Autologous breast reconstruction
Autologous breast reconstruction, also known as autogenous reconstruction, forms a breast shape by using tissue from another location on the body. The tissue used, known as a ‘flap’, is typically fat or skin, and sometimes muscle. It is normally taken from the back (LD flap), belly (DIEP flap), inner thighs (TMG flap) or buttocks.
Autologous breast reconstruction is sometimes also known as autogenous reconstruction. It uses tissue known as a flap, taken from another location on the body, to form a breast shape. This tissue is usually skin or fat, but can also be from muscle. It is normally taken from areas such as the back (LD flap), belly (DIEP flap), inner thighs (TMG flap) or buttocks.
This tissue, used as a “free flap” can be removed entirely from its original blood vessels before it is moved to a new location in the chest. Alternatively, the tissue is moved under the skin to the chest, remaining attached to its blood vessels. This type of flap is known as a “pedicled flap”. Pedicled flaps is a type of surgical technique which has been performed for a longer period of time than free flaps. They are recognised as being easier to perform because the free flap process involves microsurgery in order to attach the vessels in the chest to the tissue flap itself and ensure that there is sufficient blood flow to the newly formed breast. Pedicled flaps are typically more widely available than free flaps.
Autologous breast reconstruction offers the benefits of using personal tissue which ages naturally and changes minimally. Choosing the best location as a donor site is crucial to the decision-making process which precedes an autologous breast reconstruction. The Breastclinik provides an expert consultancy which includes examinations and discussions pertaining to the various surgical options available.
Breast reconstruction involves the complete separation of the tissue from its original blood vessels before it is moved to a new location on the chest. This is typically known as a ‘free flap’. An alternative method keeps the original blood cells attached to the tissue and moves it under the skin to the chest. This is known as a ‘pedicled flap’. The tissue is then shaped and stitched into place.
Treatments can be undergone at the same time as mastectomy, at a later date after mastectomy, or as part of a staged approach which undertakes some of the reconstruction at the same time as a mastectomy, and leaves some of the reconstruction until a later date.
An anaesthetist will be on hand to discuss the chosen form of anaesthesia with the patient prior to entering the operating room. Patients will typically not eat or drink for a period of six hours before the operation.
Later surgery for the purpose of making adjustments is entirely normal in the case of autologous breast reconstruction. This is referred to as ‘finishing work’, and can involve nipple reconstruction, repositioning of an implant or removing the donor site’s extra fat. Some of these adjustments might not be seen as essential, and it is advised that the surgeon and patient talk through adjustment options together so that preferences can be determined.
As with any form of surgery, autologous breast reconstruction poses potential risks. These can include bleeding, loss of breast sensation and the need for revision surgery.
Although there are low rates of complications which follow autologous breast reconstruction surgery, it should be noted that there is the involvement of two surgical sites – the breast area, and the ‘donor’ site which the tissue comes from. General surgical complications can also include delayed healing of wounds and scar sensitivity.
It can take two weeks before normal daily activities can be resumed following autologous breast reconstruction. For some patients, full exercise is not possible for several months.
It should be remembered that while healing from autologous breast reconstruction surgery there will be at least two areas of the body which are healing concurrently – including the reconstructed breast and the donor tissue site. The presence of multiple surgical sites means extra care should be taken in recovery. This is augmented when women have additional incisions made due to an axillary node dissection or sentinel node biopsy performed at the same time.
How long will I need to wear a post-op bra?
The amount of time a post-op, soft supportive bra is worn for will vary from individual to individual. While some women will not wear a post-op bra, for others it is necessary for four to six weeks after surgery, especially in the case of wound healing complications.
When can I drive following autologous breast reconstruction?
Driving can be resumed when any drainage tubes have been taken out, and when you have come off any prescription pain medication which was being taken after the operation. Your arms should also have significantly regained their range of motion before getting back behind the wheel.
Elena is an award-winning cosmetic surgeon who has gained international recognition for her work. She offers patients the advantages of an empathetic female consultant in several UK locations; including London, Bristol and Sussex. The Breastclinik is known for the cutting-edge techniques which it uses, as well as the unmatched level of aftercare which it provides.
The total cost of the surgery will be confirmed after the first consultation.
The cost includes the hospital, surgeon and anaesthetic fees. It also covers all post-operative visits. The initial consultation fee will be invoiced separately. The prices apply only at the time of publication and are subject to changes without notification.
Surgery costs from £10,000 for a single breast and £15,000 for both breasts.
Initial consultation fee £150
Surgery details
Anaesthetic: General
Follow up: 1,4,12 weeks 6,12 months
Final result: 3-12 months
Surgical time: 4-8 hours
Recovery time: 2-6 weeks