Microsurgical Breast
Reconstruction in Ohio

At Midwest Breast & Aesthetic Surgery, we offer the full spectrum of microsurgical reconstruction: from the gold-standard DIEP flap to a range of specialized microsurgical alternatives. Our surgeons will work with you to identify the right technique for you.

What is Natural Tissue Flap Reconstruction?

Natural tissue reconstruction uses your own skin and fat, instead of implants, to recreate the breast following a mastectomy. During microsurgical reconstruction, healthy tissue is transferred from another part of your body, and tiny blood vessels are carefully reconnected under a microscope to restore blood flow.

How We Choose the Right Flap for You

There isn’t a single best flap for every patient. The right procedure depends on your anatomy, previous surgeries, available donor tissue, cancer treatment history, and reconstructive goals.

Factors That Influence the Right Flap for You

  • Available tissue in the abdomen, thighs, or buttocks
  • Previous abdominal or other donor-site surgeries
  • Whether reconstruction is unilateral or bilateral
  • Desired breast size and symmetry
  • Overall health and recovery considerations

Our goal is to recommend the option that provides the safest procedure and the most natural long-term result for your body.

Doctor

Microsurgical
Reconstruction Options

For patients requiring single-breast reconstruction but with limited abdominal tissue, or those needing a larger reconstruction to achieve symmetry, the stacked DIEP flap is the ideal solution. While the tissue harvested is the same as in a standard bilateral DIEP flap, the stacked DIEP flap uses both the right and left halves of abdominal tissue to reconstruct a single breast.

This technique is best suited for patients seeking single-breast reconstruction, improved symmetry, or those needing additional volume.

The Superior Gluteal Artery Perforator (SGAP) flap transfers skin and fat from the upper third of the buttock while preserving the underlying muscle.

This is ideal for patients without suitable abdominal tissue or those with adequate upper buttock tissue.

The Profunda Artery Perforator (PAP) flap uses skin and fat from the upper inner thigh, providing another fully muscle-sparing option for patients who aren’t candidates for abdominal reconstruction.

For patients with suitable thigh tissue or those wanting a muscle-preserving alternative, the PAP flap may be an ideal choice.

The Transverse Upper Gracilis (TUG) flap uses skin, fat, and a small portion of the gracilis muscle from the upper inner thigh. While it involves a small amount of muscle transfer, it remains an effective option for carefully selected patients.

This is best suited for patients with limited abdominal tissue and adequate upper thigh tissue.

While the DIEP flap uses only skin and fat from the lower abdomen, the TRAM flap uses skin, fat, and abdominal muscle with a pedicle flap. This can be done as a pedicle flap, which leaves some muscle attached, or a free flap, which fully cuts and detaches the muscle.

When abdominal tissue is unavailable, the Gluteal Artery Perforator (GAP) flap uses tissue from the buttocks. It is an excellent alternative for patients with inadequate fat and tissue in the abdominal area.

Breast

When Non-Microsurgical Flaps May Be Recommended

While microsurgical perforator flaps are our preferred approach whenever appropriate, some patients may benefit from traditional flap techniques based on their anatomy or surgical history. Latissimus Dorsi Flap — harvests skin, fat, and muscle from the upper back to reconstruct the breast Pedicled Transverse Rectus Abdominis Myocutaneous (TRAM) Flap — harvests skin, fat, and abdominal muscle from the lower abdomen; transferred while remaining partially attached to its original blood supply While these techniques are less complex since they do not require microsurgical vessel reconnection, they involve the transfer of muscle tissue, which carries a higher risk of donor site complications. Our surgeons recommend these options selectively, and only when more advanced techniques are not suitable.

Recovery Timeline

First Few Days

Expect to stay in the hospital for 3 to 4 days for monitoring.

Weeks 1-2

Surgical drains remain in place to prevent fluid buildup. Patients must avoid putting any direct body weight or pressure on the incisions

Weeks 3-6

Patients wear medical compression garments to minimize swelling and support the donor site. Short, frequent walks are encouraged to boost blood circulation.

Months 2-12

Sensation in the operated area may slowly return over 6 to 12 months, often starting as a tingling feeling. Most patients return to light desk work and low-impact exercise if cleared by the surgical team.

Long-Term Results

Because microsurgical reconstruction uses your own living tissue, results are designed to be long-lasting and continue to age naturally with your body. Many patients appreciate the natural softness, warmth, and appearance that develop as healing progresses.

Frequently Asked Questions

Yes. Many patients can still undergo microsurgical reconstruction after radiation, although your treatment history may influence the timing and the flap that’s recommended.

Recovery varies depending on the procedure performed and your individual healing process. Most patients gradually return to normal activities over several weeks while continuing to heal and regain strength over the following months.

Yes. Scars are expected at both the reconstructed breast and the donor site, but they typically soften and fade over time as they mature. Your surgeon will discuss incision placement during your consultation.

Because the reconstruction uses your own living tissue, results are designed to be long-lasting and continue to age naturally with your body over time.

In many cases, yes. Most health plans that cover mastectomy also cover breast reconstruction under the Women’s Health and Cancer Rights Act, though coverage varies by plan.

*This page is for educational purposes only and is not a substitute for a consultation with a board-certified surgeon. Every patient is unique, and treatment recommendations and results vary. We encourage you to schedule a consultation with our team to discuss your options.

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