of fully autologous breast reconstruction - DIEP, TRAM, SGAP, PAP and TUG/DUG – with each procedure using tissue from different parts of the body. These procedures involve taking a flap of tissue – skin, fat, the accompanying blood supply, and sometimes muscle – from areas such as the abdomen, thighs, or buttocks and moving it to the chest, where the surgeon re-establishes blood flow to the flap through the guidance of a microscope. The flap is then shaped by the surgeon to achieve a very natural appearance and feel to the reconstruction.
Any of the aforementioned flap types has the potential to become innervated. To accomplish this, the surgeon also connects the nerves of the donor tissue to nerves in the chest, with the intent of restoring feeling to the reconstructed breast. It may take up to a year for sensation to develop in the reconstructed breast, and, ideally, sensation approaches that of a normal breast and nipple. It is important to note that the survival of the donated flap is not dependent on the restoration of feeling.
The ability of the surgeon to provide an innervated flap depends on the part of the body the flap is taken from, in addition to the distribution of nerves present in the flap itself. Certain flaps, such as DIEPs and free TRAMs, are more likely to be able to be innervated than others. Prior to surgery, the surgeon will discuss with the patient whether to consider the option of flap innervation during the reconstructive procedure. The decision as to whether the specific flap may be suitable for innervation will be made during the course of the operation itself.
Not every woman is an ideal candidate for autologous breast reconstruction. Before committing to such a procedure, it is best to discuss the pros and cons with a surgeon.