DIEP, TRAM Flap Procedures in Turkey; Start Your Journey Today.

Reconstructive surgery is a deeply personal and life-changing decision, particularly for those who have undergone mastectomy due to breast cancer.

Among the most popular options for breast reconstruction are the DIEP (Deep Inferior Epigastric Perforator) flap and the TRAM (Transverse Rectus Abdominis Muscle) flap procedures.

Turkey has emerged as a leading destination for these surgeries, offering world-class medical services at a fraction of the cost compared to Western countries.

Understanding DIEP and TRAM Flap Procedures

DIEP Flap Procedure

The DIEP flap procedure is a sophisticated form of breast reconstruction that uses the patient’s own abdominal skin and fat to create a natural-looking breast.

Unlike older techniques, the DIEP flap spares the abdominal muscles, which results in a faster recovery and a lower risk of complications such as abdominal weakness or hernia.

This procedure is highly specialized and requires a skilled microsurgeon to connect tiny blood vessels, ensuring proper blood flow to the newly constructed breast.

TRAM Flap Procedure

The TRAM flap procedure, on the other hand, involves the use of the transverse rectus abdominis muscle, along with skin and fat from the lower abdomen, to reconstruct the breast.

While this procedure is effective, it does involve the removal of muscle, which can lead to longer recovery times and a higher risk of abdominal complications compared to the DIEP flap.

Both procedures are complex and require a high level of surgical expertise, which Turkey is well-equipped to provide.

The country boasts a growing number of highly skilled plastic surgeons who are trained in the latest microsurgical techniques, making it a popular destination for those seeking reconstructive surgery.

Why Choose Turkey for DIEP and TRAM Flap Procedures?

Turkey has become a top choice for medical tourists seeking high-quality yet affordable plastic surgery.

The country’s medical tourism industry is bolstered by its JCI-accredited hospitals, experienced surgeons, and state-of-the-art facilities.

But what truly sets Turkey apart is its competitive pricing. The cost of DIEP and TRAM flap procedures in Turkey is significantly lower than in the United States or Western Europe, without compromising on the quality of care.

Factors Affecting the Cost of DIEP and TRAM Flap Procedures

Several factors can influence the cost of DIEP and TRAM flap procedures in Turkey. It’s important to understand these factors to better plan your budget.

Surgeon’s Experience

The experience and reputation of your surgeon will have a direct impact on the cost. Surgeons with a high level of expertise and a successful track record may charge higher fees.

However, investing in a skilled surgeon is crucial for achieving the best possible results.

Hospital Type

The type of hospital you choose will also affect the cost. Private hospitals in Turkey often provide a higher level of comfort and personalized care but come at a higher price.

Public hospitals, while more affordable, may have longer waiting times and less luxurious facilities.

Complexity of the Procedure

The complexity of the surgery itself can vary depending on factors like the extent of tissue required, the need for additional procedures, and the patient’s overall health.

More complex cases may require longer surgery times and more resources, which can increase the overall cost.

Geographic Location

The location of the hospital can also influence the cost. Major cities like Istanbul, Ankara, and Izmir tend to have higher prices due to the higher cost of living and greater demand for medical services. However, these cities also offer some of the best medical facilities in the country.

Prices of all types of the DIEP/TRAM Flap procedures in Turkey.

DIEP Flap Reconstruction

Definition and Details

The DIEP (Deep Inferior Epigastric Perforator) flap is a highly specialized form of breast reconstruction that has become the preferred choice for many women after mastectomy.

This procedure involves transferring skin and fat from the lower abdomen to the chest to reconstruct the breast.

Unlike the traditional TRAM flap, the DIEP flap does not involve removing the abdominal muscles, which significantly reduces the risk of complications such as abdominal weakness or hernias.

The DIEP flap procedure is particularly beneficial because it uses microsurgery to carefully dissect and reconnect blood vessels.

This ensures that the transplanted tissue receives an adequate blood supply, which is crucial for the success of the reconstruction. The procedure also offers the added benefit of contouring the abdomen, similar to the effects of a tummy tuck, which can be an appealing aspect for many patients.

Procedure Steps

Initial Consultation:

The process begins with an in-depth consultation with a specialized plastic surgeon. During this meeting, the surgeon will evaluate your overall health, discuss your medical history, and assess the donor site (typically the abdomen) to determine if you are a suitable candidate for the DIEP flap procedure. This consultation is crucial as it helps in planning the surgery and setting realistic expectations.

Pre-Operative Imaging:

Advanced imaging techniques, such as a CT angiogram or Doppler ultrasound, are often employed to map the blood vessels in the abdomen.

This step is critical as it helps the surgeon identify the best perforators to use during the procedure, ensuring a successful transfer of tissue.

Anesthesia Administration:

On the day of surgery, general anesthesia is administered to ensure that you are completely asleep and pain-free throughout the procedure.

This involves a team of anesthesiologists who monitor your vital signs and manage your comfort.

Tissue Harvesting:

The surgeon begins by making an incision along the lower abdomen, similar to a tummy tuck incision. The skin, fat, and blood vessels (but not the muscle) are carefully dissected and prepared for transfer. This step is intricate and requires precision to ensure the integrity of the blood vessels.

Microsurgical Transfer:

Once the tissue is harvested, it is meticulously transplanted to the chest area. The most critical part of the procedure involves using a microscope to connect the tiny blood vessels from the flap to the blood vessels in the chest.

This ensures that the transplanted tissue has a sufficient blood supply, which is vital for the success of the reconstruction.

