What are the Benefits of Autologous Tissue Reconstruction?

This surgical approach can be performed alone or simultaneously with implant reconstruction. It can also be done at different times, immediately after mastectomy or later.

Autologous breast reconstruction offers the following benefits compared to implant reconstruction:

  • It is generally a single procedure that lasts a lifetime because it uses the patient’s natural fat
  • There is less chance of rejection or infection since it uses donor tissue instead of a foreign body
  • This approach is more likely to look natural
  • You are more likely to regain minimal sensation in your breast with autologous reconstruction than with an implant

The tissue can be separated from its original blood vessels before being picked up and moved to its new place in your chest; this is frequently referred to as a “free flap.” Or, the tissue can remain attached to its original blood vessels and move under your skin to your chest, referred to as a “pedicled flap.” In both types, the tissue is formed into the shape of a breast and stitched into place. Because pedicled flaps have been around longer and are easier to do, they are generally more widely available.

What to Expect From Autologous Tissue Reconstruction

Autologous tissue reconstruction is more extensive than expander and implant reconstruction and involves specialized microsurgery techniques. Additionally, it may require a more extended hospital stay and recuperative period, primarily when the method uses fat removed from the belly. However, most patients are happy to avoid future implant replacements and are pleased with their naturally feeling new breasts.

Some women may require a sentinel node biopsy or axillary node dissection simultaneously, which means an additional incision. With all types of reconstruction (implant and flap), there is nearly always a later surgery to make adjustments, sometimes referred to as “finishing work.” 

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Some examples of finishing work include:

  • Nipple reconstruction
  • Reshaping a flap
  • Removing extra fat from a donor site
  • Repositioning an implant.

If you gain or lose weight, the size of a flap reconstruction can change along with the rest of your body. And once the tissue has been used to build a flap, Dr. Rancati cannot reuse tissue from that area later. The tradeoff is that flap reconstructions tolerate radiation therapy better than implants alone.

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Recovery & Results

While you’re healing from surgery, there will be two to four areas of the body that are recovering at the same time: your reconstructed breasts and the donor tissue sites. The physical effects of each type of autologous reconstruction are highly individual to your:

  • Body
  • Range of motion
  • Physical strength
  • Day-to-day activities

Breast reconstruction using a free flap is a longer and more involved surgery upfront, usually requiring a more extended hospital stay and recovery. Expect to be in the hospital for four days and have a six-week recovery time.

Results from autologous tissue reconstruction include:

  • Breasts that look and feel very much like natural breasts and progressively look better over time
  • Breasts that will not deflate or need to be replaced
  • The bottom half of your abdominal skin is removed for results similar to a tummy tuck
  • No risk of capsular contracture

Risks or Side Effects

Breast reconstruction using autologous tissue has few risks or side effects. However, some examples include the following:

  • Partial or total flap loss
  • Fat necrosis, which happens when the transferred fat cells die off
  • Thrombosis
  • Incision site infection
  • Delayed wound healing
  • Flap fibrosis/contracture
  • Additional scarring on your abdomen or where the tissue is taken from
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