My Cancer Advisor > Breast Cancer > Experiencing Surgery for Breast Cancer > In the Operating Room: Breast Reconstruction Surgery

In the Operating Room: Breast Reconstruction Surgery

There are many options for breast reconstructive surgery. One of the more popular is the TRAM flap, especially for a woman with excess belly fat or an abdomen that has been stretched out by pregnancy. You end up with a “tummy tuck”; as a fringe benefit of surgery. I like this video because it shows some nice anatomical drawings that explain the operation.

At many Breast Centers, including our own at Johns Hopkins, the TRAM flap has been replaced by the DIEP flap of abdominal tissue. This has the advantage of not taking any of the rectus abdominal muscle and thus decreases the risk of abdominal weakness or hernias.

Here’s more information from

Breast reconstructive surgery is done by an experienced plastic surgeon. This surgery is usually done at the time of total mastectomy or later (within months after mastectomy).

Immediate reconstruction can be done for early-stage (stage I or some stage II) breast cnacers, but it is usually best to wait for reconstruction if the breast cancer is more advanced (stage III or some stage II). Increasingly, a “skin-sparing mastectomy” and temporary breast implants are used as the initial process of breast reconstructive surgery, with the final stages of reconstruction performed after all the cancer treatments are completed. If you are to have a mastectomy and think you will want reconstructive surgery, it is best to discuss your choice with your cancer surgeon and a plastic surgeon before the mastectomy so they can properly plan your treatment, even if the reconstructive surgery will not be done until later.

Reconstructive surgery cannot be done for all types of breast cancer. Women who do not want or cannot have reconstructive surgery can be fitted with a breast prosthesis. This prosthesis is a breast form (made of artificial materials) that you put in your bra to make your breast look natural and balanced.

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3 Comments → “In the Operating Room: Breast Reconstruction Surgery”

  1. Jackie says:

    Thank you for sharing this video. It was fascinating. This procedure is amazing, and the plastic surgeon seems so knowledgeable.

  2. Tuesday says:

    Thanks for writing this post and sharing this informative video. DIEP Flap Breast Reconstruction really is the ideal procedure, where women undergoing mastectomy can wake up with breasts after having breast tissue removed. Not only do the breasts look more natural, but the patient gets the added benefit of a tummy tuck.

    Unfortunately, due to the complexity of this procedure there are fewer surgeons who perform this surgery. Dr Aldona Spiegel is a Board Certified Plastic Surgeon who specializes in Breast Restoration and learned the DIEP Flap method directly from the surgeon credited with its invention, Dr. Robert J. Allen. To learn more about this new technique for reconstructing breast tissue, you can visit the link below.

    Thanks again for sharing.


  3. That video is intense. Thank you for the informative post.

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