Advances in breast reconstruction surgery

If you or someone you know is considering breast reconstruction surgery following a lumpectomy or mastectomy, it’s important to know what options are available. While silicone and saline breast implants are an option, breast reconstruction surgery has advanced tremendously in recent years to include natural ways to rebuild the shape and look of the breast.

Oncoplastic breast surgery

This is a combination of operations performed by a breast surgeon and a plastic surgeon. At the same time a patient is undergoing a lumpectomy, where a breast surgeon removes a cancerous tumor, a plastic surgeon will use remaining tissue, the nipple and areola to immediately reshape and restore the natural appearance of the breast. The plastic surgeon will also modify the opposite breast to create an even look. This procedure could be a good option for women who are also candidates for a breast reduction or breast lift.

Microvascular free flap options

Following a mastectomy, a patient can choose to have an entire breast reconstructed with their natural tissue. Plastic surgeons can transfer tissue from other areas of the body to the breast. Historically, surgeons would take skin, fat and muscle from the upper back to reconstruct the breast. This is known as latissimus flap reconstruction surgery. Alternately, plastic surgeons can transfer skin, fat and muscle from the rectus, or ‘six pack’ muscle, from the lower belly to reconstruct the breast. This is TRAM flap reconstruction surgery.

However, surgeons now use the latissimus and TRAM flaps surgeries less in favor of more modern reconstructive options. These more advanced options keep the muscles associated with those two procedures intact.

One such option is the deep inferior epigastric perforator artery, or DIEP, flap technique. Plastic surgeons transfer the necessary skin, tissue (no muscle) and tiny blood vessels from a patient’s abdomen to form a new breast. Many women choose this option because of the tummy tuck benefit since excess skin and fat from the belly is removed.

Fat grafting

Liposuction can remove excess fat deposits from areas like a patient’s flanks (the area between your ribs and hip) or thighs. In the operating room, plastic surgeons purify the fat and carefully inject it into the breast to enhance the appearance of a reconstruction or in some cases to make an entire breast.

As we discuss your options, it’s also important to shed light on the “Go Flat” movement. Women eligible for reconstruction but disinterested in additional surgeries, or the idea of reconstruction in general, embrace the idea of wearing their mastectomy scars with pride.

Your surgeon should review your medical history and overall health, and explain which reconstructive options might be best for you based on your age, health, body type, lifestyle and other factors. Your surgeon should explain the limits, risks, and benefits of each option.

Deciding whether or not to have breast reconstructive surgery following cancer treatment is a very personal choice. Find a surgeon you feel comfortable with, and talk openly about any concerns and preferences you may have.


Singh_DevinderLuther Holton, MDDrs. Devinder Singh and Tripp Holton are plastic surgeons at Anne Arundel Medical Group (AAMG) Plastic Surgery and specialize in breast reconstruction including microvascular surgery at Anne Arundel Medical Center. You can reach their office at 443-481-3400 or


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