Ask the Doctor- Are There Reconstructions that Do Not Require Using Muscles

This week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question: I had a mastectomy in 2009 along with chemotherapy and radiation. I had a consultation with a plastic surgeon in New Brunswick Canada and she gave me the options for reconstruction. At that time, I couldn’t have implants because of the radiation I had.

The only option left, as I remember, was to take a muscle from my back along with fat from my stomach and recreate a breast. I didn’t choose that option because I was scared of removing a muscle from my back and putting it elsewhere.

As I can see in the description of your website, there seems to be surgeries that do not require muscles. Am I right? May I have more information please? I can’t go to your clinic because it is far away but I would like to do more research on this. Thank you very much!

Answer:  Thank you for your question. I agree that your options for reconstruction could be limited in some ways due to your radiation. Implants and radiation are more prone to problems and the results are less likely to be good or permanent. Using your own natural tissue would likely be a better option. Actually your own fatty tissue would be best. Sacrificing important muscles should also NOT be necessary. The fatty tissue from the lower tummy is the most commonly used donor tissue.

If someone doesn’t have enough tummy fatty tissue then we can use fatty tissue from other areas as an alternative. You should ask your surgeons about using your own fat without sacrificing your muscles. The procedure name is DIEP. The DIEP is a procedure using the tummy tissue but not the tummy muscles. Another approach that utilizes the buttock fat without sacrificing the muscle is called the sGAP. That would be the best place to start looking in to the subject. Let me know if you have more questions.

Question:  Thank you very much for taking the time to answer my email!

I appreciate the options you are giving me without sacrificing the muscles of my body. I wasn’t so thrilled about that kind of surgery. As I read your website, I understand that you do that surgery. Do you see good long-term results with DIEP or sGAP?

Answer: Yes. When using your own fatty tissue the long-term results are typically the most natural of all the options. When the process is successfully completed the fatty tissue is living tissue that never deteriorates. In other words the results should be permanent. Implant techniques tend to deteriorate over time due to the fact that the implant is not living tissue. Implants can leak, move out of position or need to be removed secondary to infections.

Also the body can reject them because they are a foreign body. Long term results from techniques that remove or sacrifice important muscles can have long term problems associated with removing the muscle. Furthermore the breast is not made of muscle so muscle should not be needed to make a new natural breast after mastectomy. Every situation is different and perfect results are not guaranteed with any approach. No one technique is best for every individual.

Have a question about breast reconstruction or post-surgical you’d like answered from our surgical team? Just ask!