Restore breast shape using your body’s natural tissue with autologous tissue flap reconstruction at New York Group for Plastic Surgery. Dr. Jordan M.S. Jacobs specializes in microsurgical techniques that use fat and skin from areas like the abdomen or thigh to rebuild soft, natural-looking breasts after mastectomy.
Rebuild Your Breasts Using Your Natural Tissue
An autologous tissue flap is a type of breast reconstruction that uses your own body tissue, typically from the abdomen, buttocks, or thighs, to create a new breast after mastectomy. Unlike implants, this method relies entirely on natural fat and skin for a softer, more natural result. Dr. Jacobs uses advanced microsurgical techniques to transfer the tissue and reconnect its blood vessels, ensuring it remains healthy and viable in its new location. It’s an ideal option for women seeking a more organic reconstruction without implants.
You May Consider an Autologous Tissue Flap If:
- You want to avoid using breast implants
- You have excess fat in your abdomen, thighs, or buttocks
- You prefer a more natural look and feel to your breasts
- You are not a good candidate for implant-based reconstruction
- You’ve had prior radiation therapy to the chest
- You want reconstruction that ages and changes with your body
- You are healthy enough to undergo a longer, more complex surgery
- You have realistic expectations and are committed to recovery
Explore Your Options & Visualize the Results
Dr. Jacobs will evaluate your medical history, previous cancer treatments, and any prior surgeries to determine your eligibility for autologous tissue flap reconstruction. He’ll perform a physical exam to assess the quality and quantity of donor tissue from areas like your abdomen, thighs, or buttocks, while also evaluating the condition of your skin and chest wall. If you’ve had radiation therapy, this will also be factored into your surgical planning.
To help you understand your potential results, Dr. Jacobs will use the Vectra XT 3D imaging system. This advanced tool captures detailed images of your body and uses volumetric analysis to simulate outcomes based on different flap options. Together, you’ll review these simulations, compare techniques, and develop a fully customized surgical plan that reflects your goals.
Your Autologous Tissue Flap Options at NYGPS
At New York Group for Plastic Surgery, we offer several advanced flap techniques tailored to your unique body and reconstruction goals. Dr. Jacobs uses meticulous microsurgical expertise to ensure the most natural results with minimal impact on your donor site. Depending on your anatomy, lifestyle, and aesthetic preferences, we may recommend one of the following options:
DIEP Flap:
This technique uses skin and fat from the lower abdomen without removing muscle. It preserves abdominal strength while providing a soft, natural breast shape. The deep inferior epigastric perforator (DIEP) vessels are carefully reconnected under a microscope for optimal blood flow and healing.
SIEA Flap:
Similar to the DIEP flap, this procedure also uses abdominal fat but harvests different blood vessels (superficial inferior epigastric artery). It avoids cutting through the abdominal muscles entirely, which may further reduce recovery time. Not all patients have suitable vessels for this approach, so careful evaluation is essential.
PAP Flap:
During this technique, tissue is taken from the back of the upper thigh, making it an ideal option for women who lack sufficient abdominal fat. The profunda artery perforator (PAP) vessels are used to maintain tissue health. This flap creates a smooth, natural contour while leaving a discreet scar in the thigh crease.
SGAP Flap:
This flap utilizes fat from the upper buttock and serves as a viable alternative if abdominal or thigh tissue is not suitable. It involves harvesting skin and fat supplied by the superior gluteal artery perforators. While technically more complex, it offers excellent long-term outcomes for the right candidate.
TRAM Flap:
This traditional approach involves taking fat and a portion of the rectus abdominis muscle from the lower abdomen. It can be done as a pedicled (non-microsurgical) or free (microsurgical) flap. While effective, it may result in more abdominal weakness compared to DIEP or SIEA techniques.
Your Autologous Tissue Flap Session
Your surgery will be performed under general anesthesia and typically takes 6 to 10 hours. Dr. Jacobs begins by preparing the donor site—most often the lower abdomen for a DIEP flap—by carefully dissecting the perforating blood vessels (deep inferior epigastric vessels) through the muscle without damaging the surrounding tissue. The flap, which includes skin, fat, and blood vessels (but no muscle in DIEP or SIEA flaps), is then removed and transferred to the chest.
At the recipient site, Dr. Jacobs will remove the mastectomy tissue and use microsurgical instruments to reconnect the donor vessels to the recipient vessels, usually the internal mammary artery and vein. Once blood flow is re-established, the tissue is shaped into a breast mound and secured. Both donor and recipient sites are closed using sutures, and surgical drains are placed to manage fluid buildup.
The Recovery Process After an Autologous Tissue Flap
After surgery, you’ll stay in the hospital for about 3 to 5 days so your flap can be closely monitored. You may experience soreness, swelling, bruising, and temporary numbness at both the donor and recipient sites. Surgical drains will be placed to prevent fluid buildup, and you’ll receive detailed instructions on how to care for them at home.
Most patients need 4 to 6 weeks of downtime before returning to normal activities. You’ll be advised to avoid heavy lifting, strenuous exercise, and sleeping on your stomach during this period. Dr. Jacobs and his team will schedule follow-up appointments to monitor healing and ensure optimal flap viability. Wearing compression garments and maintaining a healthy lifestyle can support recovery and improve your long-term results.
Why Choose Dr. Jordan M.S. Jacobs?
Elite Breast Reconstruction Surgeon Serving the New York Region
Dr. Jordan M.S. Jacobs is a board-certified plastic and reconstructive surgeon and a recognized expert in microsurgical breast reconstruction. As Chief of Plastic & Reconstructive Surgery at Mount Sinai Downtown, he brings elite technical precision and a patient-first philosophy to every case. If you’re considering autologous tissue flap breast reconstruction, schedule a consultation to explore your options and experience care led by one of New York’s most trusted and empathetic breast reconstruction specialists.
