Breast reconstruction can also be done by shifting body mass from other areas of the body. A common approach is to use fat and skin from the abdomen. This is called the "TRAM flap", or "tummy tuck reconstruction."

This is a more significt procedure than implant reconstruction. This surgery takes about three hours, and requires about three nights in the hospital. However, in the right patient, this procedure is an excellent choice, as it does not use implants, will not suffer harness from capsule contracture, tolerates radiation fairly well, and is cosmetically superior.

Essentially, what is done is an abdominoplasty, or "tummy tuck." But instead of discarding the excess skin and fat, it is kept alive by leaving it attached to blood vessels. The fat, skin, and blood vessels are moved onto the chest and tailored into the breast.

The blood vessels from the abdomen are removed from within one of the two rectus muscles (the "six pack" muscles), requiring the muscle to be sacrificed. This may result in some weakness of the abdominal wall, causing a bulge. In rare occasions, a hernia results, which requires repair. Because of this, the best candidates for the TRAM flap procedure are not obese, are in reasonably good physical condition, and are non-smokers. Smoking causes spasming of the blood vessels, and may result in the death of the tummy tuck tissue after surgery.

I like TRAM flaps, and have done a large number; more than 500 over the last fifteen years. But keep in mind, although it has great benefits, it also has a higher chance of complications and a longer recovery time (about six weeks).

Free TRAM flaps and the DIEP flaps are variations on this procedure involving microsurgery. There are advantages and disadvantages to these, and I would be happy to discuss these with you at the time of consultation.

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Breast Reconstruction Links:
National Cancer Institute - Understanding Breast Cancer Treatment
American Cancer Society - Breast Reconstruction After Mastectomy
CancerBACUP - Understanding Reconstruction of the Breast
American Society of Plastic Surgeons - Breast Reconstruction
INAMED Corporation
Mentor Corporation

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Breast Surgery Procedures:
   Breast Augmentation / Enlargement
   Mastopexy / Breast lift
   Breast Reduction
   Breast Reconstruction
       Implant Reconstruction
       Flap Reconstruction
       Combination Reconstruction