Autologous-tissue breast reconstruction is used if there is not enough tissue left post-mastectomy to create a new breast using tissue expansion, or a woman does not want implants. During autologous-tissue breast reconstruction, a breast is created using skin, fat, and sometimes muscle from other parts of the body. The abdomen, back, buttocks, or thighs are all donor sites.
The donor tissue, which is called a “flap,” is either surgically removed and reattached (free flap) to the chest, or left connected to its original blood supply and “tunneled” through the body to the chest (pedicle flap). There are a number of different flap techniques; which one is used depends on the individual patient.
Factors taken into consideration include how much extra tissue is available for transfer; the width and flexibility of blood vessels; and how large the breast(s) needs to be. Implants may or may not be used with autologous-tissue breast reconstruction. Constructing a nipple and areola is performed in a separate surgery. It is essential that a patient has reasonable expectations about the results reconstruction provides.