The surgeon may take the tissue for reconstructing your breast from your abdomen, back or – less commonly – your buttocks. Your doctor decides which method is best for you grounded on your body type and your medical and surgical history.
- Abdomen (TRAM flap)
Your surgeon takes away tissue – including muscle – from your abdomen in a procedure called as a transverse rectus abdominal muscle (TRAM) flap. The abdominal part of this procedure is alike to a tummy tuck (cosmetic abdominoplasty); nevertheless, the muscle is placed instead of tightened. The TRAM flap can be transferred as a free flap or a pedicle flap.
A pedicle TRAM flap is the only procedure that involves your whole rectus muscle – it is one of the four chief muscles in your abdomen. If your surgeon does a free TRAM flap, only a part of your rectus abdominal muscle is taken. In some exceptions, that part of taken muscle may be very small. Using less of your muscle for reconstruction may assist you keep hold of abdominal strength after surgery.
- Abdomen (DIEP flap)
One more type of abdominal procedure is the deep inferior epigastric perforator (DIEP) flap. This modern procedure is very similar to muscle-sparing free TRAM flap, but in this procedure skin and fat are the only tissues removed. Smallest abdominal muscle tissue is taken to create the new breast mound. A DIEP flap uses a free flap approach. An advantage to this type of breast reconstruction is that you'll preserve more strength in your abdomen. If your surgeon can't do a DIEP flap procedure for anatomical causes, he or she might decide on the muscle-sparing free TRAM flap instead.
- Back (latissimus dorsi flap)
One more surgical technique uses tissue – involving skin, fat and muscle – from your upper back. This procedure is called a latissimus dorsi flap. The tissue is tunneled beneath your skin to your chest. For the reason that the amount of skin and other tissue is usually smaller than in a TRAM flap surgery, this method may be used for reconstructing small and medium-sized breasts or for forming a pocket for a breast implant. Even though it's not very common, some women feel muscle weakness in the back, shoulder or arm following this surgery.
- Buttocks (gluteal flap)
A gluteal flap is a free flap procedure that takes tissue – possibly involving muscle – from your buttocks and replaced it to your chest area.
For the reason that sufficient blood supply is dangerous to the survival of transplanted tissue in flap surgery, your surgeon may favor not to perform a pedicled flap procedure if you're a smoker or you have diabetes, vascular disease or a connective tissue disorder. Besides, obesity may prevent you from having a pedicled TRAM flap.
Generally autologous breast reconstruction is more extensive than is a mastectomy or implant reconstruction. Flap procedures cause larger incisions that take more time to heal, but the general time to finish the breast reconstruction process may be shorter.
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