ADVANCES IN BREAST CANCER DIAGNOSIS AND TREATMENT: ESSENTIALS

Advances in breast cancer diagnosis and treatment Essentials_kapak

AUTOLOGOUS BREAST RECONSTRUCTION

Hande Akdeniz1 Gökay Baykara2

1Selçuk Universisty, Faculty of Medicine, Department of Plastic, Reconstructive and Aesthetic Surgery, Konya, Türkiye
2Private Physician, Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara, Türkiye

Akdeniz H, Baykara G. Autologous Breast Reconstruction. In: Citgez B editor. Advances in Breast Cancer Diagnosis and Treatment Essentials. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.209-219.

ABSTRACT

Autologous breast reconstruction has become the preferred method for many surgeons aiming to achieve natural, long-term aesthetic and functional outcomes, particularly in patients with large and ptotic breasts. While implant-based reconstruction offers rapid results, it often falls short in achieving symmetry and long-term durability, especially in the setting of radiotherapy. Autologous techniques, using the patient’s own tissue, provide superior outcomes in terms of contour, softness, and integration with the surrounding tissue. Various donor sites, including the abdomen, gluteal region, and thigh, offer tailored solutions based on individual anatomy and clinical context. Abdominally based flaps such as the TRAM, DIEP, and SIEA?remain the gold standard due to their suitable volume and ability to simultaneously improve abdominal contour. The DIEP flap, in particular, is favored for its muscle-sparing design, which reduces donor site morbidity while maintaining vascular reliability. However, prior abdominal surgeries, including abdominoplasty, may limit flap viability, necessitating alternative options. Gluteal and thigh-based flaps, such as SGAP, IGAP, TUG, and PAP, serve as reliable alternatives, especially in patients unsuited for abdominal tissue harvest. Each flap comes with unique considerations, such as pedicle length, tissue volume, and surgical positioning requirements. Microsurgical advancements have broadened the applicability of free flap transfers, though pedicled flaps remain valuable in certain clinical scenarios?especially when microsurgery is contraindicated. The latissimus dorsi flap, with or without implant augmentation, continues to be a dependable choice. Patient selection, medical optimization, and clear communication of expectations are essential for improving postoperative satisfaction and reducing complications. Additionally, factors such as radiotherapy, obesity, comorbidities, and previous surgical scars must be meticulously considered during surgical planning. Although the breast’s primary function is lactation, its role in body image, sexuality, and psychosocial well-being underscores the importance of reconstruction. Autologous tissue reconstruction offers the most natural and lasting results, contributing significantly to patients’ quality of life after mastectomy.

Keywords: Mammaplasty; Autologous tissue transplantation; Free tissue flaps; Perforator flap; Surgical flaps

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