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Breast Flap Reconstruction

We offer the latest options for flap surgery, which uses your body’s own tissue to rebuild your breast at the time of or after mastectomy.

Breast flap reconstruction offers an alternative to breast implants for women who have a history of radiation, want their reconstructed breast to match their unaffected breast or do not want an implant. During breast flap reconstruction procedures, we harvest tissue from your abdomen or thighs and use this to create a new breast mound, replacing the tissue that we remove during a mastectomy.

In addition to standalone breast flap and implant procedures, we offer hybrid breast reconstruction, which combines breast flap reconstruction with an implant.

Breast Reconstruction Surgery: What to Know

After a mastectomy or lumpectomy, breast reconstruction surgery has been shown to provide a variety of mental and physical benefits

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Breast reconstruction faq

Breast flap reconstruction: Why choose Henry Ford Health?

  • Integrated care: Plastic surgeons who specialize in breast reconstruction play a crucial role on our breast cancer tumor board. We are the only program in Michigan to include plastic surgeons on the breast cancer team.
  • Expert team: We perform over 250 breast reconstruction procedures every year. Our surgeons help women with breast cancer restore wholeness by using proven approaches for the best possible outcomes.
  • A focus on immediate reconstruction: This is our gold standard. Some women hesitate to have breast reconstruction because of concerns over disfigurement. Research has shown that women who can get breast reconstruction at the time of their cancer surgery experience a minimal change in quality of life, given that they come out of surgery with their reconstructed breast. Our expert team has the microsurgical experience necessary to perform these procedures, and we work to offer immediate reconstruction at the time of cancer surgery to as many women as possible.
  • Personalized treatment plans: If you are having a mastectomy, your surgeon will discuss your options soon after your breast cancer diagnosis. Depending on your goals, body type and other factors, this may include a breast flap surgery, breast implant reconstruction or a hybrid procedure. We consider what’s most important to you and give you all the information, including our treatment recommendations, so you can make an informed decision.
  • The latest procedures: We’re always learning newer and better techniques for breast flap surgery, including robotic-assisted breast reconstruction, providing you with the latest evidence-based options.
  • Streamlined referrals: When necessary, your breast flap reconstruction surgeon can refer you to other services within Henry Ford Health, such as lymphedema therapy.
  • Support throughout your care: Cancer care is a journey. We provide support throughout treatment to help aid your recovery and ensure you can enjoy the highest quality of life.
Heather's Story

Discover how Heather overcame high-risk breast cancer with RECQL gene mutation through innovative DIEP flap reconstruction surgery.

Quality of Life: An Important Part of Cancer Care

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Types of breast flap reconstruction

Each type of breast flap uses tissue taken from your abdomen, back or thigh to reconstruct a new breast mound. The procedures are named for the specific anatomical location where we harvest the tissue.

Abdominal flaps

  • DIEP (deep inferior epigastric artery perforator), including robotic-assisted DIEP
  • SIEA (superficial inferior epigastric artery)
  • TRAM (transverse rectus abdominis myocutaneous)

Back flap

  • Latissimus dorsi

Thigh flaps

  • TUG (transverse upper gracilis)
  • DUG (diagonal upper gracilis)
  • PAP (profunda artery perforator)
  • LTP (lateral thigh perforator)

Learn more about breast flap reconstruction procedures

  • DIEP Flap

    This type of breast flap procedure is also known as muscle-sparing free TRAM. It uses fat and skin from the lower abdomen to reconstruct your breast mound. It uses very little to no muscle, minimizing abdominal weakness.

    DIEP flap reconstruction may be recommended if you:

    • Have had radiation in the past.
    • Have enough abdominal tissue to transplant.
    • Want to use your own body tissue and avoid implants.
    • Can tolerate a longer operation and a longer recovery.

    DIEP flap surgery is not recommended if you:

    • Are on narcotics for chronic pain.
    • Have a history of blood clotting disorders.
    • Are a diabetic with poorly controlled blood sugars. People who have an A1C greater than 7 are not a candidate.
    • Have other complex medical problems.
    • Are an active smoker or marijuana user. These must be stopped within 8 weeks of surgery.
  • Robotic-assisted DIEP flap

    Some women may be candidates for this innovative technique, which offers more precise results, less scarring and a faster recovery. This is based on evaluation of the blood flow on your CT scan. Once you’ve obtained this, ask your provider if you are a candidate. In addition:

    Robotic-assisted DIEP flap reconstruction may be recommended if you:

    • Have had radiation in the past.
    • Have enough abdominal tissue to transplant.
    • Want to use your own body tissue and avoid implants.
    • Can tolerate a longer operation.

