The Women’s Health and Cancer Rights Act, signed into law on October 21, 1998, requires group insurance plans that cover mastectomies to also cover breast reconstruction.
Choose the procedure right for your body. Learn about your mastectomy reconstruction options.
Implant Reconstruction (IR)
Reconstruction of the removed breast tissue with a saline or silicone gel breast implant.
Tissue Flap Reconstruction (TF)
Tissue Flap (Autologous) reconstruction of the removed breast tissue utilizing a piece of tissue taken from another part of the patient's body. There are numerous various of tissue flap procedures.
Flat Closure (FC)
The decision not to reconstruct the breast(s) after mastectomy.
Types of Reconstruction
Direct To Implant (DTI)
Immediate reconstruction of the breast with an saline or silicone implant following mastectomy (performed in a single surgery).
Delayed Reconstruction
Delayed reconstruction of the breast utilizing a tissue expander placed under or over the chest muscle to stretch the tissue prior to placement of breast implants (performed in 2 or more surgeries).
Expander Fills
A tissue expander is an empty, expandable implant with a port (a metal or plastic plug, valve, or coil) which allows a surgeon to add increasing amounts of liquid (a salt water solution) over time (generally 2 to 6 months) until the skin is stretched enough to accommodate the preferred size of breast implant.
TRAM Flap
A TRAM (transverse rectus abdominis muscle) flap procedure is when a flap of skin, fat, and all or part of the underlying rectus abdominus (“6-pack”) muscle are used to reconstruct the breast.
DIEP Flap
A DIEP flap (deep inferior epigastric perforators) procedure is when blood vessels, as well as the skin and fat connected to them, are removed from the lower abdomen and transferred to the chest to reconstruct a breast after mastectomy without removing any of the abdominal muscles.
SIEA Flap
A SIEA/SIEP (superficial inferior epigastric artery/perforator) flap procedure is when the SIEA blood vessel that runs under your skin in your lower abdomen, as well as the skin and fat connected to the them, are removed from the lower abdomen and transferred to the chest to reconstruct a breast after mastectomy. While very similar to DIEP flap, SIEA uses a different section of blood vessels in the belly and does not require an incision be made in the layer that covers the rectus abdominis muscle.
Latissimus Dorsi Flap
A Latissimus Dorsi flap procedure is when an oval flap of skin, fat, muscle, and blood vessels from the upper back is moved under the skin around to the chest to rebuild the breast.
TUG Flap
A TUG (transverse upper gracilis) flap procedure is when a flap of skin, fat, muscle, and blood vessels from the upper thigh is used to reconstruct the breast.
GAP Flap
A GAP (gluteal artery perforator) flap procedure is when a section of skin and fat from the upper buttocks/hip (or bottom of the buttocks), as well as a blood vessel that runs through the buttocks, are used to reconstruct the breast. If a patient doesn't have enough extra tissue in their buttock, a "stacked/hybrid" technique may be available, using skin from both buttocks and "stacking" them on top of the other to recreate a single breast.
Recommended by Breastie, Jane.
Reconstruction Techniques
Over The Muscle (OTM)
A form of implant reconstruction utilizing a breast implant placed over the chest muscle. UTM can provide more support and a natural looking result, but requires longer healing time than OTM.
Under The Muscle (UTM)
A form of implant reconstruction utilizing a breast implant placed under the chest muscle. OTM has less healing time than UTM but requires more implant support with a tissue matrix.
Fat Grafting
Fat tissue is removed from other parts of the body by liposuction, processed into liquid and injected into the breast area to recreate the breast or to fix differences in the shape, balance, or position of the reconstructed breast. IR/AR/FC
Resensation
A surgical step that can be performed during autologous breast reconstruction, making it possible to reconnect the nerves to restore sensation after a mastectomy. AR
Fat Grafting
Fat tissue is removed from other parts of the body by liposuction, processed into liquid and injected into the breast area to recreate the breast or to fix differences in the shape, balance, or position of the reconstructed breast. IR/AR/FC
Surgical Materials
FDA Approved Breast Implant Manufacturers
Natrelle | Mentor | Sientra | Ideal IR
Saline Breast Implants
Breast implants filled with saline solution.
Silicone Breast Implants
Breast implants filled with silicone gel.
Gummy Breast Implants
Breast Implants which have a silicone shell and a silicone gel filling.
Smooth Breast Implants
Breast implants with a smooth outer surface.
Textured Breast Implants
Breast implants with a textured outer surface.
Recently, textured implants have been recalled or restricted over safety concerns in several countries because of concerns about a rare cancer, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).
Round Breast Implants
Breast implants with a round shape.
Anatomical Breast Implants
Breast implants with a "natural" teardrop shape.
Alloderm
An acellular dermal matrix used to assist with tissue expander or implant-based breast reconstruction. IR
Revision Surgery
Corrective Breast Reconstruction
Surgery to correct complications after mastectomy; also called "revision." Under the Women’s Health and Cancer Rights Act, mastectomy benefits must cover "Any physical complications at all stages of mastectomy." IR/AR/FC