Breast reconstruction is performed after mastectomy in women of all ages. There are two primary means of breast reconstruction - autologous reconstruction, which uses only the patient's own tissue, or implant reconstruction. Each of these covers a wide range of techniques.
Autologous reconstruction is usually done with flaps, which may be moved from the back or abdomen while maintaining the blood supply to the tissue, or which may be performed with microvascular surgery, reattaching small blood vessels with an operating microscope to re-establish blood supply. Examples of the former are the TRAM flap from the abdomen (using the rectus abdominus muscle) and the latissimus dorsi flap from the back. Microvascular flaps include TRAM flaps (with a modified technique) and the newer perforator flaps, which include the DIEP flap (taken from the abdomen but without muscle) as well as TUG (using tissue from the inner thigh) and GAP (gluteus) flaps. These flaps give very nice results but are larger operations and leave additional scars.
Implant reconstruction can sometimes be done at the time of mastectomy; more commonly a temporary inflatable implant called a tissue expander is placed, gradually inflated with saline in the office, and then replaced at a later operation with a permanent implant.
The choice of reconstruction is complex and depends to some extent on the type of treatment used for the breast cancer, particularly radiation treatment. Our plastic surgeons work closely with the breast cancer team and with you to determine the best choice for each individual case. Additional surgery on the opposite breast may be required.
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MESSAGE FROM THE CHIEF
William Y. Hoffman, M.D.
Professor & Chief,
Division of Plastic and Reconstructive Surgery
Stephen J. Mathes, MD
Former Chief, Division of Plastic & Reconstructive Surgery at UCSF
Read about his life »