By Mayo Clinic News Network

Reconstruction with implants

Following a mastectomy, the plastic surgeon begins the reconstruction process by placing a tissue expander beneath the muscles of the chest wall. The patient then receives a series of injections of saline into the expander as an outpatient until the desired breast size is achieved. The expander is then removed and a permanent implant, either silicone or saline, is placed. This procedure can take up 1 year to complete.

Reconstruction with the patient's tissue

Breasts can also be reconstructed using a patient's tissue. Usually the transverse rectus abdominis myocutaneous (TRAM) muscle is used with the overlying abdominal tissue. The TRAM is rotated into position or may require a free flap (a microvascular connection of the vessels) for positioning. Other tissue that can also be used include the latissimus dorsi from the back or the gluteal muscles from the buttocks.

The deep inferior epigastric perforator (DIEP) flap procedure is another option for women who would like a breast mound present immediately after reconstructive surgery. This procedure has several benefits -- a faster recovery period than traditional TRAM flap surgery, no loss of abdominal muscle tone and the "effect" of a tummy tuck because excess tissue is removed from the abdomen to reconstruct the breast.

Reconstruction of the nipple and areola

After initial surgery with either an implant or the patient's tissue, the nipple and areola can be reconstructed. A mound of tissue is made from nearby skin to create a nipple, which is then surrounded by tattooed coloration.