Breast Shaping:

After the blood vessels are connected, the surgeon shapes the transferred tissue to create a natural-looking breast. This step may involve adjusting the skin and fat to achieve symmetry with the other breast.

Abdominal Closure:

The abdomen is then closed, with the remaining tissue being pulled together to create a smoother, tighter abdominal contour. Drains are typically placed in both the chest and abdominal areas to prevent fluid accumulation.

Post-Operative Care:

After the surgery, you will be closely monitored in the hospital for several days. The focus during this period is on ensuring that the transplanted tissue is healthy and that there are no signs of complications, such as flap failure or infection.

Follow-Up Appointments:

Follow-up care is essential for monitoring the progress of your recovery and addressing any concerns. These appointments also provide an opportunity to discuss any further cosmetic adjustments, such as nipple reconstruction or symmetry procedures.

Pricing Breakdown

Initial Consultation: $200 – $400
Pre-Operative Imaging: $600 – $1,200
Anesthesia: $1,000 – $2,000
Tissue Harvesting: $4,000 – $6,000
Microsurgical Transfer: $6,000 – $10,000
Breast Shaping: $2,000 – $4,000
Abdominal Closure: $3,000 – $5,000
Post-Operative Care (Hospital Stay 3-5 days): $2,500 – $5,000
Follow-Up Appointments (Multiple Visits): $500 – $1,500

Muscle-Sparing TRAM Flap Reconstruction

Definition and Details

The Muscle-Sparing TRAM (Transverse Rectus Abdominis Myocutaneous) flap is a variant of the traditional TRAM flap that aims to reduce the amount of muscle taken from the abdomen.

In this procedure, the surgeon harvests a small portion of the rectus abdominis muscle along with the overlying skin and fat. The goal is to minimize the weakening of the abdominal wall while still providing ample tissue for breast reconstruction.

This technique is ideal for patients who require a more robust blood supply to the flap, which is provided by the muscle.

Procedure Steps

Initial Evaluation:

During your first visit, the surgeon will conduct a thorough assessment of your health and discuss your surgical options.

This includes evaluating your abdominal tissue and determining whether the Muscle-Sparing TRAM flap is the best choice for your reconstruction needs.

Pre-Operative Testing:

Similar to the DIEP flap, pre-operative tests may include imaging studies to evaluate the blood vessels and muscle structure.

Blood tests, EKG, and chest X-rays are also common to ensure you are fit for surgery.

Surgical Planning:

Detailed planning is crucial for the Muscle-Sparing TRAM flap. The surgeon will outline the specific portion of muscle to be used and create a surgical plan that minimizes the impact on your abdominal wall while ensuring sufficient tissue is available for breast reconstruction.

General Anesthesia:

The procedure is performed under general anesthesia. The anesthesiology team plays a critical role in maintaining your safety and comfort during the lengthy surgery.

Flap Harvesting:

The surgeon begins by making an incision along the lower abdomen. A portion of the rectus abdominis muscle, along with the overlying skin and fat, is harvested.

The muscle provides a robust blood supply, which is essential for the survival of the transplanted tissue.

Tissue Transfer and Microsurgery:

The harvested tissue is transferred to the chest, where the surgeon connects the blood vessels from the flap to those in the chest.

This step is less complex than the DIEP flap but still requires precision to ensure the tissue’s viability.

Breast Reconstruction:

Once the flap is in place, the surgeon carefully shapes the tissue to form a natural-looking breast. Adjustments may be made to ensure symmetry with the opposite breast.

Abdominal Closure and Recovery:

The abdomen is closed, with particular care taken to minimize the impact on muscle function. The recovery period involves careful monitoring for any signs of complications, such as infection or flap failure.

Post-Surgical Follow-Up:

Regular follow-up visits are necessary to monitor your recovery and assess the success of the reconstruction. Additional cosmetic procedures, such as nipple reconstruction, may be discussed during these visits.

Pricing Breakdown

Initial Evaluation: $200 – $400
Pre-Operative Testing: $500 – $1,000
Surgical Planning: $1,000 – $2,000
General Anesthesia: $1,000 – $2,500
Flap Harvesting: $5,000 – $8,000
Tissue Transfer and Microsurgery: $5,000 – $9,000
Breast Reconstruction: $3,000 – $5,000
Abdominal Closure and Recovery: $3,500 – $6,000
Post-Surgical Follow-Up: $400 – $1,200

Pedicled TRAM Flap Reconstruction

Definition and Details

The Pedicled TRAM flap is one of the earliest forms of autologous tissue breast reconstruction. It involves using the lower abdominal tissue (skin, fat, and muscle) to create a new breast. Unlike the free flap techniques (such as DIEP and muscle-sparing TRAM), the Pedicled TRAM flap keeps the tissue attached to its original blood supply in the abdomen.

This pedicle, or stalk of tissue, is tunneled under the skin to the chest, where it is shaped into a breast.

Procedure Steps

Comprehensive Health Assessment:

Before the surgery, a detailed evaluation of your overall health and medical history is performed. The surgeon will discuss the risks and benefits of the Pedicled TRAM flap and assess your suitability for the procedure based on your abdominal anatomy and previous surgeries.

Pre-Surgical Imaging:

Imaging studies, such as CT scans or ultrasounds, are used to map the blood vessels in the abdomen and plan the surgery.

These studies help the surgeon identify the best pathway for the pedicled flap.

Anesthesia and Preparation:

General anesthesia is administered to ensure that you are completely unconscious during the surgery. The anesthesiology team monitors your vital signs throughout the procedure, which can last up to 8 hours.

