Tissue Flap Breast Reconstruction

Autologous (tissue flap) breast reconstruction uses your own tissue to rebuild your breast after you’ve had a mastectomy or lumpectomy to treat breast cancer. Surgeons move skin, fat and sometimes muscle from another part of your body to create a soft, realistic breast shape. It’s a natural option that can age with you.

At Banner MD Anderson Cancer Center, our surgeons specialize in advanced microsurgical techniques to help restore your appearance and confidence.

Request a consultation with one of our breast reconstruction specialists.

How tissue flap reconstruction works

During tissue flap reconstruction, your surgeon takes healthy tissue from another part of your body, usually your abdomen or back, and moves it to your chest. The surgical team carefully reconnects the blood vessels, using a microscope to make sure the transferred tissue gets enough blood circulation. The new tissue is shaped to match the contour of your breast.

Autologous breast reconstruction can be done at the same time as your mastectomy or later, once you’re finished with other treatments like radiation.

Types of flap reconstruction

There are several kinds of tissue flap options. The two most common are:

• Abdominal tissue reconstruction (DIEP flap or TRAM flap): A breast reconstruction surgeon uses skin and fat from your lower abdomen to rebuild the breast. These procedures leave most of your abdominal muscles in place. There are several different variations of the abdominal flap – DIEP, TRAM, SIEA (superficial inferior epigastric artery) but they all refer to removing the excess skin and fat (the tissue that would normally be thrown away in a tummy tuck) and repositioning to the chest to recreate the breast.   
• Back tissue reconstruction (latissimus dorsi flap): A breast reconstruction surgeon uses tissue and muscle from your upper back (latissimus dorsi) to create or support a breast mound.

Benefits of autologous reconstruction

Tissue flap reconstruction has several advantages over implants:

• Results look and feel more natural.
• The tissue ages and changes with your body over time.
• You don’t need to maintain or replace anything. 
• With abdominal tissue reconstruction, your belly may look flatter after surgery, as if you had a “tummy tuck.”

Many people choose autologous reconstruction because it gives them the most natural, long-term result.

Risks and considerations

Tissue flap surgery is more complex than implant surgery. It involves different parts of your body, and surgeons have to carefully reconnect blood vessels. The surgery itself takes longer, which means you’ll need more time under anesthesia. You’ll also need more time to recover afterward.

Possible risks of natural breast reconstruction include:

• Healing problems or infection at the breast or the site where the tissue was removed
• Fat necrosis (firm spots caused by reduced blood flow)
• Abdominal or back weakness
• Needing more than one procedure to make the breasts symmetrical

Not everyone is a candidate for this procedure. Your surgeon will discuss whether this is the safest and most effective option for your health and body type.

Learn more about risks and complications.

Recovery and aftercare

Most people stay in the hospital for three to five days after flap surgery. You’ll be encouraged to take gentle walks soon after surgery to help your body circulate your blood and heal.

• It’s normal to have tightness, swelling or soreness both at the breast and at the site where tissue was removed.
• Don’t lift anything heavy or exercise strenuously until your surgeon tells you it’s OK.
• You should fully recover in about six to eight weeks.

Read more about recovery and aftercare.

Who may be a good candidate

You may be a good candidate for autologous reconstruction if you:

• Have enough tissue in your abdomen or back to remove for reconstructing your breast
• Are in good overall health 
• Don’t smoke
• Have had or expect to need radiation therapy
• Want a more natural look and feel than implants provide
• Have not had major abdominal surgery in the past
• Your weight is at a healthy level for having surgery safely

If you aren’t a good candidate for tissue flap reconstruction, your surgeon may recommend implant-based reconstruction or hybrid reconstruction instead.

Why choose Banner MD Anderson Cancer Center?

At Banner MD Anderson, our breast reconstruction experts focus exclusively on breast cancer recovery. Our surgeons are experienced in advanced microsurgical procedures like DIEP and TRAM flaps and they work closely with your cancer care team to carry out your treatment plan.

We’re focused on your safety, comfort, appearance and emotional healing. You can count on our compassionate support, personalized care plans and exceptional outcomes to help you heal with confidence. 

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