Instead of having artificial implants inserted, you can have a new breast mound built or constructed using your own tissue. The tissue may come from your abdomen (belly) or buttocks.
Transverse rectus abdominus muscle (TRAM) flap
The surgery also gives you a tummy tuck. During this procedure, one of two muscles from your abdomen, along with skin and fat, is transferred to your mastectomy site.When this tissue is cut free from its original location, it’s called a free flap. Or the tissue can be tunneled under the skin to the breast area. Your surgeon shapes this muscle, skin, and fat into a breast shape, so you may not need an implant. Transferring this tissue also causes a tightening of your stomach. TRAM flaps tend to behave more like the rest of your body tissue, for example, they may change as you gain and lose weight. The procedure itself is more complicated and requires more time in the operating room. This may not be a good choice for women who have back problems because removing stomach muscles can increase stress on the back. If you have this type of surgery, you’ll have a horizontal scar across your lower abdomen plus a scar on your chest.
Gluteal free flap
The free flap is a newer technique in reconstructive surgery. The surgeon removes part of the skin and fat from your buttocks, and grafts it onto the mastectomy site. This is a more complex operation, sometimes requiring two teams of surgeons. One team may remove the flap, and the second prepares the blood vessels. As with a TRAM free flap, its success depends on tissues getting proper nourishment from the blood vessels.
Deep inferior epigastric perforator (DIEP) flap
For this newer procedure, the surgeon detaches blood vessels and surrounding fat and skin in your lower abdomen and moves them to the mastectomy site. Abdominal muscle is left intact, but blood vessels must first be dissected from the muscle.