Breast Reconstruction using Abdominal Tissue

If you have questions about breast reconstruction using body tissue, talk to a specialist at Banner MD Anderson Cancer Center. It’s a complex procedure with lots of options to consider. We can assist you with determining which option might be best for you and help you plan your breast reconstruction surgery at our state-of-the art surgical facility.

What Is Breast Reconstruction Using Abdominal Tissue?

Breast reconstruction with flap surgery (tissue from your own body) is a complex procedure performed by a plastic surgeon. Very natural-looking results can be achieved using flap surgery with tissue from your stomach (abdomen). There are different abdomen tissues and methods to move the tissue that can be used based on blood supply and the surgeon’s preference.

This type of surgery is often done in two stages. First, over the course of months, you use an expander to stretch the skin and tissue. Then you have surgery to complete the tissue transfer and reconstruction. You may also consider having an operation for nipple reconstruction.

Advantages of Reconstruction with Abdominal Flap

• Natural-looking breast shape and feel
• Belly will be flatter and tighter (like a tummy tuck)
• No implant required

Disadvantages of Reconstruction with Abdominal Flap

• Longer surgery
• Requires a specially trained surgeon
• Causes scarring on stomach
• Potential loss of abdominal strength
• Longer hospitalization and recovery
• Possibility for complications at two areas of the body
• Not suitable for thin women without extra belly tissue
• Not suitable for women who have had other abdominal surgeries
• Not suitable for women who plan on getting pregnant

Risks and Side Effects with Abdominal Tissue Flap Surgery

• Changes in breast sensation
• Prolonged time in surgery
• Risks of anesthesia
• Longer recovery and healing time of stomach and breast
• Poor wound healing
• Fluid collection (seroma)
• Blood clots
• Infection
• Bleeding
• Tissue death (necrosis) due to insufficient blood supply
• Loss of sensation around donor site
• Abdominal weakness or hernia

Types of Abdominal Flaps

• Pedicled Transverse Rectus Abdominis Myocutaneous (TRAM): Consisting of skin, fatty tissue and muscle, with fascia; the flap remains connected to its blood supply and moved together to the breast area.
• Free Transverse Rectus Abdominis Myocutaneous (TRAM): Consists of skin, fatty tissue and muscle, with fascia, the flap is disconnected from its blood supply and connected to the blood supply in the chest.
• Muscle-Sparing & Perforator Flaps: A flap may be created with removing little to no fascia or muscle, or only a small amount. This has shown to reduce problems that can occur from removing supporting structures of the abdominal wall.
• Free Superficial Inferior Epigastric Artery (SIEA): Consisting of skin, fatty layer and superficial inferior epigastric artery, vein and perforators (small blood vessels), the flap is disconnected from its blood supply and is connected to the blood supply in the chest. This is not a common procedure as often the superficial inferior epigastric artery and vein are too small to be used.
• Free Deep Inferior Epigastric Perforator (DIEP): Consisting of skin, the fatty layer and the deep inferior epigastric artery, vein and perforators, the flap is disconnected from its blood supply and is connected to the blood supply in the chest.
• Free Muscle-Sparing TRAM: Consisting of skin, the fatty layer and a small portion of muscle with or without fascia, the flap is taken off its blood supply and is connected to the blood supply in the chest. Most fascia and muscle are spared.

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