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Autologous breast reconstruction uses the woman’s own body tissues (fat and muscle) that are collected from other parts of her body to create a new breast. The reconstructed breast has a more natural feel than a breast implant.
There are different types of tissue techniques used for autologous breast reconstruction.
The TRAM flap is the most common technique used for breast reconstruction. It uses muscle (transverse rectus abdominis muscle or TRAM), fat and skin tissue from a woman’s abdomen to reconstruct the breast.
During the surgery, the tissue flap may either be:
A LATS flap uses muscle (latissimus dorsi), fat and skin from the back. The flap is moved under the skin to the mastectomy site and remains attached to its original blood supply. An implant is also used for women who need a larger breast.
This technique also adds fullness to the lower part of the breast, which helps to create a natural looking breast.
DIEP stands for deep inferior epigastric artery perforator. With a DIEP flap, skin, fat and blood vessels (but not muscle) are removed from the abdomen and placed under the skin on the chest to form a breast.
Because the muscle in the abdomen is left in place with the DIEP flap method, there is less potential for weakening of the abdominal muscles than when muscle is removed during a TRAM flap.
A free flap procedure uses skin, fat, muscle and blood vessels from one area of the body, such as the abdomen (TRAM flap) or from the buttocks (gluteal free flap). These tissues are placed under the skin on the chest to create a breast.
The free flap method is not used very often and needs a plastic (reconstructive) surgeon skilled in microsurgery to reconnect tiny blood vessels to the flap in the new breast location.
Side effects can occur with any type of autologous breast reconstruction, but not everyone has them or experiences them in the same way. The side effects are similar for the different types of flap surgeries. Side effects of autologous breast reconstruction will depend mainly on the:
It is strongly recommended that women who smoke stop at least 3 months before and 1 month after having an autologous breast reconstruction. Smoking affects blood flow to the skin and underlying tissues, which can lead to infection, delayed healing and increase the risk of dead tissue in the flap (flap necrosis). Many surgeons will not offer reconstruction to women who do not quit smoking.
Side effects can happen any time during autologous breast reconstruction. Some may happen during, immediately after, or a few days or weeks after surgery. Most side effects go away after surgery. Late side effects can occur months or years after surgery. Some side effects may last a long time or be permanent.
It is important to report side effects to the healthcare team.
Some potential side effects of autologous breast reconstruction include:
Women who have autologous breast reconstruction surgery should talk to their doctor about a follow-up plan that suits their individual situation.