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What You Need to Know

Breast cancer is a life-changing diagnosis that often necessitates a mastectomy, the surgical removal of one or both breasts. While the removal of breast tissue is a crucial step in treating breast cancer, many women are left with the desire to regain their sense of femininity and self-confidence through breast reconstruction. Fortunately, there are several options available for breast reconstruction after a mastectomy.

In this article, we explore these options, including breast implant reconstruction, direct-to-implant reconstruction, autologous tissue flap reconstruction, and nipple reconstruction, to help you make an informed decision that aligns with your individual needs and preferences.

Breast Implant Reconstruction

Breast implant reconstruction is a popular choice among women seeking to restore the shape and size of their breasts after a mastectomy. This procedure involves the insertion of silicone or saline implants to create a breast mound. It is a relatively straightforward surgery, and many patients appreciate the shorter recovery time compared to other options. Implants also provide immediate results, which can be psychologically beneficial for some women.

However, breast implant reconstruction may require additional surgeries in the future. Implants have a limited lifespan, typically around 10-15 years, and may need to be replaced or adjusted over time. In rare cases, implants can also lead to complications like implant rupture, capsular contracture, or infection. Therefore, while breast implant reconstruction offers convenience and quick results, it may not be the best long-term option for everyone.

Direct to Implant Breast Reconstruction

Direct-to-implant (DTI) breast reconstruction combines mastectomy and implant placement in a single surgery. This is suitable for some patients, particularly those with smaller breasts or minimal tissue removal during the mastectomy. DTI reconstruction can offer immediate results, sparing patients the need for tissue expanders and multiple surgeries.

However, not all women are candidates for DTI reconstruction. It may not be suitable for those requiring larger reconstructions or those with significant tissue loss during the mastectomy. Additionally, the final outcome may not always be as natural-looking as with other methods

Autologous Tissue Flap Reconstructions

Autologous tissue flap reconstructions involve using a patient’s own tissue to reconstruct the breast mound. This can yield more natural-looking and feeling breasts. Autologous tissue flap reconstructions offer long-lasting results and have a lower risk of complications related to implants. However, they are more extensive surgeries with longer recovery periods. There are several types of autologous tissue flap reconstructions:

Pedicled TRAM (Transverse Rectus Abdominis Myocutaneous) Flap
The pedicled TRAM flap uses tissue from the abdominal area to create a new breast mound. This technique preserves the blood supply by keeping a section of the rectus abdominis muscle attached to the tissue. While it provides excellent results, it can be associated with longer recovery times and a higher risk of abdominal muscle weakness.

Free TRAM (Transverse Rectus Abdominis Myocutaneous) Flap
Similar to the pedicled TRAM flap, the free TRAM flap uses abdominal tissue. However, it detaches the tissue completely and reattaches it at the recipient site, usually in the chest. This reduces the risk of muscle weakness but involves a more extended recovery period.

DIEP (Deep Inferior Epigastric Perforator) Flap
The DIEP flap also utilizes abdominal tissue, but it spares the abdominal muscle entirely, making it a preferred choice for patients concerned about muscle function. While it’s more complex, it provides natural-looking results and reduces abdominal muscle-related risks.

TAP (Thoracodorsal Artery Perforator) Flap
The TAP flap uses tissue from the upper back. It can be an excellent option for patients who may not be suitable candidates for abdominal tissue flap reconstructions. TAP flap surgery preserves muscle function and offers a viable alternative to abdominal-based reconstructions.

Nipple Reconstruction

Nipple reconstruction is the final step in breast reconstruction. After the breast mound is created, nipple reconstruction can complete the natural appearance of the breast. Nipple reconstruction involves creating a flap of tissue on the breast mound and arranging it to provide the appearance of a nipple. Finally, tattooing can create the appearance of the areola.

The best option for breast reconstruction after a mastectomy depends on your individual circumstances, preferences, and desired outcomes. Each method has its advantages and limitations, and it is essential to consult with the board-certified plastic surgeons at the New York Group for Plastic Surgery to determine the most suitable approach for you. By considering your unique needs and goals, you can make an informed decision that helps you regain confidence and restore your sense of self after a mastectomy.


New York Group for Plastic Surgery specializes in breast reconstruction, DIEP flap, augmentation, reduction, and implant revision to name a few. To learn more about the aesthetic procedures we offer and their cost, contact us and we’ll provide you with all the information you need to make a decision and start your journey to a more confident you.

Contact Us (914) 366-6139