Partial breast reconstruction with autologous tissue
Restoration of breast shape after breast-conserving surgery, when a visible volume deficit or change in shape occurs following the removal of a tumor.
What is a partial breast reconstruction?
In a partial breast reconstruction, the entire breast is not rebuilt; instead, a local volume deficit or deformity is corrected following a breast-conserving operation.
During a lumpectomy, the tumor is removed along with a portion of the surrounding breast tissue. Sometimes the breast shape is well-preserved, but with larger defects or difficultly located tumors, a visible difference in volume, shape, or symmetry can occur.
In those cases, a partial breast reconstruction can help restore the breast shape. Autologous tissue can be used for this, usually from the lateral back region.
One possible technique for this is the TDAP flap, where skin and fatty tissue from the lateral back are moved to the breast while the back muscle is preserved.
INDICATIONS
When is a partial breast reconstruction indicated?
procedure
How is a partial breast reconstruction performed?
The technique depends on the size, shape, and location of the breast defect. When extra volume is required, autologous tissue from the lateral back can be used via a TDAP flap.
Safety
With a TDAP flap, skin and fatty tissue from the lateral back are used. The latissimus dorsi back muscle remains completely intact.
This distinguishes the TDAP flap from older techniques where the back muscle was moved along with the tissue.
Results
The goal is to restore the breast shape after breast-conserving surgery.
A partial reconstruction can provide better symmetry, restoration of lost volume, and a more natural breast contour.
Aftercare
Most patients remain in the hospital for 1 to 3 days.
Strenuous activities are generally discouraged for 4 to 6 weeks. The final result develops gradually in the months following the surgery.
Recovery
Recovery after a partial breast reconstruction
Recovery after a partial breast reconstruction is usually shorter than with a total breast reconstruction using free flap surgery.
After a TDAP flap, patients usually stay in the hospital for 1 to 3 days. During the first few weeks, the focus is on wound healing, comfort, and gradual mobilization.
Strenuous activities and intensive sports are usually discouraged for 4 to 6 weeks.
The scar is typically located on the lateral back and can often be hidden under the bra strap or in a natural skin fold.
Technique
TDAP flap: reconstruction with tissue from the lateral back
The TDAP flap stands for Thoracodorsal Artery Perforator flap.
In this technique, skin and fatty tissue from the lateral back are moved to the breast to fill a local volume deficit. The tissue remains connected to its blood supply and is rotated toward the breast.
Because the tissue is moved locally, microvascular connection is usually not required.
The major advantage is that the back muscle is preserved. Only skin and fatty tissue are used.
FREQUENTLY ASKED QUESTIONS
Your questions about partial breast reconstruction answered
What is the difference between partial and total breast reconstruction?
In a partial breast reconstruction, a portion of the breast is restored after breast-conserving surgery. In a total breast reconstruction, an entirely new breast is built after a mastectomy.
When is a partial breast reconstruction necessary?
A partial reconstruction may be necessary when a visible volume deficit, asymmetry, or change in breast shape occurs after a lumpectomy.
What is a TDAP flap?
A TDAP flap is a technique where skin and fatty tissue from the lateral back are used to fill a breast defect. The back muscle is preserved during this process.
Is muscle removed during a TDAP flap?
No. In a TDAP flap, the latissimus dorsi back muscle remains intact. Only skin and fatty tissue are moved.
Can a partial reconstruction be performed immediately?
Yes. In many cases, the reconstruction can be performed during the same operation as the lumpectomy. Sometimes it is performed at a later time.
How long does recovery take?
Most patients recover gradually over several weeks. Strenuous activities are usually discouraged for 4 to 6 weeks.
Related procedures
More information on related reconstructive treatments:
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