Flap Creation:

The surgeon makes an incision in the lower abdomen and carefully dissects the rectus abdominis muscle, along with the overlying skin and fat, while keeping the tissue attached to its original blood supply. This tissue is then tunneled under the skin to the chest.

Breast Reconstruction:

Once the tissue is positioned in the chest, the surgeon shapes it to form a new breast. This step involves meticulous attention to detail to achieve a natural look and feel.

Abdominal Wall Closure:

The abdomen is closed using specialized techniques to minimize the impact on muscle function.

Due to the extensive muscle harvesting, patients may require additional support, such as mesh, to strengthen the abdominal wall.

Recovery and Monitoring:

After the surgery, you will stay in the hospital for several days. During this time, your medical team will monitor the flap to ensure it is receiving adequate blood flow and check for any signs of complications.

Rehabilitation:

Given the impact on the abdominal muscles, rehabilitation may involve physical therapy to strengthen the core and improve mobility.

The recovery period is longer compared to other flap procedures, and patients need to follow specific guidelines to avoid complications.

Ongoing Follow-Up:

Regular follow-up visits are essential to monitor the success of the reconstruction and address any concerns.

Additional surgeries may be needed to refine the shape of the breast or to perform a symmetry procedure.

Pricing Breakdown

Comprehensive Health Assessment: $250 – $450
Pre-Surgical Imaging: $600 – $1,000
Anesthesia and Preparation: $1,200 – $2,500
Flap Creation: $5,500 – $8,500
Breast Reconstruction: $4,000 – $7,000
Abdominal Wall Closure: $4,500 – $7,500
Recovery and Monitoring (Hospital Stay 4-7 days): $3,000 – $6,000
Rehabilitation (Physical Therapy): $500 – $1,500
Ongoing Follow-Up: $500 – $1,200

SIEA Flap Reconstruction

Definition and Details

The SIEA (Superficial Inferior Epigastric Artery) flap is a sophisticated and lesser-known option for breast reconstruction. This technique is similar to the DIEP flap in that it uses skin and fat from the lower abdomen to reconstruct the breast.

However, the key difference lies in the blood supply. Instead of relying on the deep inferior epigastric perforators, the SIEA flap uses the superficial inferior epigastric artery and vein, which are located closer to the surface and do not involve any muscle dissection.

Procedure Steps

Initial Assessment and Vessel Mapping:

The process begins with an in-depth consultation where the surgeon evaluates your abdominal tissue and maps out the superficial inferior epigastric vessels using Doppler ultrasound.

This step is crucial to determine whether you have adequate SIEA vessels for the procedure.

Pre-Operative Preparations:

Preparations include standard pre-operative tests such as blood work, chest X-rays, and possibly an EKG.

The surgeon will also discuss any medications you need to stop before surgery and give you specific instructions for the day of the procedure.

Anesthesia Administration:

General anesthesia is administered to ensure that you are completely comfortable and pain-free during the surgery, which typically lasts between 6 and 8 hours.

Flap Harvesting:

The surgeon makes an incision along the lower abdomen, similar to that used in a tummy tuck. The skin, fat, and the superficial inferior epigastric vessels are carefully dissected without disturbing the underlying muscles. The flap is then prepared for transfer.

Microsurgical Transfer:

The harvested tissue is transferred to the chest, where the surgeon reconnects the superficial inferior epigastric artery and vein to blood vessels in the chest using microsurgery.

This step requires high precision to ensure a successful blood flow to the new breast tissue.

Breast Reconstruction:

Once the blood vessels are successfully connected, the surgeon shapes the transferred tissue to create a natural-looking breast. Adjustments are made to ensure symmetry with the opposite breast.

Abdominal Closure:

The abdominal incision is closed, resulting in a flatter and more contoured abdomen. Since no muscle was taken, the recovery is generally quicker, and the risk of abdominal complications is lower.

Post-Operative Care:

After surgery, you will be monitored closely in the hospital for several days. The medical team will ensure that the flap is healthy and check for any signs of complications such as flap failure or infection.

Follow-Up and Recovery:

Follow-up appointments are scheduled to monitor your recovery and address any issues. These appointments also provide an opportunity to discuss further cosmetic procedures, such as nipple reconstruction or adjustments to enhance symmetry.

Pricing Breakdown

Initial Assessment and Vessel Mapping: $300 – $600
Pre-Operative Preparations: $500 – $1,000
Anesthesia Administration: $1,000 – $2,000
Flap Harvesting: $6,000 – $10,000
Microsurgical Transfer: $7,000 – $12,000
Breast Reconstruction: $3,000 – $5,000
Abdominal Closure: $3,500 – $5,500
Post-Operative Care (Hospital Stay 3-5 days): $2,500 – $5,000
Follow-Up and Recovery: $600 – $1,200

Latissimus Dorsi Flap with Implant Reconstruction

Definition and Details

The Latissimus Dorsi flap is a versatile breast reconstruction technique that involves using muscle, fat, and skin from the back to reconstruct the breast.

Often, this tissue transfer is combined with a breast implant to achieve the desired breast size and shape.

The Latissimus Dorsi flap is particularly useful in cases where the patient does not have enough abdominal tissue for procedures like the DIEP or TRAM flap, or when additional support is needed to hold an implant in place.

During the procedure, the latissimus dorsi muscle, which is located in the upper back, is tunneled under the skin to the chest while maintaining its original blood supply.

This muscle provides a reliable and well-vascularized flap, reducing the risk of complications such as flap failure. The use of an implant allows for a more customizable breast size, making it a popular choice for women who desire a fuller reconstruction.

