Breast Reconstruction - before and afterWomen who have breast cancer have many difficult decisions to make along the way. If one of those is decide if breast reconstruction is right for you, and it is, you’ll need to evaluate which technique you prefer.

There are three main ways to reconstruct the shape of your breast or breasts:

  • Use breast implants.
  • Use your own tissue, known as a flap procedure.
  • Combine a flap with implants.

Let’s look at the various options available to patients wanting breast reconstruction.

Breast Reconstruction Using Implants

Most women who choose reconstruction with implants do well. There are several advantages of reconstruction done using implants.

  • We can do it at the same time as your Mastectomy, or start when you have your surgery and then complete later.
  • There is only one surgical site.
  • You can choose for your reconstruction the size and shape.

For women who choose to delay reconstruction, I often put in a short-term tissue expanders during the mastectomy to help prepare for reconstructive surgery later.

Flap Procedures

Flap procedures use tissue from other parts of your body, such as your tummy, back, thighs, or buttocks to rebuild the breast shape. Tissue flaps usually look more natural and behave more like natural breast tissue than implants.

  • When doing a TRAM (transverse rectus abdominis muscle) flap, I use tummy tissue. In this case, there are two types: Pedicle flap, where the flap remains attached to the original blood supply; and Free TRAM flap, where I completely remove and move the tissue up to the chest.
  • For the DIEP (deep inferior epigastric perforator) flap, I take the fat and skin from the same area as the TRAM flap but not the muscle to form the breast.
  • For the gluteal free flap or GAP flap, I use tissue from the buttocks to create the breast.
  • Another option is the transverse upper gracilis flap or TUG flap. In this case, I use muscle and fatty tissue from along the bottom fold of the buttock extending to the inner thigh.

Advantage of Flaps

In addition to flaps feeling more like natural breast tissue, flaps will enlarge or shrink if you gain or lose weight. And, while breast implants sometimes need to be replaced, this is not a concern with flaps.

Disadvantage of Flaps

Keep in mind that flaps require more surgery and a longer recovery than implants. After all, there are two surgical site and two scars.

Breast Reconstruction Options

“Hybrid” Approach

With the Hybrid Reconstruction approach, I rebuild the breasts with live fat combined in a single stage with breast implants. This technique gives added size and projection to the new breasts when a single donor site tissue transplant is not enough. Effectively, patients have breast augmentation and reconstruction all in one surgical procedure.

Fat grafting

Have you already had reconstruction, but aren’t happy with the shape of your breasts? Using liposuction, I harvest fat from another part of the body (e.g., buttocks, thighs, or tummy) and transfer it to the reconstructed breast to help fix your breast shape. Fat is really useful for fine-tuning the reconstruction for getting the breast as smooth as possible.

3D Nipple Tattooing

I am pleased to work with a very talented tattoo artist who uses 3D tattooing to create an image of a nipple on the skin. Although actually flat, it is amazingly realistic looking.

Many Considerations

There is much to think about when approaching all the options for breast reconstruction. We are here to answer your questions and help you navigate the entire process. Please contact my patient coordinators to schedule an appointment. Call 312.757.4505 or send us an email at

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Located in Chicago’s Lincoln Park, our offices are a warm, friendly and comfortable place to share your wants, needs and concerns.