Reconstruction using your own tissue

This method uses skin, fat and in some instances, muscle from another part of your body to fill the empty skin envelope of the skin-sparing mastectomy. These tissues can be moved either as a pedicled flap to the breast or, as a free flap. (Further explanations of these flaps follow below).

What's the advantage of this technique?

Using your own tissue (autologus) avoids any foreign-body reaction like capsular contracture, which can happen with an implant-based reconstruction. It usually results in a more natural appearence, especially when matching a single breast to the unaffected side. Free Tissue Transplant follows the normal evolution of ageing, in comparision to an implant-based reconstruction, which does not. Additionally, radiation therapy doesn't have any major adverse effect on the outcome of the reconstruction when using autologous tissue flaps.

What are the disadvantages?

Using tissue from another body part creates additional scars, which are not necessary in an implant-only reconstruction. The actual operation is more complex and lengthy, therefore there's a higher risk of additional post-operative complications and, a longer hospital stay.

Which areas of the body can be used?

There are now a number of options available with regard to the donor area for an autologous breast reconstruction. These range from the lower abdomen (tummy), buttocks (along the crease) and inner thigh. Depending on your body habitus, the volume required to reconstruct your new breast and, your own personal preference, the donor site will specifically be selected. 

What's the difference between a pedicled and a free flap?

Pedicled flaps - skin, muscle and fat - are moved from the back or abdomen to the chest area by tunnelling it under the skin, thereby meaning that the blood supply to the muscle doesn't need to be cut.

In a free flap - skin, fat and sometimes muscle from the donor region is transferred to the chest by completely cutting the blood supply and reconnecting to a new blood supply on the chest using microsurgical techniques.