Mastering reconstruction: A comprehensive guide to autologous tissue transfer in breast cancer recovery

Almost 300,000 American women are diagnosed with breast cancer every year. The statistics are staggering. Imagine, for a moment, standing in a room with eight women. Odds are at least one of them will face this health challenge during her lifetime, with the American Cancer Society noting that a significant 13 percent of women find themselves in this situation.

The path ahead after the diagnosis can be daunting. For many, the road to recovery might involve a mastectomy, a surgical procedure that removes one or both breasts. The thought alone can be emotionally overwhelming. Yet, amidst this challenging decision, there may be more options than you first realize.

Many facing a mastectomy will explore breast reconstruction. Implants are a popular option, but not the only one. Another option worth considering is autologous tissue transfer, a procedure in which a skilled plastic surgeon uses your own tissue to recreate the breasts.

Remaking a breast

"If you've had breast cancer, there are two ways to make a breast," said ASPS Member Surgeon Anureet Bajaj, MD.

Mastectomy patients could choose to rebuild the breast with an implant or to have autologous tissue transfer, depending on their preference and individual case. With the latter, autologous tissue – another way to say your own tissue – is taken from a donor site on your abdomen, back, buttocks or thighs to reconstruct your breast.

Advantages of autologous tissue transfer

Using your tissue instead of implants will give you more sensitivity in your breasts compared to getting implants.

"You would have sensation over the reconstructed breast because typically, after a mastectomy, you lose all sensation to that area," Bajaj said.

The procedure also has many additional advantages.

"It's more natural. It's going to look and feel natural. It will age with the patient. There's no risk of all the other associated risks that happen with implants," said Bajaj. "With implants, you may have rupture, you may develop capsular contracture. Implants may not necessarily last you an entire lifetime, whereas your own tissue should."

Disadvantages of autologous tissue transfer

There are also some drawbacks to consider. For starters, the surgical procedure can be lengthier. Additionally, there's the aesthetic concern of scars – not only will the breast area show surgical marks, but the tissue donor site will also have scars. Plus, the recovery phase can demand a bit more patience and endurance.

Given that both the donor and receiving areas need to heal, you might find the recovery longer and more taxing than with implants alone.

Types of tissue transfer

Depending on your unique needs and preferences, there are several varieties of autologous tissue transfer.

TRAM flap

A transverse rectus abdominis myocutaneous flap harvests tissue from your lower abdomen, incorporating skin, fat and sometimes part of your abdominal muscle.

DIEP flap

The deep inferior epigastric perforator flap is much like TRAM flap surgery. The main difference is that DIEP flap surgery draws from the lower abdominal tissue but leaves the muscle untouched, minimizing abdominal weakness afterward.

SIEA flap (also known as SIEP flap)

This method is similar to the DIEP flap but involves different blood vessels. It's less commonly used by practitioners since only a limited number of people have the required blood vessels for a successful operation.

SGAP/IGAP flap

This method uses tissue from the buttocks, which are transferred to your chest area to reconstruct the breast.

Latissimus dorsi flap

With this technique, the surgeon takes tissue from your back (under the shoulder blade area), including muscle, skin and fat segments.

TUG flap

The transverse upper gracilis flap method uses tissue from the inner thigh.

Choosing the right procedure

Each flap surgery has pros and cons, and the best choice depends on individual factors such as your body shape and personal preferences. It's essential to consult with a board-certified plastic surgeon who specializes in breast reconstruction. They can help you determine which technique best suits your unique circumstance and body.

Who's an ideal candidate for autologous tissue transfer?

If you're looking for an authentic look and feel plus want some level of sensation in the area, or you lack enough tissue for traditional implants, autologous tissue transfer might be your solution. It's a good option, especially if you've faced complications with implants before or are undergoing radiation treatments.

Postoperative healing

It's normal to feel sore in the areas where the surgery occurred. For the first few weeks, take it easy and avoid strenuous activities. Drains to help remove extra fluids will be removed when they're no longer needed. Wear loose clothing to help with comfort. As the months go by, you can start getting back into your usual routine and exercise. Although you'll have scars, they will fade.

Moving forward

If you're considering breast reconstruction following a mastectomy, autologous tissue transfer is an alternative to breast implants, even though the surgery might be more involved. As always, when considering plastic surgery, it's vital to speak with an ASPS Member Surgeon who is experienced in the specific procedure you're interested in.

To find a qualified plastic surgeon for any cosmetic or reconstructive procedure, consult a member of the American Society of Plastic Surgeons. All ASPS members are board certified by the American Board of Plastic Surgery, have completed an accredited plastic surgery training program, practice in accredited facilities and follow strict standards of safety and ethics. Find an ASPS member in your area.