Why is autologous breast reconstruction better than breast implants?

by David H. Song, MD, Washington Regional Chief, Plastic Surgery
October 16, 2017

Women who have a mastectomy often are concerned with how their breast will look and feel after reconstructive surgery. About 80 percent of women choose to get a breast implant after having breast cancer surgery. While this is a great option for some women, it’s not for everyone.

We offer an alternative to implants – autologous breast reconstruction – which uses tissue from a woman’s own body to reconstruct the breast. Nearly everyone is a candidate for this procedure, and I think it should be the standard of care in breast reconstruction.

How does autologous breast reconstruction work?

Autologous breast reconstruction involves rebuilding the breast using only a patient’s own body parts. No artificial breast implants are involved.

Autologous #breastreconstruction involves rebuilding the #breast using only a patient’s own body parts. via @MedStarWHC

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While there are several types of flap reconstruction for breasts, we use what’s called a DIEP flap. A DIEP flap uses blood vessels in the abdomen called deep inferior epigastric perforators, as well as the skin and fat connected to these blood vessels. We take these blood vessels, skin and fat and transplant them from the abdomen to the chest, molding them to rebuild the breast.

DIEP flap surgery may be done at the same time as a mastectomy or at a later date, depending on what your doctor recommends and what you prefer.

There are very few patients who aren’t good candidates for this procedure. We may not recommend autologous breast reconstruction if a patient has other health problems, such as heart or lung conditions. These conditions may prevent women from being good candidates for breast implants as well. And, of course, a patient needs enough extra skin and fat for us to transplant to the breast. So, for example, a 5-foot-5-inch woman who’s 98 pounds with D-cup breasts likely wouldn’t have enough tissue to borrow from. But aside from these two extreme types of cases, there aren’t any reasons why someone couldn’t consider autologous breast reconstruction. 

It’s important to talk to your doctor about the pros and cons of a breast reconstruction procedure.

Request an appointment with me through our secure online form , or contact me at (202) 444-8751 so we can discuss whether autologous breast reconstruction is right for you.

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How a DIEP flap compares to implants

For a woman who’s had a mastectomy, a DIEP flap is the best option, in my opinion. A DIEP flap results in a nice, supple breast that a woman will have the rest of her life. Breast implants, in contrast, only last 10 to 15 years before needing to be replaced in an additional surgery.

A #DIEPflap results in a nice, supple #breast that a #breastreconstruction patient will have the rest of her life. via @MedStarWHC

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One potential side benefit of DIEP flap surgery is that patients get a sort of “tummy tuck” effect when we take the skin and fat from the abdomen to build their new breasts. If we can’t take enough skin and fat from the tummy to rebuild a patient’s breast, we can take it from the thighs or buttocks if necessary.

Something to keep in mind is that breast implants aren’t compatible with radiation treatments. This means women with artificial breast implants may have issues if they need to have some forms of diagnostic imaging, such as CT scans or X-rays, as well as future cancer treatment with radiation oncology. These are some potentially serious downsides patients should consider before deciding to go with an implant.

There are small chances of complications or failure in DIEP flap surgeries. Patients have a 0.8 percent chance of getting a hernia from transplanting the tissue from the abdomen. And in rare cases—about 1 out of 100 surgeries—the transplant can fail. Both of these are highly dependent on the skillset of the surgeon. That’s why it’s critical for patients who are interested in autologous breast reconstruction to choose a surgeon who has a great deal of experience with the procedure.

Our expertise with autologous breast reconstruction

Dr. Maurice Nahabedian and I have performed more DIEP flap surgeries than anyone else in the region. Between the two of us, we’ve done somewhere between 3,500 and 4,000 of these technically challenging surgeries. The next-closest group to us in terms of the number of surgeries has only done 800 to 900 of these procedures.

Patients from all over the country who have had mastectomies have come here for reconstruction. In fact, after I moved here from Chicago, my first 12 patients were women who followed me from there because they wanted me to complete their reconstructions.

Every body shape is different. That means each breast we reconstruct is going to be just a little different than all the others. We go over the possibilities with each of our patients, walking them through their options and learning the goals they hope to accomplish with their reconstruction. That’s how we personalize our care and ensure women have an outcome they’ll be happy with for the rest of their lives.

I wish no one had to go through breast cancer. But we have options available to rebuild patients’ breasts after the often painful and difficult process of being treated for the disease. Patients may sometimes feel like they’ve lost their femininity after treatment. But we’re able to help restore their senses of self-esteem and womanhood as they take the steps they need to reclaim their lives. If there’s a silver lining to breast cancer and its treatment, it’s that. And I’m glad to be a part of that process for my patients.

Category: Healthy Living     Tags: autologousbreast implantsbreast reconstructionDIEPDIEP flapDr. David Song