There are several ways to reconstruct the breast after mastectomy for breast cancer. The two main categories are 1. Implant (silicone gel, tissue expansion, saline) 2. Autologous Tissue (your own body tissues). There are advantages and disadvantages with both types, however, as reconstructive plastic surgeons, we have a bias toward using your own natural tissues (Autologous Tissue) to create the most natural and long lasting breast mound. Plastic Surgery has evolved now to the point where we can take blocks of tissue from another part of the body and "transplant" them elsewhere to reconstruct another part. This ability to move these blocks of tissue hinges specifically on the ability of the surgeon to transplant this block of tissue on blood vessles and nerves, and "reconnecting" them to the new area. This is very similar to the concept of organ transplanation where the kidney or heart is reconnected to the body on their main blood vessels.
Microsurgical Breast Reconstruction is a technique that has become available in the past 20 years, and recently further refined by dedicated plastic surgeons to move highly specific blocks of tissue (mainly abdominal, butocks, and thigh--skin and fat--on an artery and vein), and transplant them to the breast area. Because of the technical expertise required to perform this operation, only a few plastic surgeons perform these operations on a regular basis.
This has created a demand to find surgeons who can provide optimal outcomes for breast reconstruction.
Microsurgical breast reconstruction has become synonymous now with the terms DIEP flap, SIEA, GAP, and TUG flaps. These are "perforator" flaps which are technical terms for the same concept of "transplanting" tissue blocks.