Procedure Steps

Comprehensive Evaluation and Planning:

The process begins with a detailed consultation with the surgeon, where your medical history, body anatomy, and surgical goals are discussed.

The surgeon will assess whether you have sufficient back tissue and whether combining the flap with an implant is the best approach for your reconstruction.

Pre-Surgical Imaging and Marking:

Pre-operative imaging may include a chest X-ray or MRI to evaluate the chest area and back muscles. The surgeon will mark the areas on your back and chest where the incisions will be made.

This step is crucial for ensuring that the tissue is harvested accurately and positioned correctly.

Anesthesia and Patient Positioning:

General anesthesia is administered, and you are positioned on your side or stomach to allow the surgeon access to the back.

The surgery typically takes 4 to 6 hours, depending on the complexity of the reconstruction.

Flap Harvesting:

The surgeon makes an incision along the back to access the latissimus dorsi muscle. The muscle, along with the overlying skin and fat, is carefully dissected and prepared for transfer. The tissue remains attached to its blood supply during the transfer to the chest.

Tunnel Creation and Flap Transfer:

A tunnel is created under the skin from the back to the chest, through which the flap is passed. The surgeon then positions the flap in the chest, where it will form the new breast.

Implant Placement (If Required):

If an implant is part of the reconstruction plan, it is placed beneath the latissimus dorsi flap to achieve the desired breast size and shape. The implant adds volume and helps to contour the breast, especially if the natural tissue is insufficient.

Incision Closure:

Both the back and chest incisions are closed using sutures, and drains may be placed to prevent fluid accumulation. The back incision usually results in a horizontal scar that can be concealed by most clothing.

Post-Surgery Monitoring:

You will be monitored in the hospital for a few days to ensure the flap is healing properly and that the implant is positioned correctly. Pain management, flap viability, and wound care are closely observed during this period.

Follow-Up and Physical Therapy:

Follow-up appointments are scheduled to monitor your recovery and check the condition of the reconstructed breast. Physical therapy may be recommended to help you regain strength and mobility in your back and shoulder.

Pricing Breakdown

Comprehensive Evaluation and Planning: $400 – $700
Pre-Surgical Imaging and Marking: $600 – $1,200
Anesthesia and Patient Positioning: $1,200 – $2,500
Flap Harvesting: $5,500 – $8,500
Tunnel Creation and Flap Transfer: $3,500 – $6,500
Implant Placement: $2,000 – $4,000
Incision Closure: $2,000 – $3,500
Post-Surgery Monitoring (Hospital Stay 3-5 days): $2,500 – $5,000
Follow-Up and Physical Therapy: $700 – $1,500

SGAP Flap Reconstruction

Definition and Details

The Superior Gluteal Artery Perforator (SGAP) flap is a specialized technique used in breast reconstruction that utilizes skin and fat from the upper buttocks to create a new breast mound.

The SGAP flap is an excellent option for women who prefer not to use abdominal tissue or who have insufficient abdominal fat for reconstruction.

This procedure is particularly well-suited for patients who have undergone multiple abdominal surgeries or who wish to avoid any impact on their abdominal muscles.

The SGAP flap does not involve the transfer of muscle tissue, which preserves muscle function in the donor area. Instead, the flap relies on the superior gluteal artery and veins, which are carefully dissected and reconnected to blood vessels in the chest.

Procedure Steps

Detailed Consultation and Planning:

The process starts with an in-depth consultation where the surgeon evaluates your overall health, buttock anatomy, and surgical goals.

The surgeon will explain the procedure, including the potential risks and benefits, and assess whether the SGAP flap is the right option for you.

Pre-Operative Imaging:

Imaging studies, such as MRI or Doppler ultrasound, are conducted to map the superior gluteal artery and its perforators.

This step is essential for planning the surgery and ensuring that the best blood vessels are selected for the flap.

Anesthesia and Surgical Positioning:

The surgery is performed under general anesthesia. You will be positioned on your stomach or side to allow the surgeon access to the upper buttocks.

The procedure can take between 6 and 8 hours, depending on its complexity.

Flap Harvesting:

An incision is made along the upper buttocks, and the skin and fat, along with the superior gluteal artery and veins, are carefully dissected.

The tissue is prepared for transfer, with meticulous care taken to preserve the blood vessels.

Microsurgical Transfer:

The harvested tissue is transferred to the chest, where the surgeon reconnects the superior gluteal artery and veins to the blood vessels in the chest using microsurgery. This step is critical for ensuring that the tissue receives adequate blood flow.

Breast Mound Formation:

The transferred tissue is shaped to form a new breast mound. The surgeon pays close attention to achieving symmetry with the opposite breast and creating a natural appearance.

Donor Site Closure:

The incision on the buttocks is closed, resulting in a buttock lift effect. Drains may be placed to prevent fluid accumulation, and the area is dressed to support healing.

Post-Surgical Monitoring:

You will be monitored closely in the hospital for several days to ensure that the flap is healthy and that there are no complications such as flap failure or infection. Pain management and wound care are provided during this time.

Follow-Up Care and Recovery:

Follow-up appointments are scheduled to monitor your recovery and address any concerns. These visits also provide an opportunity to discuss additional procedures, such as nipple reconstruction or adjustments to enhance symmetry.

Physical therapy may be recommended to help you regain strength and mobility in the donor area.

