Types of Breast Reconstruction

There are different types of surgical and non-surgical solutions to breast reconstruction.  Your doctor can help you evaluate which solution may be appropriate for you.

Surgical Solutions

• Implants
  Synthetic breast implants are made of either silicone, saline, or a combination of the two.  They are typically inserted below the breast muscle and form the reconstructed breast.  This method involves the least amount of surgery to accomplish reconstruction.  Implants are often the best option for slim, small-breasted women who do not have a lot of excess tissue in other parts of their bodies to be used to form new breasts.  While a number of articles have been published about the risk of synthetic breast implants, the actual risk is extremely low when the implants are FDA approved and used correctly.
• TRAM Flaps
  TRAM stands for Transverse Rectus Abdominus Myocutaneous flap, referring to the transverse rectus abdominal muscle located in the lower abdomen above the pubic bone.  This option takes skin, fat, muscles and blood vessels from the lower abdomen and tunnels them up the torso into the breast area.  It is a good option for women who have excess abdominal fat.  It doesn't work for slim women who do not have much fat in that area or for those who have significant scarring from previous surgical procedures.  TRAM flaps have the advantage of looking like normal tissue.  For someone touching the reconstructed breast, they also feel like normal tissue, although for the person having the reconstruction, they have little sensation.  TRAM flaps have a positive side effect of accomplishing a "tummy tuck" – removing the excess fat leads to a flatter belly.
• DIEP Flaps
  DIEP (pronounced "deep") stands for Deep Inferior Epigastric Perforator and is similar to the TRAM flap except that it does not involve taking any muscle from the abdominal area.  In this procedure, the tissue is completely detached from the belly and then reattached to the chest area.  Establishing a blood supply – hooking up the blood vessels – is a highly specialized surgery performed by trained microsurgeons, and is not available everywhere.  DIEP flaps also have the advantage of providing a tummy tuck.  Because they do not involve the removal of muscle, most women recover more quickly from the surgery and have a lower risk of losing muscle strength in their abdomen.  It is not an option for women who do not have excess body fat.
• Other Surgical Approaches
  Other breast reconstruction procedures use excess tissue from the buttocks or shoulder areas.

Non-Surgical Solutions

• Prostheses
  Some women prefer not to have reconstructive surgery or decide to delay it.  For those women, external breast prosthesis is an option.  Prostheses come in many shapes, sizes, colors and materials.

Insurance Coverage
Check with your insurance company before you have breast reconstruction surgery.  Coverage for this procedure can vary by company and by plan, or even depend in part on the timing of your surgery.