What are the some breast reconstruction options?

Implants v. "Flaps": Following a mastectomy, there are two types of reconstruction: "flaps", where skin, fat, +/- muscle are transferred from one part of the body to the chest wall, or; "implants" where a tissue expander is placed under the chest wall muscle and slowly expanded to effectively grow new skin, after which the expander is replaced with a permanent implant. Each have their pro's&con's.

Implant or Tissue: The simplest method is to expand/ stretch the skin over a few weeks and then trade the expander for a permanent implant. Other options involve moving skin and/or muscle from one part of the body up to the breast to reconstruct it. There are several options for this.

Main decision: The main decision here is implant-based reconstruction versus tissue based reconstruction. Implant based is easier on you but has associated implant/scar problems over the life of the patient in the average case. Tissue-based involves larger scale surgery and multiple site scars.

Breast cancer: I just have a brief discussion about options this past week. The options include fat grafting into the pec major muscle with follow up fat grafting after using the brava. Sons method involves implants in a single stage or using tissue expanders in two stages. The third is flap surgery such as the diep flap. Of course any if these methods can also be used in combination for the needs of my patients.

Several options: Breast reconstruction uses the patient's own tissue (from another part of the body) or a breast implant. There are multiple tissue options. More than 1 surgery is usually needed. The degree of scarring, recovery and risks vary depending on the technique used. The nipple and areola can also be reconstructed. Some patients also have surgery on the other breast for best symmetry.

Implants vs. Tissue: Options for breast reconstruction following mastectomy are: 1) Tissue expanders followed by implants, 2) Tissue flap reconstruction, including TRAM, DIEP flap, and other flaps, 3) Combination of flap and implant (latissimus + implant), and 4) Prosthesis -- meaning no reconstruction and wearing a prosthesis. There are advantages and disadvantages to each type. Have a discussion with your surgeon.