Pricing Breakdown

Detailed Consultation and Planning: $400 – $700
Pre-Operative Imaging: $800 – $1,200
Anesthesia and Surgical Positioning: $1,200 – $2,500
Flap Harvesting: $7,000 – $11,000
Microsurgical Transfer: $8,000 – $12,000
Breast Mound Formation: $3,500 – $6,500
Donor Site Closure: $2,500 – $4,500
Post-Surgical Monitoring (Hospital Stay 4-7 days): $3,500 – $6,500
Follow-Up Care and Recovery: $700 – $1,500

IGAP Flap Reconstruction

Definition and Details

The Inferior Gluteal Artery Perforator (IGAP) flap is a specialized breast reconstruction technique that uses skin and fat from the lower buttocks to create a new breast.

The IGAP flap is an excellent choice for women who do not have sufficient abdominal tissue or who prefer to avoid abdominal surgery.

This method is particularly suitable for patients who have undergone multiple abdominal surgeries or who wish to preserve their abdominal muscles.

Unlike the SGAP flap, which uses tissue from the upper buttocks, the IGAP flap harvests tissue from the lower part of the buttocks. This approach provides ample tissue for breast reconstruction while also offering a natural buttock lift.

The IGAP flap does not involve any muscle transfer, which helps preserve the function of the gluteal muscles and minimizes the impact on the donor site.

Procedure Steps

Comprehensive Health Evaluation:

The process begins with a thorough health evaluation and consultation with your surgeon. During this meeting, the surgeon will assess your suitability for the IGAP flap, discuss your surgical goals, and explain the risks and benefits of the procedure.

Imaging and Surgical Planning:

Pre-operative imaging, such as an MRI or Doppler ultrasound, is used to map the blood vessels in the lower buttocks.

This imaging is crucial for planning the surgery and ensuring that the best vessels are selected for the flap.

Anesthesia and Patient Positioning:

General anesthesia is administered, and you will be positioned on your stomach or side to allow access to the lower buttocks.

The surgery typically takes 6 to 8 hours, depending on the complexity of the procedure.

Flap Harvesting:

An incision is made along the lower buttocks, and the skin and fat, along with the inferior gluteal artery and veins, are carefully dissected.

The tissue is prepared for transfer, with meticulous care taken to preserve the blood vessels.

Microsurgical Transfer and Reconnection:

The harvested tissue is transferred to the chest, where the surgeon uses microsurgical techniques to reconnect the inferior gluteal artery and veins to the blood vessels in the chest.

This step is critical for ensuring that the tissue receives adequate blood supply and survives in its new location.

Breast Mound Shaping:

The transferred tissue is shaped into a breast mound, with attention paid to achieving symmetry with the opposite breast. The surgeon works to create a natural and aesthetically pleasing result.

Donor Site Closure and Buttock Contouring:

The incision on the lower buttocks is closed, resulting in a natural buttock lift. Drains may be placed to prevent fluid accumulation, and the area is dressed to support healing.

Post-Surgical Care and Monitoring:

Follow-Up Appointments and Recovery:

Follow-up appointments are scheduled to monitor your recovery and discuss any additional procedures you may need. Physical therapy may be recommended to help you regain strength and mobility in the donor area, and to ensure a smooth recovery.

Pricing Breakdown

Comprehensive Health Evaluation: $400 – $700
Imaging and Surgical Planning: $800 – $1,200
Anesthesia and Patient Positioning: $1,200 – $2,500
Flap Harvesting: $7,000 – $11,000
Microsurgical Transfer and Reconnection: $8,000 – $12,000
Breast Mound Shaping: $3,500 – $6,500
Donor Site Closure and Buttock Contouring: $2,500 – $4,500
Post-Surgical Care and Monitoring (Hospital Stay 4-7 days): $3,500 – $6,500
Follow-Up Appointments and Recovery: $700 – $1,500

PAP Flap Reconstruction

Definition and Details

The Profunda Artery Perforator (PAP) flap is an advanced breast reconstruction technique that utilizes skin and fat from the upper inner thigh to create a new breast.

The PAP flap is an ideal option for women who do not have enough abdominal tissue for reconstruction or who prefer to avoid abdominal surgery.

The procedure is muscle-sparing, meaning it does not involve the transfer of any muscle tissue, which helps preserve function in the donor area.

The PAP flap relies on the profunda femoris artery and its perforators to supply blood to the transferred tissue. This method provides ample tissue for breast reconstruction, and the resulting scar

Procedure Steps

Initial Consultation and Assessment:

The process begins with a comprehensive consultation where your surgeon evaluates your overall health, thigh anatomy, and surgical goals.

The surgeon will discuss the procedure in detail, including the risks, benefits, and expected outcomes.

Imaging Studies and Planning:

Pre-operative imaging, such as MRI or Doppler ultrasound, is used to map the profunda femoris artery and its perforators.

This imaging is crucial for planning the surgery and ensuring that the best blood vessels are selected for the flap.

Anesthesia and Surgical Positioning:

General anesthesia is administered, and you will be positioned to allow access to the upper inner thigh. The surgery typically takes 6 to 8 hours, depending on the complexity of the procedure.

Flap Harvesting:

An incision is made along the upper inner thigh, and the skin and fat, along with the profunda femoris artery and veins, are carefully dissected. The tissue is prepared for transfer, with meticulous care taken to preserve the blood vessels.

Microsurgical Transfer:

The harvested tissue is transferred to the chest, where the surgeon uses microsurgical techniques to reconnect the profunda femoris artery and veins to the blood vessels in the chest.

This step is critical for ensuring that the tissue receives adequate blood supply and survives in its new location.

Breast Mound Formation:

The transferred tissue is shaped into a breast mound, with attention paid to achieving symmetry with the opposite breast. The surgeon works to create a natural and aesthetically pleasing result.

Donor Site Closure:

The incision on the inner thigh is closed, resulting in a natural thigh lift effect. Drains may be placed to prevent fluid accumulation, and the area is dressed to support healing.

