Breast Reconstruction Using Natural Tissue

Written by Maureen Donohue | Published on July 21, 2012
Medically Reviewed by George Krucik, MD

What Is a Flap Breast Reconstruction?

A flap procedure is a type of breast reconstruction surgery. It is used to restore the shape of the breast after mastectomy. Mastectomy is a procedure that removes the breast as a treatment for breast cancer.

A flap procedure is an alternative to using breast implants. It replaces breast tissue with tissue from another area of the body, such as the abdomen. Many women think that flap procedures provide a more natural appearance than implants. However, there are increased risks associated with flap surgery.

These risks include:

  • hernia where the tissue was removed
  • loss of sensation at the donor site
  • changes of sensation in the breast
  • necrosis, or tissue death, in the breast

What Is the Procedure for Breast Reconstruction Using Natural Tissue?

Three types of tissue flap can be used to reconstruct the breast:

  • A TRAM flap uses skin, fatty tissue, and muscle from the lower abdomen.
  • A latissimus dorsi flap uses skin and muscle from the back.
  • A DIEP flap uses the abdominal blood supply, fat, and skin, but preserves the muscle.

The tissue flaps are moved into place on the chest wall using one of two techniques:

In a rotation-flap procedure, the tissue flap is left attached to its original blood supply at one end. The free end is tunneled under the skin. It is then rotated into position on the chest wall.

In a free-flap procedure, the tissue flap is completely disconnected from its original blood supply. It is reconnected to an existing blood supply in the chest using microsurgery.

Once the tissue flap has been positioned, the surgeon shapes it into the contour of a breast. The shape may need to be refined with additional surgeries.

When Should I Have Breast Reconstruction Surgery?

Breast reconstruction can be performed in conjunction with your mastectomy, if you do not require radiation. If radiation is necessary, reconstruction should be postponed until several months after your last treatment. This will allow any side effects to become clear. Radiation can cause tissue deformation and hardening. It may make you unsuitable for a flap procedure.

Your surgeon may suggest implanting a tissue expander at the time of your mastectomy. This stretches the skin. The expander makes it it easier to perform reconstructive surgery when you are ready.

Discuss all of your surgical options with your doctor.

What Are the Risks of a Flap Breast Reconstruction?

Breast reconstruction with tissue flaps carries the same risks as any surgery. These include bleeding and infection. However, this surgery also presents unique wound healing challenges. TRAM flaps and latissimus dorsi flaps remove muscle from the abdomen or back.

This poses a risk of:

  • postoperative hernia
  • weakness
  • abdominal bulging

In an interview with Healthline, Dr. David S. Goldberg emphasized the importance of selecting the right surgeon and the right hospital. Doing so can reduce complications and maximize your results.

Dr. Goldberg, a plastic surgeon from Monterey, CA, said, “It is critical to find a breast center that specializes in this technique. You’re not just choosing a plastic surgeon. You need a multidisciplinary team that includes a plastic surgeon, oncologist, and radiologist. They must be used to working together. That will give you the best chance for a good outcome.” (D.S. Goldberg, personal communication, July 18, 2012)

What Kind of Results Can I Expect?

Using your own tissue can result in a cosmetically appealing breast. The size, fullness, and shape of the new breast can be closely matched to your other breast. However, your breast will not look or feel the same as it did before surgery.

“Flap procedures produce the most elegant and sophisticated results,” said Dr. Goldberg. “They are considered the gold standard of breast reconstruction.” (D.S. Goldberg, personal communication, July 18, 2012)

New Techniques in Breast Reconstruction

Surgeons continue to refine their techniques and materials. Progress has led to better options and more natural results. One of the most promising new techniques is autologous fat grafting. This technique uses modified liposuction techniques. It transfers fat stem cells from where you don’t need them and puts them in the breast.

This technique is already in use to add fullness and correct defects in reconstructed breasts. According to Dr. Goldberg, surgeons may soon be able to use it to reconstruct an entire breast. (D.S. Goldberg, personal communication, July 20, 2012)

Was this article helpful? Yes No

Send us your feedback

Thank you.

Your message has been sent.

We're sorry, an error occurred.

We are unable to collect your feedback at this time. However, your feedback is important to us. Please try again later.

Show Sources

Trending Now

Beyond Back Pain: 5 Warning Signs of Ankylosing Spondylitis
Beyond Back Pain: 5 Warning Signs of Ankylosing Spondylitis
There are a number of potential causes of back pain, but one you might not know about is ankylosing spondylitis (AS). Find out five warning signs of AS in this slideshow.
Common Asthma Triggers and How to Avoid Them
Common Asthma Triggers and How to Avoid Them
Learn about some of the most common triggers for asthma, as well as measures you can take to minimize your risk of exposure, symptoms, and flares.
Understanding the Progression of Ankylosing Spondylitis
Understanding the Progression of Ankylosing Spondylitis
One serious potential cause of back pain is ankylosing spondylitis. Get an understanding of what this condition is, how it progresses, and potential complications in this slideshow.
How to Evaluate Your Multiple Sclerosis Treatment Plan
How to Evaluate Your Multiple Sclerosis Treatment Plan
Every multiple sclerosis (MS) patient is different, and no single treatment plan works for everyone. Learn more about what to consider when evaluating your MS treatment plan.
Numbness, Muscle Pain and Other RA Symptoms
Numbness, Muscle Pain and Other RA Symptoms
The symptoms of RA are more than just joint pain and stiffness. Common symptoms include loss of feeling, muscle pain, and more. Learn more in this slideshow.