Flap Breast Reconstruction

Autologous reconstruction

Your own tissue, moved to the chest, when an implant should not be the reconstruction.

The approach

Using your own tissue

Autologous reconstruction rebuilds the breast with tissue from your own body, most often skin and fat from the lower abdomen, sometimes from the thigh or buttock. The tissue is moved with its blood supply and shaped on the chest. There is no implant to rupture and no capsule to contract.

It is a longer operation than an implant, and it leaves a scar where the tissue was taken. It is the reconstruction we discuss when radiation has damaged the skin, when an implant has already failed, when the chest wall needs more than a device can give, or when you do not want another implant.

Not every woman is a candidate. Prior abdominal surgery, how much tissue is available, and medical conditions that affect wound healing all matter. Dr. Sayah examines that in person. The cancer timing still belongs to Dr. Funk.

Fat grafting is sometimes used afterward to blend the edges. That is a separate, smaller procedure, described under micro-fat grafting.

This is general information about how these questions are usually approached. It is not a diagnosis, and it does not replace a visit. Screening and treatment are planned for one person at a time.

What the operation asks of you

A flap reconstruction is longer than an implant operation, and the recovery includes two sites: the chest and the place the tissue came from. Most often that is the lower abdomen. The scar there is low. The tissue that moves keeps its blood vessels, which is what makes the reconstruction living tissue rather than a graft that has to take. Muscle-sparing techniques are used when your anatomy allows, so the abdominal wall is not given up casually.

You are a candidate only if there is enough tissue, if prior scars have not cut the vessels, and if healing conditions are acceptable. Smoking, poorly controlled diabetes, and some previous abdominal operations remove this option or change the donor site to the thigh or the buttock. Dr. Sayah examines that. He does not describe a DIEP flap to someone who cannot have one.

The breast made from your own tissue changes with weight gain and loss, does not rupture, and does not form a capsule around a device. It can still need revision and fat grafting to match the other side. Plan on that possibility when you plan the time off.

Common questions

Frequently asked questions

Is this the same as a tummy tuck?

Tissue is often taken from the lower abdomen, and the donor site is closed in a way that can resemble a tummy tuck. The point of the operation is the breast and a living blood supply, not the abdomen.

Will I lose muscle?

Many modern abdominal flaps spare the rectus muscle and take skin and fat with the blood vessels that feed them. Which vessels are used is decided from your anatomy.

Get started

Talk this through with the physicians who share your file.

Breast surgery, pathology, and reconstructive surgery are in one practice.

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