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SIEA Flap Reconstruction: What to Expect

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During SIEA flap reconstruction surgery, an incision is made along your bikini line. Then, a portion of skin, fat, and blood vessels is taken from the lower half of your belly and moved up to your chest and formed into a breast shape. No muscle is moved in a SIEA flap.

The tiny blood vessels in the flap, which is the tissue that now makes up your new breast, are matched to blood vessels in your chest and carefully reattached under a microscope.

SIEA flap reconstruction surgery takes about 6 to 8 hours.

After SIEA flap reconstruction surgery: You'll be moved to the recovery room after surgery, where hospital staff members will monitor your heart rate, body temperature, and blood pressure. If you're in pain or feel nauseated from the anesthesia, tell someone so you can be given medication.

You'll then be admitted to a hospital room. For an SIEA flap, you usually stay in the hospital for about 5 days.

SIEA incision lines where you'll likely have scars

TRAM Flap breast reconstruction - lines of incisio
A Reconstructed breast incisions
B Repositioned navel incision
C Abdominal incision

Your doctor will give you specific instructions to follow for your recovery. For detailed information on how to care for the dressings, stitches, staples, and surgical drains, visit the Mastectomy: What to Expect page.

It can take about 6 to 8 weeks to recover from SIEA flap reconstruction surgery. Your doctor may recommend that you wear a compression girdle for up to 8 weeks after surgery. Because you've had surgery at two sites on your body (your chest and your belly), you might feel worse than someone who had only mastectomy and it will probably take you longer to recover. You'll likely have to take care of three incisions: on your breast, your lower abdomen, and around your navel. If you had axillary dissection under your arm at the same time, there will be a fourth incision to take care of. You'll probably have drains in your reconstructed breast and in your abdominal donor site -- and under your arm if you had lymph nodes removed.

As with any abdominal surgery, you may find that it's difficult or painful to sit down or get up from a sitting position. It also might be hard to get in and out of bed. Your doctor or physical therapist can show you how to move until your abdominal area heals. If you have severe pain, ask your doctor about medications you can take.

It's important to take the time you need to heal. Follow your doctor's advice on when to start stretching exercises and your normal activities. You usually have to avoid lifting anything heavy, strenuous sports, and sexual activity for about 6 weeks after SIEA flap reconstruction.

It sometimes takes as long as a year or more for your tissue to completely heal and for your scars to fade, and you may decide to have additional “finishing” work done, such as reshaping the flap or reconstructing a nipple.


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