Tissue flap surgery is a way to rebuild the
shape of a breast using skin, fat, and muscle from another part of the body. It
is usually done after part or all of the breast is removed (mastectomy) because of cancer. It may also be done for
women who have problems with breast development.
reconstruction usually takes more than one surgery. The first surgery may be
done during the same surgery as mastectomy, or it may be done later as a
separate procedure. The nipple and the brown area around it (areola) are
created at a later time.
Tissue flap surgery is done by a
plastic surgeon. The breast surgeon who does your
mastectomy can refer you to a plastic surgeon with special training in breast
You will meet with the plastic surgeon before your
mastectomy to discuss the best procedure for you. The surgeon can show you
pictures of other women who had the surgery you are considering. You can ask to talk to women who have had the surgery.
If you are not comfortable with the surgeon or the recommended treatment,
you can see another surgeon to get a
Tissue flap surgery
may be done in two ways:
There are different types of tissue flap surgery, named
for the area of the body where the tissue is taken.
Tissue flap surgery is done using
general anesthesia, so you sleep during the procedure.
Depending on the procedure, the surgery may take several hours to complete, and
you may need a
When you wake up from
surgery, you will have bandages over the surgery sites, and you may wear a
special bra that holds your bandages in place. You will also have drainage
tubes to collect fluid and keep it from building up around the surgery
You will stay in the hospital about 5 days so your doctor
can be sure there is good blood supply to the skin over the reconstruction. A
physical therapist may show you exercises while you
are still in the hospital. These can help keep your shoulder from getting
Most woman have soreness, redness, and swelling in the
breast and the area where the tissue was taken. The swelling may last for
several weeks. You may need pain medicine for a week or two. Your doctor may
antibiotics to help prevent infection.
You may be able to go back to work or your normal routine in 3 to 6
weeks. Most women need to avoid strenuous activity for several weeks.
Tissue flap surgery is usually done to
restore the appearance of a breast after mastectomy. It may also be done for
women who have problems with breast development.
reconstruction may help a woman feel better about her appearance. Some women
say it helps them feel better about their bodies, more alive,
feminine, and sexual—and happier about life.
Most women who have tissue flap
surgery are happy with the results. Compared to breast reconstruction with
implants, tissue flap procedures require a longer surgery and recovery time but
result in a more natural-looking breast.
cannot restore normal feeling to your breast, but with time, some feeling may
Many of the risks associated with breast
reconstruction are the same as those with any surgery: infection, poor wound
healing, bleeding, or a reaction to the anesthesia used in surgery.
Other risks associated with tissue flap surgery include:
Some women are at higher risk for problems, so tissue flap
surgery may not be a good choice for them. This includes women who:
If you will need to have
radiation therapy after mastectomy for breast cancer,
your surgeon may want you to wait and have reconstruction after your treatment.
Radiation can affect the success of tissue flap surgery.
can choose when to have surgery, be sure to discuss the pros and cons of having
it at the same time as mastectomy and the pros and cons of waiting until later.
Some women want to get started with reconstruction right away. Others may feel
overwhelmed by a cancer diagnosis, so they put off the decision to have
reconstruction until they feel ready to deal with it. Be sure you understand
It is important to know that your breasts will look
different after surgery. Your new breast may feel firmer and look rounder or
flatter than your other breast. Some women have surgery on the other breast to
make them look as much alike as possible.
can be a long process. It may take several months for your breast to heal. And
it may be a year before you can see the final result.
incisions will leave scars on your breasts and wherever the tissue was taken.
These will fade with time. The surgeon will try to make incisions that leave as
few scars as possible.
Federal law requires insurance companies
that cover mastectomy for breast cancer to also cover breast reconstruction.
Check with your insurance company to find out what your costs will be.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
June 28, 2013
Sarah Marshall, MD - Family Medicine
& Douglas A. Stewart, MD - Medical Oncology
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