What does breast reconstruction using my own body tissue involve?

Stuart A. Linder, MD
Plastic Surgery

Breast cancer reconstruction using one’s own tissue is referred to as "autologous flap reconstruction." Tissue may be either brought up attached as a pedicle or used as a free-flap with microvascular anastamosis. The most common tissue flaps include: latissimus dorsi flap (back), TRAM transverse musculocutaneous flap (rectus muscles) uni or bipedicle or "free-flap," and DIEP deep inferior epigastric flap. The tissue helps to recreate a new breast with both soft fatty tissue and a skin paddle.

The 3 most common options for autogenous breast reconstruction are the TRAM flap, DIEP flap, or latissimus flap. The TRAM flap, or transverse rectus abdominis myocutaneous flap, involves removing skin, fat, and muscle from the abdomen and bringing it up to the breast. This can be done in several different ways, involving either rotating the blood supply of the muscle up towards the breast, or cutting the blood vessels of the muscle and attaching them to the blood vessels in the chest area. Your surgeon will determine which is best for you. Many patients like this option since they get a “tummy tuck” with the procedure.

The DIEP flap, or deep inferior epigastric perforator flap, uses skin and fat from the belly, but does not involve cutting any muscle. The benefit of this technique is that there is no abdominal weakness or potential for hernia. This is a more complex technique, in that it involves microsurgery to attach the blood vessels (inferior epigastric perforator) to the blood vessels in the chest.

Finally, the latissimus dorsi flap involves recreating a breast using muscle from the back. This is generally well tolerated, and recovery time is shorter than a reconstruction using abdominal tissue. Since many women don’t have a large back muscle, sometimes this procedure is combined with an implant to give the size, as well as feel of a real breast.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.