Richard M. Kline, Jr., M.D.James E. Craigie, M.D.
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Perforator Flap Breast Reconstruction

East Cooper Plastic Surgery has led the southeastern United States in bringing the options of perforator flap reconstruction to patients recovering from breast cancer. Dr. Kline trained at LSU during the development of the DIEP flap, and Dr. Craigie completed a fellowship at LSU in microsurgical breast reconstruction.

Dr. Kline performed a DIEP flap in Charleston, SC on January 28, 1998 (see photo), probably the first  successful perforator flap breast reconstruction in the Southeast. Dr. Craigie completed his fellowship in 2001, and returned to Charleston to begin building our present  perforator flap operative team.

Hundreds of successful flaps later, the team now routinely performs all types of perforator flap reconstructions, including simultaneous bilateral DIEPs, s-GAPs, and i-GAPs. Many of these patients had undergone numerous previous surgeries, either with implants or flaps. Many had suffered damage from radiation. Some had all but given up hope for a successful reconstruction.

Altogether, our  team has performed well over 300 perforator  flap breast reconstructions, with an overall success rate of 98.6%.

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First successful
South Carolina DIEP flap, 1998

After | larger view


Right mastectomy, left lumpectomy with radiation:
bilateral DIEP flap reconstructions

Before | larger view

After | larger view


Cancer L breast:
skin-sparing mastectomy with immediate DIEP reconstruction,
delayed right breast reduction

Before | larger view

After | larger view


Cancer right breast:
mastectomy with immediate DIEP flap reconstruction

Before | larger view

After | larger view


Bilateral mastectomies:
delayed reconstruction with bilateral DIEP flaps

Before | larger view

After | larger view


Right mastectomy with radiation:
DIEP flap reconstruction, left breast lift

Before | larger view

After | larger view


Right mastectomy: left prophylactic mastectomy
with immediate bilateral DIEP flap reconstructions

Before | larger view

After | larger view


Patient with strong family history of breast cancer,
has had tummy tuck, desires prophylactic mastectomies
and autogenous reconstruction:
immediate bilateral s-GAP reconstruction

Before | larger view

After | larger view


Bilateral mastectomies, radiation right side,
multiple failed implants, has had lower body lift:
reconstruction with bilateral s-GAP flaps

Before | larger view

After | larger view


American Society of Plastic SurgeonsJoint Commission National Quality Approval