In addition to traditional breast reconstruction techniques using implants, muscle flaps, and donor tissue, PeaceHealth Medical Group is proud to offer advanced microsurgical breast reconstruction techniques. Dr. Gabriel and Dr. Champaneria work closely with PeaceHealth Southwest’s Kearney Breast Cancer Center to guide patients through their breast cancer treatment and restoring their body with breast reconstruction. Microsurgical breast reconstruction allows the patient to have natural looking breast recreated from their own tissue, which is taken from other areas of the body. This specialized microsurgery allows patients to avoid many of the concerns associated with traditional breast reconstruction techniques. Women in the Portland metro area and Southwest Washington are encouraged to learn more about their options for breast reconstruction, including the advantages of microsurgical breast reconstruction by PeaceHealth Medical Group in Vancouver, WA.
"There is no substitute for a surgeon who is kind, compassionate and caring. If you are considering any type of plastic surgery, then you can look no further than Dr. Gabriel. He is knowledgeable, skilled, and able to handle whatever his patients demand. In addition, being easy on the eyes doesn't hurt his persona in the least."- K.C. / Healthgrades / May 18, 2018
"Five Stars - There isn't really anything I can write that hasn't been written before except to say that if you are considering any kind of plastic surgery in the Vancouver/Portland area, you won't find anyone more qualified than Dr. Gabriel. He is kind, compassionate, and open. I appreciate his straightforwardness and quick whit. Thank god for a Dr. with a sense of humor."- Anonymous / Vitals / May 17, 2018
"I can't tell you enough how incredible how Dr. Manish C Champaneria did a fantabulous job on my Top Surgery (double mastectomy). I am very satisfied, proud and very confident person thanks to Dr. Manish C Champaneria . I never thought that having this procedure would ever be possible. The whole peace health plastic surgery team came threw. From the insurance coordinator who fought for me and took care of everything that was needed for my surgery to happend. I feel very grateful and blessed to have met the Peace Health plastic Surgery team. I feel like they are family to my partner and I. They asked and answered every question that I needed to know about my surgery. I recommend Dr. Manish C Champaneria and Peace Health plastic Surgery for any Transgender reconstruction procedures. Thankyou PHPS Team ! I LOVE YOU GUYS!!!"- X.M. / Facebook / May 10, 2018
"Dr. Gabriel is simply the best. He is an excellent surgeon, very innovative and thorough. He exudes confidence while remaining professional and polite. His office staff obviously love their jobs and make sure that the patients are welcomed and seen promptly. I'm not his typical patient but he always treats me like I'm his only patient."- S.E. / Healthgrades / May 07, 2018
"Kindness and Dedication - That is what comes to mind when I think of Dr. Gabriel and world is a better place for having him in it. His disarming personality and kindness he and his staff exude is more than anyone could ask for. Because of his dedication for women, he and his wife created "The Pink Lemonade Project" which provides real voices and unending support though a what could have been a lonely and scary place."- Anonymous / Vitals / May 07, 2018
Breast reconstruction surgery can be performed using musculocutaneous flaps or perforator flaps. Perforator flaps for breast reconstruction use microsurgery to reconstruct the breast using tissue from other areas of the body without removing the muscles. Microsurgical breast reconstruction with perforator flaps often creates more natural looking breasts than reconstruction with implants and the patient does not need to worry about muscle weakness or movement limitations from muscle flap reconstruction techniques. There are several possible donor sites that can be used to create perforator flaps and the surgeon will carefully select the best site to use.
DIEP (Deep Inferior Epigastric Perforator) reconstruction is a refined version of the TRAM flap, in that the DIEP utilizes only the blood vessels, fat, and skin from the abdomen. The rectus abdominal muscle is left intact. Though DIEP can be performed many years post mastectomy, it is also commonly performed immediately after mastectomy.
