For women with Breast Cancer, reconstruction is an extremely important part of the process. It is an exceedingly personal decision, though most women do in fact decide to undergo reconstruction. They want to look and feel like a whole and complete woman again; one who is still feminine and sexy. Although reconstruction through implants is the choice for many women, a large number of women prefer to undergo reconstruction using muscle and soft tissue flaps. They are seeking breasts that feel more natural and are created through their own living tissue.

There are several ways in which this type of reconstruction can be performed. One is known as the TRAM Flap method, and is done in two ways. The Free Flap method involves an area of skin, fat and muscle being removed from the abdomen; freed from the rest of the blood supply and tissue. It is then placed in the chest area and reconnected to the blood supply using microsurgical techniques. The other possibility with this method is using a Pedicle Flap. The Pedicle Flap method does not require that the flap of muscle and soft tissue be removed completely; rather, it is tunneled up through the chest wall while remaining attached to the blood supply. The breasts often feel much more natural and the process includes a tummy tuck, resulting in a flatter, more streamlined abdominal area.

Several other methods of reconstruction using soft tissue flaps are available, although they are not used as frequently. DIEP and SGAP flaps are two other methods that do not use muscle; only skin and fat, and the tissue is removed from either the abdomen or the buttock. A Latissimus Dorsi Flap uses muscle, skin and fat from the back. The muscle and tissue is left connected to the blood supply and tunneled from the back to the mastectomy site, creating the new breast. Often times with this method, an implant is also required to achieve a fuller breast, as there is not enough of the donor tissue to reach the desired size.

Breast reconstruction using muscle and soft tissue flaps unfortunately does not leave the patients with much sensation in the new breasts, although they look and feel very natural. The surgical process is also longer and much more involved. In turn, the recovery process can be much more arduous.

Breast cancer patients have many options when considering their reconstruction. Dr. Savalia helps guide his patients through the decision making process by making a recommendation on the method that he feels is best suited to that individual. However, the decision is ultimately the patient’s. It is important that the breast cancer patient knows that there are many options available to her, each one with the possibility of a beautiful result.

Elaina Hollis

Patient Coordinator