Flap-based breast reconstructions

Breast cancer reconstruction is generally broken down into two major categories: Implant based and autologous. Both can provide excellent aesthetic results in the well selected patient although the decision ultimately comes down to the patient under the guidance of a reconstructive plastic surgeon. Implant based reconstruction is beyond the scope of this text, rather we will discuss autologous based reconstructive options. Broadly classified, tissue based reconstruction can be categorized as local or free tissue transfer. The general theme is the use of excess or expendable tissue in order to reconstruct breast defects. Studies have shown women are more satisfied with autologous based reconstruction compared to implanted based [1]. In this chapter we will discuss different tissue flap options in the reconstructive plastic surgeons armamentarium, special considerations and how it relates to the oncologic breast surgeon.