Post-Surgical Monitoring:

Follow-Up Care and Physical Therapy:

Follow-up appointments are scheduled to monitor your recovery and address any concerns. Physical therapy may be recommended to help you regain strength and mobility in the donor area, and to ensure a smooth recovery.

Pricing Breakdown

Initial Consultation and Assessment: $400 – $700
Imaging Studies and Planning: $800 – $1,200
Anesthesia and Surgical Positioning: $1,200 – $2,500
Flap Harvesting: $7,000 – $10,000
Microsurgical Transfer: $8,000 – $12,000
Breast Mound Formation: $3,500 – $6,500
Donor Site Closure: $2,500 – $4,500
Post-Surgical Monitoring (Hospital Stay 4-7 days): $3,500 – $6,500
Follow-Up Care and Physical Therapy: $700 – $1,500

Price Analysis of Breast Reconstruction Flap Procedures in Istanbul, Ankara, and Izmir.

DIEP Flap Reconstruction

Istanbul:

Consultation and Evaluation: $500 – $800
Imaging and Planning: $900 – $1,500
Anesthesia and Preparation: $1,500 – $2,800
Surgical Procedure: $10,000 – $15,000
Post-Surgical Care: $4,000 – $7,000
Total Estimated Cost: $16,900 – $27,100

Ankara:

Consultation and Evaluation: $400 – $700
Imaging and Planning: $800 – $1,200
Anesthesia and Preparation: $1,200 – $2,500
Surgical Procedure: $9,000 – $13,500
Post-Surgical Care: $3,500 – $6,500
Total Estimated Cost: $14,900 – $24,400

Izmir:

Consultation and Evaluation: $450 – $750
Imaging and Planning: $850 – $1,300
Anesthesia and Preparation: $1,300 – $2,600
Surgical Procedure: $8,500 – $12,500
Post-Surgical Care: $3,000 – $5,500
Total Estimated Cost: $13,000 – $22,650

TRAM Flap Reconstruction

Istanbul:

Consultation and Evaluation: $500 – $800
Imaging and Planning: $950 – $1,600
Anesthesia and Preparation: $1,600 – $2,900
Surgical Procedure: $11,000 – $16,000
Post-Surgical Care: $4,500 – $8,000
Total Estimated Cost: $19,550 – $28,300

Ankara:

Consultation and Evaluation: $400 – $700
Imaging and Planning: $850 – $1,300
Anesthesia and Preparation: $1,300 – $2,600
Surgical Procedure: $9,500 – $14,500
Post-Surgical Care: $3,800 – $6,800
Total Estimated Cost: $15,850 – $25,900

Izmir:

Consultation and Evaluation: $450 – $750
Imaging and Planning: $900 – $1,400
Anesthesia and Preparation: $1,300 – $2,600
Surgical Procedure: $8,800 – $13,500
Post-Surgical Care: $3,200 – $5,800
Total Estimated Cost: $14,650 – $23,050

SIEA Flap Reconstruction

Istanbul:

Consultation and Evaluation: $400 – $700
Imaging and Planning: $800 – $1,200
Anesthesia and Preparation: $1,200 – $2,400
Surgical Procedure: $8,500 – $12,000
Post-Surgical Care: $3,500 – $6,500
Total Estimated Cost: $13,400 – $22,800

Ankara:

Consultation and Evaluation: $350 – $650
Imaging and Planning: $700 – $1,000
Anesthesia and Preparation: $1,000 – $2,200
Surgical Procedure: $7,500 – $11,000
Post-Surgical Care: $3,000 – $5,500
Total Estimated Cost: $12,550 – $20,350

Izmir:

Consultation and Evaluation: $400 – $650
Imaging and Planning: $750 – $1,100
Anesthesia and Preparation: $1,100 – $2,300
Surgical Procedure: $7,800 – $11,500
Post-Surgical Care: $2,800 – $5,200
Total Estimated Cost: $12,850 – $20,850

TUG Flap Reconstruction

Istanbul:

Consultation and Evaluation: $500 – $750
Imaging and Planning: $900 – $1,400
Anesthesia and Preparation: $1,500 – $2,700
Surgical Procedure: $10,500 – $15,500
Post-Surgical Care: $4,000 – $7,000
Total Estimated Cost: $16,400 – $27,350

Ankara:

Consultation and Evaluation: $400 – $650
Imaging and Planning: $800 – $1,200
Anesthesia and Preparation: $1,300 – $2,500
Surgical Procedure: $9,500 – $13,500
Post-Surgical Care: $3,500 – $6,500
Total Estimated Cost: $15,500 – $24,350

Izmir:

Consultation and Evaluation: $450 – $700
Imaging and Planning: $850 – $1,300
Anesthesia and Preparation: $1,400 – $2,600
Surgical Procedure: $8,800 – $12,500
Post-Surgical Care: $3,000 – $5,500
Total Estimated Cost: $14,500 – $22,600

LD Flap Reconstruction

Istanbul:

Consultation and Evaluation: $400 – $700
Imaging and Planning: $800 – $1,200
Anesthesia and Preparation: $1,200 – $2,500
Surgical Procedure: $9,500 – $14,000
Post-Surgical Care: $3,500 – $6,000
Total Estimated Cost: $14,400 – $24,400

Ankara:

Consultation and Evaluation: $350 – $650
Imaging and Planning: $700 – $1,000
Anesthesia and Preparation: $1,000 – $2,200
Surgical Procedure: $8,500 – $12,000
Post-Surgical Care: $3,000 – $5,500
Total Estimated Cost: $13,550 – $21,350

