Like all surgery, SIEA flap surgery has some risks. Many of the risks associated with SIEA flap surgery are the same as the risks for mastectomy. However, there are some risks that are unique to SIEA flap reconstruction.
Tissue breakdown: In rare instances, the tissue moved from your belly to your breast area won’t get enough blood after the vessels are reattached and some of the tissue might die. Doctors call this tissue breakdown “necrosis.” Some symptoms of tissue necrosis include pain and bleeding, the skin turning dark blue or black, numbness, and sores that ooze a bad-smelling discharge or pus. You also may run a fever or feel sick. If this happens, your surgeon can trim away the dead tissue. This is done in the operating room under general anesthesia.
Lumps in the reconstructed breast: If the blood supply to some of the fat used to rebuild your breast is cut off, the fat may be replaced by firm scar tissue that will feel like a lump. This is called fat necrosis. These fat necrosis lumps may or may not go away on their own. They also might cause you some discomfort. If the fat necrosis lumps don't go away on their own, it's best to have your surgeon remove them. After having mastectomy and reconstruction, it can be a little scary to find another lump in your rebuilt breast. Having them removed can give you greater peace of mind, as well as ease any discomfort you might have.
Hernia or muscle weakness at the donor site: A hernia happens when part of an internal organ (often a small piece of the intestine) bulges through a weak spot in a muscle. Most hernias happen in the abdomen. They usually happen when someone who has a weak spot in an abdominal muscle strains the muscle, perhaps by lifting something heavy.
If you have an SIEA flap, you have a small risk of hernia. Your risk of hernia is much lower with an SIEA flap than with any type of TRAM flap. This is because an SIEA flap uses no muscle to rebuild your breast. Still, after any abdominal surgery, there is some risk of hernia.
Hernias can be painful and can cause a noticeable bulge in your abdomen. Hernias usually are treated by surgically repairing the opening in the muscle wall. The surgery is generally done on an outpatient basis.