Types of Breast Reconstruction: Exploring Your Options


After breast cancer surgery, it is normal to feel a huge sense of relief– you’ve protected your life, and that’s what counts the most. However, it is normal to want your old figure back, and many women would like to know what options are available to reconstruct their breasts after surgery. Breast reconstruction surgery is a highly personal matter– some women see no need for any further surgery at all, and there is nothing wrong with that. For those who’d like to explore their options, here are a few of the most common plastic breast surgery techniques for women who have had cancer breast surgery:

Flap Procedures

Flap procedures are among the most complicated of breast reconstruction surgeries and are completed in several different ways. No matter the approach, all involve taking tissue from one body site, usually the back or abdomen and possibly the buttocks, and transferring it to the breast area. This skin transferal process can be complex, so Dr. Aya-ay reserves this method for specialized cases. Customized flap techniques include:

Pedicle TRAM

In this flap procedure, fat, muscle, and skin are cut from the abdominal area and then transferred to the breast area by pushing the tissue to its new location underneath the skin. Dr. Aya-ay then creates a new breast mound with the transferred tissue.

DIEP (deep inferior epigastric perforation)

This is similar to pedicle TRAM, but only the skin and fat are removed from the abdomen. By only removing minuscule amounts of muscle, you’ll retain more abdominal strength from DIEP when compared to pedicle TRAM.

Latissimus Dorsi Flap

This muscle is located in your back area– Dr. Aya-ay excises part of the muscle and then tunnels it underneath the skin to your breast area, again using it to create a new breast mound.

Goldilocks Surgery

This surgery’s fanciful name comes from its middle-of-the-road approach. After unhealthy breast tissue has been removed in a tissue-sparing mastectomy procedure, Dr. Aya-ay uses the remaining healthy fatty breast tissue to form a new breast mound that can be augmented later if desired. Goldilocks surgery is typically more suitable for larger, heavier breasts, but smaller breast sizes may also be candidates. Since it doesn’t involve any donor sites on your body, recovery is typically faster.

Tissue Expansion and Implant

With this approach, Dr. Aya-ay places a type of balloon underneath your skin either above or below your chest muscle. This balloon is then gradually filled with saline over some time– usually weeks to several months. After the chest tissue has expanded enough, the surgeon then inserts either saline or silicone-filled implants into the area to create a new breast.

Nipple Reconstruction

Nipples can also be reconstructed to resemble their original appearance. This may include special tattooing of the areola and the dark area surrounding the nipple. Keep in mind that breast reconstruction surgery does have limitations. A consultation is the best way to get an understanding of the options available to you.

Melanie L. Aya-ay, MD

If you’d like more information about breast reconstruction surgery, or to schedule a consultation with Dr. Aya-ay, you should visit Melanie Aya-ay, M.D. Plastic Surgery online. Dr. Aya-ay is board-certified by the American Board of Plastic Surgery and is dedicated to continually improving her skills and results. Dr. Aya-ay and her professional staff warmly welcome all new patients and invite you to call the office or fill out a contact form on the website. A staff member will promptly reply.

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