Izmir:

Consultation and Evaluation: $400 – $650
Imaging and Planning: $750 – $1,100
Anesthesia and Preparation: $1,100 – $2,300
Surgical Procedure: $8,000 – $11,500
Post-Surgical Care: $2,800 – $5,200
Total Estimated Cost: $12,050 – $20,750

Pap Flap Reconstruction

Istanbul:

Consultation and Evaluation: $450 – $700
Imaging and Planning: $850 – $1,300
Anesthesia and Preparation: $1,300 – $2,600
Surgical Procedure: $9,000 – $13,500
Post-Surgical Care: $3,500 – $6,500
Total Estimated Cost: $14,200 – $24,600

Ankara:

Consultation and Evaluation: $400 – $650
Imaging and Planning: $800 – $1,200
Anesthesia and Preparation: $1,200 – $2,400
Surgical Procedure: $8,500 – $12,500
Post-Surgical Care: $3,200 – $5,800
Total Estimated Cost: $13,100 – $22,550

Izmir:

Consultation and Evaluation: $400 – $650
Imaging and Planning: $750 – $1,100
Anesthesia and Preparation: $1,200 – $2,500
Surgical Procedure: $7,800 – $11,500
Post-Surgical Care: $2,800 – $5,200
Total Estimated Cost: $12,950 – $20,550

MS Flap Reconstruction

Istanbul:

Consultation and Evaluation: $500 – $750
Imaging and Planning: $900 – $1,400
Anesthesia and Preparation: $1,500 – $2,800
Surgical Procedure: $10,000 – $15,500
Post-Surgical Care: $4,000 – $7,000
Total Estimated Cost: $16,900 – $27,450

Ankara:

Consultation and Evaluation: $400 – $700
Imaging and Planning: $800 – $1,200
Anesthesia and Preparation: $1,300 – $2,600
Surgical Procedure: $9,000 – $13,500
Post-Surgical Care: $3,500 – $6,500
Total Estimated Cost: $14,000 – $24,500

Izmir:

Consultation and Evaluation: $450 – $700
Imaging and Planning: $850 – $1,300
Anesthesia and Preparation: $1,400 – $2,600
Surgical Procedure: $8,800 – $12,500
Post-Surgical Care: $3,000 – $5,500
Total Estimated Cost: $13,500 – $22,600

Grafting Flap Reconstruction

Istanbul:

Consultation and Evaluation: $500 – $800
Imaging and Planning: $950 – $1,500
Anesthesia and Preparation: $1,500 – $2,800
Surgical Procedure: $9,500 – $14,000
Post-Surgical Care: $4,000 – $7,000
Total Estimated Cost: $16,450 – $27,100

Ankara:

Consultation and Evaluation: $400 – $700
Imaging and Planning: $800 – $1,200
Anesthesia and Preparation: $1,200 – $2,500
Surgical Procedure: $8,500 – $12,000
Post-Surgical Care: $3,500 – $6,500
Total Estimated Cost: $13,400 – $22,900

Izmir:

Consultation and Evaluation: $450 – $750
Imaging and Planning: $850 – $1,300
Anesthesia and Preparation: $1,300 – $2,600
Surgical Procedure: $8,200 – $12,000
Post-Surgical Care: $3,000 – $5,500
Total Estimated Cost: $13,100 – $21,150

Comparing Costs Across Major Turkish Cities

When considering a DIEP or TRAM flap procedure in Turkey, it’s helpful to compare costs across the country’s major medical hubs, namely, Istanbul, Ankara, and Izmir. Each city offers a different experience and price point.

Istanbul

As Turkey’s largest city and a global medical tourism hub, Istanbul offers the widest range of options for reconstructive surgery.

The cost of DIEP and TRAM flap procedures in Istanbul typically ranges from $10,000 to $17,000. Istanbul is home to many of Turkey’s top surgeons and hospitals, making it an attractive choice despite the higher cost.

Ankara

Ankara, Turkey’s capital, is known for its high-quality medical services at slightly more affordable prices compared to Istanbul.

The cost of these procedures in Ankara ranges from $8,500 to $15,000. Ankara’s hospitals are well-equipped, and the city is less crowded than Istanbul, offering a more relaxed environment for recovery.

Izmir

Izmir is another popular destination for medical tourists, offering a blend of quality and affordability. The cost of DIEP and TRAM flap procedures in Izmir ranges from $9,000 to $16,000. Izmir is known for its beautiful coastal scenery, which can provide a serene backdrop for your recovery.

Quality of Care in Turkey

One of the key concerns for patients considering surgery abroad is the quality of care. Turkey has a well-regulated healthcare system, with many hospitals and clinics holding international accreditations such as JCI (Joint Commission International).

This ensures that they meet high standards of safety, hygiene, and patient care.

Moreover, Turkish surgeons often receive training in Europe or the United States, bringing a global perspective to their practice.

Many of them are members of international professional organizations such as the American Society of Plastic Surgeons (ASPS) and the International Society of Aesthetic Plastic Surgery (ISAPS).

How to prepare for a DIEP/TRAM Flap procedure?

Personal Preparations

Understanding the Procedure

Description: Educate yourself about the specific type of breast reconstruction you will undergo, whether it’s TRAM Flap, DIEP Flap, SIEA Flap, LD Flap, SGAP Flap, PAP Flap, MS Flap, Grafting Flap, RFFF Flap, or Profunda Artery Perforator (PAP) Flap. Understanding the details will help you know what to expect and how to manage your recovery.
Action: Read reputable sources, ask questions during consultations, and discuss with patients who have undergone similar procedures.

