Autologous (Flap) Reconstruction

The term autologous breast reconstruction refers to a family of related procedures, all of which utilize the patient’s own body tissue to reconstruct breasts after a mastectomy. Depending on the patient’s body type, reconstructive tissue may be taken from the abdomen, back, or other areas of the body. The main advantage of autologous reconstructions is their long-lasting, maintenance-free results. Patients are invariably delighted with the outcomes of autologous procedures, which create symmetrical breasts with a natural look and feel. Generally, if a patient gains weight after an autologous reconstruction, some of the weight gain will go into her new breast tissue, mirroring any weight gain in the opposite breast.
Plastic surgery New York Doctors Keegan  and Vickery were pioneers of the team approach to autologous reconstruction, and they remain the longest-standing team of breast microsurgeons in the New York City area. Their team approach maximizes safety, while ensuring that operative time is kept to a minimum.
Autologous procedures can refer to any of the following:
  • DIEP Flap reconstruction is the autologous breast reconstruction technique that has the highest success rate and most predictable results. In this procedure, the microsurgeon harvests lax skin and fat from the abdominal area, and uses that tissue to reconstruct the breast area. The abdomen is then closed in a manner similar to a tummy tuck. Unlike the TRAM Flap, which directly harvests the abdominal muscle, the microvascular DIEP Flap leaves abdominal architecture fully intact.
  • SIEA Flap reconstruction is similar to the DIEP Flap reconstruction procedure, except that the reconstructive tissue is harvested from just underneath the abdominal skin. While the DIEP Flap does cause a minor disturbance of the abdominal muscles, the SIEA Flap procedure is limited to the fat immediately underneath the skin, and does not involve the abdominal muscles at all.
  • LD Flap reconstruction utilizes all or part of the patient’s latissimus dorsi, which is a long, flat muscle of the back. Though it is possible in some cases to perform purely autologous LD Flap reconstructions, this technique is usually combined with implants in a hybrid reconstruction.
  • GAP, I-GAP, TUG, TRAM, and other flap reconstruction procedures harvest tissue from other areas, such as the abdominal muscles, buttocks, and thighs. Though certain patients may benefit from these lesser-used procedures, most mastectomy patients can expect better results with the DIEP Flap, SIEA Flap, or LD Flap procedures.
Top plastic surgeons in NYC Doctors Keegan and Vickery perform all autologous reconstructions at Mount Sinai Hospital, where patients may elect to stay in a private room on a luxurious floor designed specifically for patients recovering from breast surgery. Autologous procedures are often completed at the time of the mastectomy, eliminating the expense and discomfort of an additional major surgery. Depending on the exact procedure chosen, most patients are able to move comfortably within a few days after the surgery, and most patients return to their normal lives within three to four weeks. We are committed to making the entire surgical process as convenient and stress-free as possible. For patients and families who may be visiting from outside of Manhattan, we are always happy to assist with hotel accommodations, as well as transportation and other logistics.

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Immediate Post-Mastectomy Hybrid Reconstruction: DIEP Flap Plus Implant