    Robotic-assisted DIEP flap surgery is not recommended if you:

    • Are on narcotics for chronic pain.
    • Have a history of blood clotting disorders.
    • Are a diabetic with poorly controlled blood sugars. People who have an A1C greater than 7 are not a candidate.
    • Have other complex medical problems.
    • Are an active smoker or marijuana user. These must be stopped within 8 weeks of surgery.
  • SIEA Flap

    This type of breast flap procedure is similar to the DIEP procedure in that it uses your lower abdominal tissue to create your breast mound. It is also a transplant of tissue like the DIEP flap.

    The major difference is the arteries that supply blood flow to the newly constructed breast mound. In a SIEA flap procedure, these blood vessels are not located as deep in the body. In many cases, these arteries are too small to provide enough blood flow. A woman’s specific anatomy helps to determine whether an SIEA or DIEP flap is the better option, a decision that your surgeon will make during the operation.

    SIEA flap reconstruction may be recommended if you:

    • Have enough abdominal tissue to transplant.
    • Want to use your own body tissue and avoid implants.
    • Can tolerate a longer operation and a longer recovery.

    SIEA flap surgery is not recommended if you:

    • Are on narcotics for chronic pain.
    • Are a diabetic with poorly controlled blood sugars. People who have an A1C greater than 7 are not a candidate.
    • Have other complex medical problems.
    • Are an active smoker or marijuana user. These must be stopped within 8 weeks of surgery.
  • TRAM Flap

    This type of breast flap procedure uses skin, fat and the rectus muscle (six-pack muscle) from the lower abdomen to reconstruct your breast mound. It’s left attached to its base (known as a “pedicled” flap) and tunneled under the skin to the chest.

    Most women will not require the TRAM flap, which has been largely replaced by the DIEP flap procedure.

    TRAM flap reconstruction may be recommended if you:

    • Are not a candidate for the DIEP flap.
    • Have had radiation in the past.
    • Have enough abdominal tissue to transplant.
    • Want to use your own body tissue and avoid implants.
    • Can tolerate a longer operation and a longer recovery.

    TRAM flap surgery is not recommended if you:

    • Are on narcotics for chronic pain.
    • Have had an open gallbladder removal.
    • Are a diabetic with poorly controlled blood sugars. People who have an A1C greater than 7 are not a candidate.
    • Have other complex medical problems.
    • Are an active smoker or marijuana user. These must be stopped within 8 weeks of surgery.
  • Latissimus Dorsi Flap

    During this procedure, your surgeon rotates the latissimus dorsi muscle (one of the largest muscles in the back) to your chest. After it’s rotated, the surgeon will place a tissue expander underneath it. The expander will be filled with saline periodically until the breast is the desired size, at which time it will be exchanged for an implant.

    Latissimus dorsi flap reconstruction may be recommended if you:

    • Have had radiation in the past.
    • Have had a failed breast flap procedure.
    • Don’t have enough tissue to transplant from your abdomen or thighs.
    • Desire to use your own body tissue for breast reconstruction.
    • Are not interested in a longer operation and recovery.

    Latissimus dorsi flap surgery may not be recommended if you are:

    • Are on narcotics for chronic pain.
    • A competitive swimmer, mountain climber or someone who already has inherent shoulder dysfunction
    • Unable to attend weekly or biweekly visits for drain expansion.
    • A diabetic with poorly controlled blood sugars. People who have an A1C greater than 7 are not a candidate.
    • An active smoker or marijuana user. These must be stopped within 8 weeks of surgery.
  • TUG Flap

    This type of breast flap procedure uses skin, fat and muscle from the upper inner thigh to reconstruct your breast mound. It may be used when the abdomen cannot be used as a tissue donation site. It is similar to the DUG flap procedure, with the major differences being the incision’s location and orientation. In a TUG flap procedure, the incision is made laterally across the upper thigh.

