Autologous Tissue Flap Reconstruction

Another option for breast reconstruction surgery is using your own body tissue, including both skin and fat. This method to reconstruct your breasts is known as autologous, or perforator flap reconstruction. To do this, your surgeon transplants your live skin, fat, blood vessels, and muscle from another part of your body—usually the abdomen, buttock, back, thigh, or hip area—to the upper chest. Your surgeon will try to use tissue from the part of your body that has sufficient excess available.

We categorize flap procedures by the type of tissue we use. The types of flap surgery are:

  • Deep inferior epigastric artery perforator (DIEP) flaps—use tissue from the abdomen.
  • Superior and inferior gluteal artery perforator (SGAP and IGAP) flaps—use skin and fat from your upper buttocks -- the area that bulges out and we fondly call our “love handles.”
  • Inner thigh (transverse upper gracillis (TUG)) flaps—use tissue from the upper thighs.
  • Profunda artery perforator (PAP) flaps—use tissue from the back of the upper thigh.

The advantages of the tissue flap approach are vast:

  • It usually lasts a lifetime.
  • Because the tissue is live, your body will not reject it.
  • Tissue from your belly, buttocks, and upper thighs is very similar to breast tissue, so it feels natural and matches your skin color.
  • We are able to preserve the underlying muscle.
  • It offers the added benefit of a tummy tuck, thigh, or butt lift.
  • The breast feels natural to the touch.
  • Some women report regaining sensation in the area.

It is worth considering that flap procedures take longer than an implant procedure. The surgery involves two surgical sites (the chest as well as the abdomen, buttocks, or thighs), and it requires a longer hospital stay than an implant procedure. The hospital stay is typically five days.

After the Procedure

After you leave the hospital, you will likely feel tired and sore but we can prescribe medication to ease your pain. You should be able to return to work and resume normal activities within four to eight weeks. You may have bruising and swelling for up to eight weeks. If you choose to have nipple reconstruction, we will do that at a later date. Scars should fade over time. Most women report the reconstruction greatly helps their sense of self-esteem and optimism for the future.

Insurance Concerns

The Women’s Health and Cancer Rights Act of 1998 requires group health plans, insurance companies, and health maintenance organizations (HMOs) that pay for mastectomy, also pay for reconstruction of the breast removed with mastectomy. Insurance should also cover surgery and reconstruction of the opposite breast for symmetry, and treatment of any complications. Additional information is available by calling the Department of Labor at 866-444-3272.