If you’re exploring breast reconstruction options after mastectomy or lumpectomy, choosing the right procedure can be difficult. You might wonder if you’re a better candidate for implants or for a more natural approach. One option that may align with your goals and body type is autologous tissue flap reconstruction, which uses your tissue to recreate the breast shape. This technique provides long-term results and allows for a natural feel and appearance to be maintained.
At the New York Group for Plastic Surgery, our board-certified plastic surgeons specialize in advanced reconstructive procedures, including microsurgical flap techniques. In this article, we’ll help you understand how autologous tissue flap reconstruction works and whether it may be the right fit for your unique body type, lifestyle, and goals.
What is autologous tissue flap reconstruction?
Autologous tissue flap reconstruction, also called flap reconstruction, uses your skin, fat, and sometimes muscle from another area of your body to rebuild the breast. This technique differs from implant-based reconstruction, as it does not use synthetic material. Instead, your natural tissue is transplanted from a donor site, such as the abdomen, thighs, or buttocks, and reshaped into a breast mound.
Because the procedure uses living tissue, the reconstructed breast may look, feel, and move more naturally than a breast reconstructed with an implant. It also adapts more seamlessly to weight changes over time. However, flap surgery is a complex microsurgical procedure that requires careful pre-operative planning and specialized surgical expertise.
Common flap procedures include:
- DIEP flap: skin and fat from the lower abdomen, the muscle is preserved
- SIEA flap: similar to DIEP but without cutting abdominal muscles
- TRAM flap: includes muscle from the abdomen
- PAP flap: uses tissue from the inner upper thigh
- SGAP/IGAP flaps: use tissue from the upper or lower buttocks
- LAT flap and TDAP flap: use tissue from the upper back/side of the chest
- Stacked flap reconstruction: combine multiple flaps for added volume
- Fat grafting: use liposuctioned fat to shape or refine the breast
Flap reconstruction may be right for you if:
You prefer a natural look and feel
Unlike implants, flap reconstruction creates a breast using your own tissue, resulting in a more natural texture, warmth, and softness. If having a reconstructed breast that feels like the rest of your body is important to you, this technique may be a better option.
You want long-term results without implants
Flap reconstruction avoids many of the risks associated with implants, such as rupture, capsular contracture, or the need for future replacements. If you’re seeking a long-term solution with fewer maintenance issues, autologous reconstruction can offer peace of mind.
You have had radiation therapy
Radiation can affect skin elasticity and healing. If you’ve undergone or will undergo radiation, a tissue flap reconstruction may be a better match for your needs, as the transplanted tissue brings its own blood supply and supports better healing in previously treated areas.
You have enough donor tissue on your body
Autologous reconstruction depends on available tissue from donor areas like the abdomen, thighs, or buttocks. If you have sufficient skin and fat in these areas, you may be an ideal candidate for flaps such as DIEP, PAP, or SGAP.
On the other hand, if you are very thin or have undergone significant surgery in a potential donor site (like a tummy tuck), your surgeon may recommend an alternative flap or a hybrid approach combining a smaller flap with an implant.
You want a breast that changes with your body
Since autologous flaps are made from your own tissue, they can gain or lose volume in sync with your body. If you anticipate fluctuations in weight over time and want your breasts to change naturally with your body, this method can offer more harmony than implants.
You are open to a longer recovery period
Flap surgery requires a longer surgery and recovery than implant-based options because it involves operating on both the chest and the donor site. If you’re physically healthy and can commit to a more extended recovery, flap reconstruction may be a rewarding option.
You’re working with a skilled microsurgical team
Not all plastic surgeons are trained in the delicate microsurgical techniques required for flap reconstruction. At NYGPS, our surgeons are nationally recognized for their expertise in DIEP, SIEA, PAP, and stacked flap procedures, with the advanced skills necessary to connect tiny blood vessels and ensure healthy tissue transfer.
Let us help you decide what’s best for your body
Ultimately, the best breast reconstruction option is the one that fits your body, your health status, and your personal goals. Autologous flap reconstruction isn’t for everyone, but for the right candidate, it offers unmatched aesthetic and functional benefits.
If you’re considering autologous tissue flap reconstruction, schedule a consultation with our experienced team. We’ll guide you through your options, use advanced imaging to evaluate donor sites, and craft a custom surgical plan tailored to your body type and lifestyle.
