A new breast, constructed with the body’s own tissue
After a mastectomy, breast reconstruction can help restore balance to the body — both physically and mentally. Using the body’s own tissue, a breast can be constructed that feels natural and is durable. With the DIEP flap as the gold standard and alternative techniques when abdominal tissue is not an option.
What is total breast reconstruction with autologous tissue?
In total breast reconstruction with autologous tissue, an entirely new breast is constructed using skin and fat from the patient’s own body.
No implant is used. The goal is a breast that feels soft, warm, and natural, and that evolves naturally with the body.
For many patients, this is the most natural and durable form of breast reconstruction after a mastectomy.
The most commonly used technique is the DIEP flap, which utilizes skin and fatty tissue from the lower abdomen. When the abdomen is not suitable as a donor site, alternatives such as the SGAP flap, lumbar flap, or PAP flap may be considered.
Flap surgery
What is flap surgery?
Breast reconstruction with autologous tissue is performed via flap surgery.
A flap is a piece of skin and fatty tissue with its own blood vessels that is moved from another location on the body to the chest.
Using microsurgery, these blood vessels are reconnected to blood vessels in the chest region. This ensures the tissue remains viable and can form a new breast.
This makes flap surgery technically more complex than reconstruction with implants, but the result often feels more natural and is not dependent on a prosthesis.
The choice of donor site and technique is always customized, depending on the patient’s physique, medical history, and expectations.
INDICATIONS
When to choose total breast reconstruction with autologous tissue?
procedure
What is the procedure for total breast reconstruction with autologous tissue?
A flap reconstruction is a microsurgical procedure performed under general anesthesia. The technique depends on the donor site, but the basic principle remains the same: skin and fat are moved and reconnected to blood vessels in the chest region. A flap reconstruction is a microsurgical procedure under general anesthesia and is among the most specialized techniques within reconstructive breast surgery.
Safety
Total breast reconstruction with autologous tissue is a specialized microsurgical procedure.
During the operation, the tissue is carefully harvested with its blood vessels. These blood vessels are then reconnected under a microscope in the chest region.
Following the procedure, the blood flow to the flap is closely monitored.
Results
The goal is to create a breast that looks and feels as natural as possible.
Many patients experience a natural feel, a stable long-term result, and less dependence on subsequent procedures.
The DIEP flap is usually the first choice and is internationally considered the gold standard.
When abdominal tissue is not possible, other donor sites such as the gluteal region, flank, lower back, or upper leg can be used.
Aftercare
After the operation, the patient usually remains in the hospital for 5 to 7 days.
During the first few weeks, the focus is on wound healing, monitoring the flap, and gradual mobilization.
Strenuous exertion and intensive sports are discouraged for approximately 6 weeks.
Recovery
Recovery after total breast reconstruction with autologous tissue
After the operation, the patient usually remains in the hospital for 5 to 7 days. During this period, the blood flow to the flap is closely monitored.
Lifting heavy loads or intensive sports is discouraged for approximately 6 weeks. Most patients wear a supportive bra during this period.
The final result develops gradually in the months following the surgery. Fatigue and swelling are normal in the first few weeks and will gradually subside.
TECHNIQUES
DIEP flap and alternative flap techniques
The DIEP flap is usually the first choice for total breast reconstruction with autologous tissue. When the abdomen is not suitable as a donor site, other techniques may be considered.
DIEP flap — lower abdomen
The DIEP flap uses skin and fatty tissue from the lower abdomen. The abdominal muscles are preserved. This technique is considered the gold standard for breast reconstruction with autologous tissue and allows for the simultaneous improvement of the abdominal contour.
SGAP flap — gluteal region
The SGAP flap uses skin and fatty tissue from the upper gluteal region. This technique can be a good alternative when there is insufficient abdominal tissue or when the abdomen is not suitable.
Lumbar flap — flank or lower back
The lumbar flap uses tissue from the flank or lower back. This technique is used less frequently but can be valuable with a suitable physique or when other donor sites are less appropriate.
PAP flap — upper leg
The PAP flap uses skin and fatty tissue from the back of the upper leg. This technique may be considered for slimmer patients or when abdominal and gluteal tissue are not ideal.
Frequently asked questions
Your questions about total breast reconstruction answered
What is the best technique for breast reconstruction with autologous tissue?
In most cases, it is first determined whether a DIEP flap is possible. This technique uses skin and fatty tissue from the lower abdomen and is internationally considered the gold standard. When the abdomen is not suitable, alternatives such as SGAP, lumbar, or PAP flaps can be discussed.
Is muscle removed during a DIEP flap?
In a DIEP flap, the abdominal muscle is generally not removed. Only the small blood vessels running through the muscle are carefully dissected. This ensures that the function of the abdominal wall is preserved as much as possible.
Can reconstruction with autologous tissue be performed after radiotherapy?
Yes. Reconstruction with autologous tissue can be particularly beneficial after radiotherapy, as healthy, well-vascularized tissue is brought to the irradiated area.
Is breast reconstruction with autologous tissue better than implants?
For many patients, autologous tissue provides a more natural and durable result. However, the choice depends on the individual situation.
How long does recovery take?
Most patients resume their normal activities gradually after 4 to 6 weeks. The final result continues to develop in the months following the surgery.
Are corrections needed later?
Sometimes small corrections are performed after a few months to further refine the result. This may involve lipofilling, scar revision, adjustment of the breast fold, or symmetry correction of the other breast.
When is nipple reconstruction performed?
Nipple reconstruction is usually performed only once the breast has fully healed. This is often several months after the reconstruction and can usually be done under local anesthesia.
Related procedures
More information on related reconstructive treatments:
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