    TUG flap reconstruction may be recommended if you:

    • Have had radiation in the past.
    • Do not have enough abdominal tissue to transplant.
    • Have had a previous tummy tuck, DIEP or TRAM procedure.
    • Want to use your own body tissue and avoid implants.
    • Want to use tissue from your thighs instead of your abdomen.
    • Want natural-looking breasts.
    • Can tolerate a longer operation and a longer recovery.

    TUG flap surgery is not recommended if you:

    • Are on narcotics for chronic pain.
    • Are a diabetic with poorly controlled blood sugars. People who have an A1C greater than 7 are not a candidate.
    • Have other complex medical problems.
    • Are an active smoker or marijuana user. These must be stopped within 8 weeks of surgery.
  • DUG Flap

    This type of breast flap procedure uses skin, fat and muscle from the upper inner thigh to reconstruct your breast mound. It may be used when the abdomen cannot be used as a tissue donation site. It is similar to the TUG flap procedure, with the major differences being the incision’s location and orientation. In a DUG flap procedure, the incision is made diagonally down the upper thigh.

    DUG flap reconstruction may be recommended if you:

    • Have had radiation in the past.
    • Do not have enough abdominal tissue to transplant.
    • Have had a previous tummy tuck, DIEP or TRAM procedure.
    • Want to use your own body tissue and avoid implants.
    • Want to use tissue from your thighs instead of your abdomen.
    • Want natural-looking breasts.
    • Can tolerate a longer operation and a longer recovery.

    DUG flap surgery is not recommended if you:

    • Are concerned about a thigh scar that’s visible in a bathing suit.
    • Are on narcotics for chronic pain.
    • Are a diabetic with poorly controlled blood sugars. People who have an A1C greater than 7 are not a candidate.
    • Have other complex medical problems.
    • Are an active smoker or marijuana user. These must be stopped within 8 weeks of surgery.
  • PAP Flap

    This type of breast flap procedure uses skin, fat and other tissue from your thighs to reconstruct your breast mound. Unlike some other flap procedures, this reconstruction doesn’t use any of your muscle. It is similar to the lateral thigh flap (LTP) procedure, with the major difference being the location where we harvest the tissue. In a PAP flap procedure, we transplant tissue from the back of the upper thigh, just below your buttocks, also known as the banana roll.

    PAP flap reconstruction may be recommended if you:

    • Have had radiation in the past.
    • Do not have enough abdominal tissue to transplant.
    • Have had a previous tummy tuck or TRAM.
    • Want to use your own body tissue and avoid implants.
    • Have small or medium-sized breasts.
    • Want natural-looking breasts.
    • Can tolerate a longer operation and a longer recovery.

    PAP flap surgery is not recommended if you:

    • Are on narcotics for chronic pain.
    • Are a diabetic with poorly controlled blood sugars. People who have an A1C greater than 7 are not a candidate.
    • Have other complex medical problems.
    • Are an active smoker or marijuana user. These must be stopped within 8 weeks of surgery.
  • LTP Flap

    This type of breast flap procedures uses skin, fat and tissue from your outer thighs to reconstruct your breast mound. Unlike some other flap procedures, this reconstruction doesn’t use any of your muscle. It is similar to the PAP flap procedure, with the major difference being the location where we harvest the tissue. In an LTP flap procedure, we transplant tissue from the upper outer thigh, also known as the saddlebag area.

    LTP flap reconstruction may be recommended if you:

    • Have had radiation in the past.
    • Do not have enough abdominal tissue to transplant.
    • Have had a previous tummy tuck or TRAM.
    • Want to use your own body tissue and avoid implants.
    • Want natural-looking breasts.
    • Can tolerate a longer operation and a longer recovery.

    LTP flap surgery is not recommended if you:

    • Are concerned about a thigh scar that’s visible in a bathing suit.
    • Are on narcotics for chronic pain.
    • Are a diabetic with poorly controlled blood sugars. People who have an A1C greater than 7 are not a candidate.
    • Have other complex medical problems.
    • Are an active smoker or marijuana user. These must be stopped within 8 weeks of surgery.
Newly diagnosed?

Take the next step. Find a breast cancer expert.

Meet the Breast Cancer Team
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