Choosing the Right Reconstruction For You

One of the most challenging aspects of the breast reconstruction process is figuring out which type of breast reconstruction is the best fit for each patient. Unfortunately, there is no simple algorithm that can do this. With several options now available for reconstruction and so many resources to obtain information on the topic, it can be challenging to arrive at a final decision.

As described throughout our website, there are many reconstructive options available to women these days. Simply put, they can be summarized like this:

• No reconstruction at all
• Reconstruction with the use of implanted materials
  • Two stages with tissue expanders followed by breast implants
  • Single-stage or straight-to-implant
• Reconstruction using only natural tissues
  • Pedicled flaps (generally require muscle)
    • Latissimus dorsi flap
    • Pedicled-TRAM flap
  • Free Flaps
    • Require muscle
      • Full-muscle free TRAM flap
      • Muscle-sparing free TRAM flap
    • Muscle-sparing (perforator flaps)
      • From the abdomen
        • Free DIEP flap
        • Free SIEA Flap
      • From other locations
        • Free GAP flap (buttock)
        • Free TUG or PAP flaps (thigh)
• Reconstruction using natural tissue and implants
  • Can be done by adding implants under almost any of the natural tissue reconstruction listed above

While additional options may exist, this roughly summarizes the significant types of breast reconstruction currently available.

When comparing these options, the main point to understand is that every one of them has potential advantages and disadvantages. When I discuss these options with my patients, I encourage them to list the “pros” and “cons” for each type of reconstruction. But I don’t think my opinion should be their only source. I encourage them to further refine this list by tapping into other resources, such as online communities and websites dedicated to educating patients about their breast reconstruction rights and options.

Another crucial point to understand is that not all of these reconstructive techniques may be an option for every patient. One’s past medical history, past surgical history, current medical issues, and anticipated treatments for breast cancer may significantly impact the outcomes of specific reconstructions, making other options more likely to succeed.

Since each patient presents a unique set of variables and desires, they must spend time with their Reconstructive Plastic Surgeon to go through their options one-by-one. Discussing each option’s risks and benefits will help you eventually arrive at the reconstruction that is the best fit for you.