Autologous Tissue Surgery

Autologous Tissue Surgery for Breast Reconstruction

Autologous breast reconstruction surgery uses tissue from your own body to recreate the breast. The new breast volume is created entirely with living tissue for a natural, long-lasting result.

There are two techniques used for positioning the tissue flap to create the new breast:

  • Pedicle flap — In this procedure tissue is moved to the chest without cutting the original blood supply, by tunneling the flap under the skin and attaching in the chest area.
  • Free flap — Because the tissue is cut free, the surgeon moves the flap to the chest and attaches the blood vessels in the new location.

There are a number of options for flap surgery, identified by the areas of the body that provide the tissue.

  • DIEP flap — The DIEP (Deep Inferior Epigastric Perforator) comes from the lower abdomen, without removing muscle. Preserving the abdominal muscles prevents weakening of the area and the chance of developing hernias. In DIEP flap surgery, very small arteries and veins are separated from the abdominal muscle for reattachment in the chest, leaving the muscle intact. The DIEP flap removes tissue similar to an abdominoplasty (tummy tuck) with improvement in abdominal contour.

  • TRAM flap — TRAM (Transverse Rectus Abdominis Myocutaneous) uses skin, fat and rectus muscle(s) from the lower abdomen to form breast tissue.
  • GAP and TUG flap — For women with insufficient abdominal tissue for breast reconstruction, GAP (Gluteal Artery Perforator) flaps are tissue and skin taken from the buttock area, and TUG (Transverse Upper Gracilis) acquires tissue and muscle from the inner thigh, near the groin.

The DIEP flap has many advantages for women who are good candidates for the procedure, but can only be performed by highly trained surgeons skilled in microsurgery. Virginia Mason plastic surgeons have specialized fellowship training in microvascular surgical procedures.

What to Expect After Autologous Breast Reconstruction Surgery

Tissue flap surgery is complex and takes many hours to complete. You may spend about four days in the hospital where special attention will be given to the blood supply and health of the transplanted breast tissue. Typically, women have soreness and swelling in the breast and in the area where tissue was removed, and you may need pain medication for one to two weeks. Women should plan on avoiding strenuous activity for several weeks, though many find they can return to light activity and work in three to six weeks.

Risks of Autologous Breast Reconstruction Surgery

In addition to the same risks as other surgery, including bleeding, poor healing or infection, other risks with tissue flap surgery include:

  • Complicated healing — Blood or fluid can collect near the wounds.
  • Pain — Longer term pain or discomfort may result.
  • Muscle weakness — If muscle is taken in the tissue removal, weakness at the site could result.
  • Flap or tissue loss — Tissue can deteriorate if the blood supply is compromised. In this event more surgery may be needed.

For more information about autologous tissue breast reconstruction, call (206) 341-0564.