Jefferson University Hospitals

Types of Breast Reconstruction

Breast Implants

Saline and silicone-gel implants are both commonly used for breast reconstruction. When inserting an implant, the plastic surgeon usually first places a tissue expander (temporary device to create a soft pocket) in the breast cavity. This is often done at the same time as the mastectomy but can be done later in women who decide to postpone their reconstruction.

The tissue expander is then gradually inflated over the following weeks and later exchanged for the final saline or silicone implant in a second procedure.

Tissue Flaps

  • DIEP Flap: A newer type of tissue flap surgery, the DIEP flap (deep inferior epigastric perforator) uses skin and fat taken from your lower abdomen to create a new breast. The results are similar to a "tummy tuck." This method requires use of a microscope and no abdominal muscle is removed during the surgery. With a DIEP, patients often experience less pain and recover faster than with a traditional TRAM flap.
  • PAP Flap: The profunda artery perforator, or PAP flap, is also a newer type of microsurgical breast reconstruction  being offered at Jefferson. The PAP flap makes use of the excess tissue of the posterior upper thigh to re-create the breast.
  • Latissimus Dorsi Flap: The latissimus dorsi flap involves taking muscle and skin from your back to re-create a new breast. Often times, this technique is used in combination with an implant to provide additional breast volume.
  • TRAM Flap: The TRAM flap (transverse rectus abdominus myocutaneous) uses muscle, fat and skin from your lower abdomen to reconstruct the breast. This technique may be done either as a rotated or pedicled flap, or as a free (microsurgical) flap.
  • SGAP Flap and IGAP Flap: These flap procedures use skin and fat removed from your upper or lower buttock. Similar to the DIEP, a microscope is used to supply bloodflow to the tissue.
  • SIEA Flap: The SIEA flap (superficial inferior epigastric artery) also uses tissue from your lower abdomen to re-create a new breast. Like a DIEP flap, no abdominal muscle is moved.

Other Elements of Breast Reconstruction

  • Nipple Areola Reconstruction: Creating the nipple areola is the final surgical component to breast reconstruction, involving the formation of a nipple mound. Tissue for the new nipple and areola is taken from another part of your own body.
  • Nipple Areola Tattooing: The finishing touch to breast reconstruction is having your nipple areola tattooed, which is a simple fast procedure that can take as little as 15 minutes and is normally done in your plastic surgeon's office.
  • Surgery on the Opposite Breast: Achieving symmetry with the newly reconstructed breast may be done through a breast reduction, breast lift, or breast enlargement with an implant.