Breast Reconstruction Options: Tissue vs. Implant

There are several options in breast reconstruction, which can be divided into two main groups: autologous breast  reconstruction using one's own tissue, and implant-only breast reconstruction without a donor site.

The breast is best replaced with like tissue and the best long-term replacement is abdominal tissue (DIEP/SIEA) flaps or buttock tissue (SGAP/IGAP) flaps. These procedures are longer, as they require microsurgical transfer of tissue from one area of the body to another, and re-connection of blood vessels. If this approach is not desired or indicated, a simpler flap can be performed using muscle and skin from the back area, just underneath the shoulder blade. This procedure is called the latissimus flap and is usually combined with an implant. For small defects, the TAP flap can also be used from the back area, but this does not include the back muscle; only a small amount of skin and fatty tissue is transferred.

For patients wishing to have implant-only reconstruction, it is usually performed in two stages, with a tissue expander being inserted first to expand the remaining skin since there is no skin replacement with a flap. Once the skin is adequately stretched, an implant is placed.

For more information about the various breast restoration techniques, visit our Procedures page.