Reconstruction using your own tissues

Patients can choose to use their own tissues for breast reconstruction if they have excess skin and fat in their abdomen, back, medial thigh or buttocks. Tissue is disconnected with blood vessels from those areas and transferred to the chest (auto-transplantation) where the blood vessels are reconnected under the microscope.

The mostly commonly used site is the abdomen. Taking tissue from the abdomen used to include taking the rectus muscle (six pack muscle) and was called a TRAM flap.TRAM pic


This technique has since evolved and the muscle can be spared. This newer flap is called a DIEP flap (deep inferior epigastric perforator), named after the blood vessels which are used to transplant it.

Muscle sparing tram


Patients who are good candidates for a DIEP flap include

  • Patients at a healthy and stable weight
  • Patients who do not have serious medical conditions
  • Have excess skin and fat below the belly button
  • One or both breasts are being reconstructed
  • Delayed or immediate reconstruction
  • Patients who have had radiation
  • Patients who have rejected breast implants in the past
  • Patients who do not want implants in their body
  • Patients who can afford to recover for 4 weeks

Patients who are poor candidates for a DIEP flap include

  • Obese patients
  • Smokers
  • Patients with serious medical conditions
  • Thin patients who do not have enough tissue below the belly button
  • Patients who cannot afford to recover for 4 weeks

The DIEP flap surgery takes between 5-7 hours for one breast and 6-10 hours for both breasts. The recovery time includes 3-4 days in hospital as well as 4-6 weeks off of work.

For patients who do not have enough abdominal tissues, the back flap (latissimus dorsi flap) can also be considered and is often combined with a breast implant.


For more information on breast reconstruction

Contact us to book an appointment to discuss your breast reconstruction options with Dr. Perry.