Health Assessment and Optimization

Description: Ensure that you are in the best possible health before surgery. Address any existing health issues that could affect your surgery or recovery.
Action: Schedule a comprehensive health check-up including blood tests, imaging studies, and other relevant tests. Follow your doctor’s recommendations for managing chronic conditions, such as diabetes or hypertension.

Lifestyle Adjustments

Description: Modify your lifestyle to support a smooth recovery process. This includes dietary changes, exercise, and avoiding harmful substances.
Action: Adopt a balanced diet rich in vitamins and minerals, quit smoking, and limit alcohol intake. Engage in regular, gentle exercise to enhance your overall fitness.

Mental Preparation

Description: Prepare emotionally and mentally for the procedure and recovery period. It is important to have a positive mindset and realistic expectations.
Action: Consider counseling or support groups to discuss your feelings and expectations. Practice relaxation techniques such as meditation or deep breathing exercises.

Arranging Support Systems

Description: Ensure that you have adequate support from family and friends during your recovery period.
Action: Arrange for someone to help with daily tasks, transportation, and emotional support. Create a recovery plan that includes assistance with household chores and personal care.

Home Preparation

Description: Prepare your home environment for a smooth recovery.
Action: Set up a comfortable recovery area with easy access to necessities. Stock up on medications, toiletries, and healthy food. Ensure that your home is free from obstacles that could hinder mobility.

Financial Planning

Description: Understand the cost implications of the procedure and plan your finances accordingly.
Action: Review the total estimated cost, including pre-surgical, surgical, and post-surgical expenses. Discuss payment plans with your healthcare provider and check if your insurance covers the costs.

Medication Management

Description: Prepare for the management of medications before and after the surgery.
Action: Create a list of current medications and supplements. Discuss any necessary adjustments with your doctor. Arrange for prescriptions to be filled before your surgery date.

Pre-Surgical Testing

Description: Complete all required pre-surgical tests and screenings.
Action: Follow your doctor’s instructions for fasting, imaging, and laboratory tests. Ensure that all results are available and reviewed by your surgical team.

Educational Materials

Description: Gather information on post-surgical care and recovery.
Action: Obtain educational materials about the recovery process, including wound care, pain management, and physical therapy exercises.

Medical Preparations

Detailed Consultation

Description: Have a thorough consultation with your surgical team to discuss the procedure, expectations, and any concerns.
Action: Schedule a pre-surgical appointment to review the surgical plan, discuss anesthesia options, and understand the post-operative care requirements.

Pre-Operative Physical Exam

Description: Undergo a comprehensive physical examination to assess your readiness for surgery.
Action: Visit your primary care physician or a specialist to ensure you are fit for surgery. Complete any required pre-operative assessments.

Pre-Surgical Imaging

Description: Obtain necessary imaging studies to plan the surgical procedure.
Action: Schedule and complete imaging studies such as mammograms, MRIs, or CT scans as required by your surgical team. Ensure all images are reviewed and interpreted by your doctor.

Anesthesia Evaluation

Description: Meet with an anesthesiologist to discuss anesthesia options and any concerns.
Action: Attend a pre-anesthesia evaluation to review your medical history, discuss anesthesia risks, and plan the appropriate type of anesthesia for your procedure.

Blood Tests and Lab Work

Description: Complete necessary blood tests and laboratory work to ensure you are in optimal condition for surgery.
Action: Schedule blood tests to check for markers such as blood count, electrolytes, and liver function. Ensure that all lab results are reviewed by your surgical team.

Pre-Surgical Instructions

Description: Follow specific pre-surgical instructions provided by your healthcare team.
Action: Adhere to instructions related to fasting, medication adjustments, and pre-surgical hygiene. Confirm any restrictions or guidelines with your surgical team.

Surgical Planning and Marking

Description: Participate in detailed surgical planning and marking to ensure accurate execution of the procedure.
Action: Attend pre-surgical appointments where the surgical team will mark the site and finalize the surgical plan. Discuss any last-minute questions or concerns.

Medication and Pain Management Plan

Description: Establish a plan for managing pain and medications during recovery.
Action: Discuss pain management options with your doctor, including prescription medications and over-the-counter options. Ensure you understand how to manage pain and follow post-operative instructions.

Post-Operative Care Plan

Description: Develop a comprehensive post-operative care plan with your healthcare provider.
Action: Review instructions for wound care, activity restrictions, follow-up appointments, and signs of complications. Make sure you have a clear understanding of the recovery process.

Emergency Contact Information

Description: Have contact information for your healthcare team readily available in case of emergencies.
Action: Save important phone numbers and instructions for contacting your surgical team or healthcare provider if you experience any issues or concerns during recovery.

Risks and Considerations

As with any surgical procedure, there are risks associated with DIEP and TRAM flap surgeries. These include infection, bleeding, blood clots, and complications related to anesthesia.

Additionally, there is a risk of flap failure, where the transplanted tissue does not establish proper blood flow and must be removed.

Choosing a highly experienced surgeon and following all pre- and post-operative instructions can help minimize these risks.

Conclusion

Undergoing a DIEP or TRAM flap procedure is a significant decision, both emotionally and financially. Turkey offers an appealing combination of high-quality medical care and affordable pricing, making it an ideal destination for patients seeking breast reconstruction.

By thoroughly understanding the costs and planning your journey carefully, you can achieve excellent results while enjoying significant savings.

Whether you choose Istanbul, Ankara, or Izmir, Turkey’s medical community is ready to provide the care and expertise you need to restore your body and confidence.