Various types of rotational flaps can be utilized to create neo-breasts. Two of the most common and popular options include TRAM flaps and Latisimus Dorsi flaps. Post-reconstruction, patients usually have to stay in the hospital several days to recover.
TRAM flaps are Transverse Rectus Abdominus Myocutaneous flaps and takes the fatty tissue from your abdomen to create a new breast. This is a popular option because patients get a tummy tuck in addition to a new breast. In most people, there is sufficient tissue to create a nice sized breast. The drawback to this procedure is that patients often have a weak abdominal wall.
Latisimus Dorsi flaps are muscle-skin flaps taken from your back to reconstruct your breast. These flaps often lack the volume to create a full-sized breast and are used in conjunction with breast implants. These types of reconstruction often look and feel more natural than implant-alloderm reconstructions because you have both muscle and fat camouflaging the implant.
These are the most advanced and technically demanding breast reconstruction techniques available today. We are able to take spare tissue from different parts of your body, from areas where it won’t be missed, and utilize it to make a new breast. Using perforator flaps, only skin and fat will be removed, leaving your muscles intact. These are the best reconstructive options in terms of donor site morbidity and aesthetic appearance of the reconstructed breast.
The most common area to take tissue from is the abdomen. Like the TRAM flap, patients get a tummy tuck along with the reconstruction. However, unlike the TRAM, there will be no abdominal weakness following this procedure.
Other areas we can take tissue from include the buttocks (IGAP, SGAP), the inner thigh (Gracilis, TUG), and outer thigh (ALT). These can all create very nice breasts with relatively minor donor site morbidity.
Despite the superior aesthetic results of autologous free tissue transfers, the drawbacks to these procedures is the need to be hospitalized for several days. The flap needs to be monitored carefully during the post-operative period and there is always a risk of flap failure and the need to surgically re-explore the flap. Overall, free tissue transfers have a success rate of 95-98%.
Autologous Fat Grafting
Autologous Fat Grafting is a safe and effective procedure for secondary breast reconstruction. This procedure can help to improve contour, volume, and over breast symmetry. Autologous breast reconstruction involves taking skin and fatty tissue from another part of your body and moving it to the chest area to give the reconstructed breast natural feeling volume. The donor tissue can be grafted on from your stomach or back (e.g. TRAM flap reconstruction, Latissimus Dorsi reconstruction) or from other parts of your body where the vessels are divided and reconnected to your chest blood vessels. This later type of breast reconstruction is a free flap micro-surgical reconstruction (e.g. DIEP reconstruction, ALT reconstruction, SGAP reconstruction, or IGAP reconstruction).This procedure is continuing to grow in popularity because of the resulting appearance of the breast and the near-normal sensation.
Revisional Breast Reconstruction
Revisional Breast Reconstruction can be performed as maintenance or corrective procedure. Dr. Liu and Dr. Kwon perform revisions and enhancements on previous reconstructions and augmentations to shape, contour and redefine breast symmetry. As the field continues to improve and evolve, advances are being made in surgical techniques to help enhance any previous procedures.