SIEA (Superficial Inferior Epigastric Artery) breast reconstruction is a procedure in which abdominal skin and fat is removed and used to reconstruct a breast. This same tissue is discarded in patients that undergo cosmetic surgery for a 'tummy tuck'. Although the abdominal tissue used is the same as the DIEP, the SIEA relies on a distinctive blood supply and requires less surgical dissection than the DIEP. Whether the SIEA flap or DIEP flap can be used for reconstruction depends on intraoperative findings related to vessel size and blood flow. The decision between DIEP and SIEA is usually an intraoperative decision based on blood supply. If the surgeon determines the patient has an appropriate blood supply for an SIEA breast reconstruction procedure, benefits include less post-operative pain and speedier recovery.
SGAP (Superior Gluteal Artery Perforator) reconstruction can be an excellent option for patients who do not have sufficient abdominal tissue to donate to the reconstructed breast. During a SGAP flap reconstruction, skin and fat is moved from the upper buttock up to the chest, and used to create a breast mound. One advantage of SGAP is that no muscle is moved, so recovery time will be less than it would for a TRAM flap.
TUG (Transverse Upper Gracilis) creates a flap from tissue transferred from the medial thigh or the buttocks. Also called Transverse Upper Thigh (TUT), the TUG procedure is best for patients with small to medium sized breasts and most patients find the results are very natural looking with a youthful projection and shape.
Microsurgical breast reconstruction is performed in an accredited surgical facility with the patient under general anesthesia. The length of the surgery can vary greatly depending on the technique being used and whether one or both breasts are being reconstructed. Patients should expect to spend 1 – 4 nights in the hospital for monitored care. Once the surgeon has cleared the patient to continue their recovery at home, they will receive post-operative care instructions that will minimize their discomfort and speed their recovery. The surgeon will also talk to the patient about scheduling their first follow up appointment. Most patients return to work in about 3 – 4 weeks after their procedure.
Plan Your Procedure
- Procedure Recovery Location
Microsurgical Breast FAQs
Patients should speak to a plastic surgeon in conjunction with the doctor treating their breast cancer when deciding their cancer treatment plan. Since PeaceHealth Medical Group Plastic Surgery works so closely with PeaceHealth’s Southwest’s Kearney Breast Cancer Center, Dr. Gabriel and Dr. Champaneria can help the oncologist explain reconstruction options to the patient and determine which reconstruction technique will be best for the patient. Dr. Gabriel and Dr. Champaneria strive to ensure that every breast cancer patient receives the best reconstruction to allow them to feel whole and comfortable in their body.
Both Dr. Gabriel and Dr. Champaneria have spent extra time in surgical fellowships that have increased their skill and knowledge in breast reconstruction surgery. Dr. Gabriel studied breast surgery in a fellowship with world-renowned plastic surgeon, Dr. G. Patrick Maxwell. Dr. Champaneria completed a reconstructive microsurgery fellowship with 6 world-renowned microsurgeons to learn about microsurgical breast reconstruction techniques.
Benefits of Microsurgery?
Compared to traditional breast reconstruction techniques, patients who have microsurgery breast reconstruction have less post-operative pain, more natural looking breasts, a faster recovery, and a lower rate of a second operation. Perforator flap breast reconstruction also allows the new breasts to grow and shrink along with weight changes in the body, so the chest remains proportionate.
When To Have Reconstruction?
Patients have many options when choosing when to have their breast reconstruction surgery. Many patients have their reconstruction performed at the same time as their mastectomy if they do not need further treatment. If the mastectomy will be followed by more therapy, patients can have staged breast reconstruction, which will save the patient’s natural breast skin by inserting a tissue expander that can be removed after treatment is completed for breast reconstruction surgery. Other patients may choose to delay their breast reconstruction and wait months or years to have their breast reconstruction. A federal law passed in 1998 now requires health insurance companies to cover breast reconstruction surgery, which has prompted many former breast cancer patients to consider their reconstruction options.