Women face many choices when it comes to their breast cancer treatment, and one of the most important ones is what type of breast reconstruction surgery to have after mastectomy. Two reconstructive techniques available to women are implant reconstruction or autologous reconstruction (free flap), which uses your body’s own tissue to build natural-looking breasts.
When deciding which surgery is best for you, one option to consider is free flap reconstruction with ReSensation that results in a natural-looking breast while also giving you the opportunity to potentially restore sensation.
Autologous breast reconstruction uses natural tissue to create warm, soft breast mounds after mastectomy.
... patients who have autologous reconstruction felt greater satisfaction, as well as had improved psychosocial well-being.
One of the most difficult things women face after mastectomy is the loss of feeling in their breasts.
... losing sensation can be a shocking blow that affects her emotional well-being ...
How is autologous breast reconstruction performed?
Autologous breast reconstruction, also called free flap reconstruction, uses natural tissue to create warm, soft breast mounds after mastectomy. The most commonly performed autologous flap surgery today is the DIEP (deep inferior epigastric perforator) flap.1 Considered one of the most advanced forms of reconstruction, the DIEP flap uses abdominal skin, fat and tiny blood vessels called “perforators” to create a new breast mound. DIEP is a form of free flap surgery, since the tissue is completely removed from the belly and relocated to the chest. Since skin and fat tissue but not muscle are harvested, women are at lower risk of experiencing abdominal weakness after surgery.2 A SIEA (superficial inferior epigastric artery) flap is a similar procedure to the DIEP, using the same tissue but different blood vessels.
Reasons women choose free flap breast reconstruction
When it comes to choosing the type of breast reconstruction you will have – or whether to reconstruct your breasts at all – there’s not necessarily a quick and easy decision. Most women have reconstruction using breast implants1, but studies indicate there are many reasons women may want to consider free flap reconstruction.
Research has shown patients who have autologous reconstruction felt greater satisfaction with their breasts, as well as had improved psychosocial well-being and sexual well-being, compared to patients who had implants.3,4 Other reasons to consider autologous reconstruction include:
Uses own tissue. Since it is made of your own tissue and fat, the flap results in a breast that looks and moves more naturally than an implant. The reconstructed breast will also age and change with your body.5
Avoid long-term implant issues. Breast implants are not lifetime devices, and the longer you have them, the more likely it is that complications will occur and the implants will need to be removed, according to the FDA.6 While autologous flap procedures like the DIEP flap can be more intensive, a review of studies conducted between 2000 and 2012 suggests implants have a higher risk of surgical-site infection and reconstructive failure that could result in follow-up surgery.7
May create “tummy tuck” effect. Since several types of flaps take tissue from the abdomen, women may end up with a flatter belly after it’s all over. Some liken this to having a tummy tuck.
Another consideration with free flap breast reconstruction
One of the most difficult things women face after mastectomy is the loss of feeling in their breasts. During a mastectomy, the nerves that bring sensation to the breast are severed when tissue is removed, which can lead to permanent numbness. Whether a woman underwent mastectomy as part of her breast cancer treatment or as a prophylactic step, losing sensation can be a shocking blow that affects her emotional well-being, intimacy and body image.8
Women now have the option to potentially restore feeling to their chest area with ReSensation, a breast nerve repair technique developed by AxoGen, a global leader in peripheral nerve regeneration and repair. ReSensation uses allograft nerve tissue to reconnect the nerves in the chest with those in the flap. Over time, this guides regrowth of nerve fibers and can lead to sensory restoration.
ReSensation can only be performed during free flap reconstructions – not implants. ReSensation can be performed during an immediate or a delayed free flap reconstruction, including women who previously had implants, are having them removed and undergoing autologous breast reconstruction.
Making the breast reconstruction decision
When making reconstructive surgery recommendations, surgeons will take into account many factors, including: a woman’s body type (such as whether there is enough tissue in the abdomen for use in forming a flap) and previous surgeries that may have impacted the blood vessels or nerves in the abdomen or chest area.
In addition, women should be aware that each type of surgery has its own set of risks and benefits. For example, compared to implant surgery, free flap surgery is generally more intensive, has a longer recovery time and requires a surgeon with specialized skills in microsurgery.9
It’s also important for women to keep in mind that not all plastic surgeons know how to do autologous flap techniques, and some only do certain types of autologous surgeries but not others. A few but growing number of plastic surgeons perform ReSensation with autologous flap surgeries. Click here to learn more about the procedure and to find a ReSensation provider near you.
Expanding the Scope of Breast Reconstruction to Include Sensation: An Interview with Dr. Warren Ellsworth
We’ve started trying to restore sensation for women who are undergoing breast reconstruction using their own (autologous) tissue. I most commonly do this during DIEP flap reconstruction, which is when I take skin and fat from the abdomen to create new breasts. I form the abdominal tissue into a flap and move it to the […]Read More
Dr. Jules Walters, a board-certified plastic surgeon in New Orleans, was not satisfied that his breast reconstruction patients had to deal with a lifetime of numb breasts. Wanting to find a solution, he began incorporating ReSensationSM into free flap breast reconstruction. “I want to offer women the chance to not just have reconstructed breasts, but […]Read More
After a mastectomy, many women feel relieved to be cancer-free and look forward to focusing on their future and simply enjoying life. But with this new chapter comes more decisions, including whether to have breast reconstruction. By having a full understanding of the many breast reconstruction options available, and choosing a plastic surgeon who offers […]Read More
Ensuring Women Know About All of Their Breast Reconstruction Choices: A Conversation with Dr. Kamran Khoobehi
With over 20 years of experience as a plastic surgeon, Dr. Kamran Khoobehi has distinguished himself with his aesthetic and reconstructive results – including performing an eyelid reattachment surgery. To save the sight of a young woman injured by a dog bite, Khoobehi operated for six hours under magnification to reconnect the delicate skin, connective […]Read More