Natural Tissue vs. Implant
Reconstruction Comparison

Breast reconstruction is a complex process, and you’ll have many decisions to make on your journey to feeling whole again.

Our procedure comparison chart gives you an overview of the two major types of reconstruction: natural tissue (flap) reconstruction and implant reconstruction. Your personal health and circumstances may make some options more feasible than others, but your personal preferences also matter a great deal. This chart is a great starting point for discussing breast reconstruction with your Friedman Center physician.

Flap Reconstruction

Implant Reconstruction

Immediate or delayed

Either. Flap reconstruction can frequently be done at the same time as a mastectomy (or lumpectomy in the case of partial reconstruction), but it can also occur later.

Either. If tissue expanders are needed, then reconstruction will be done in two stages.

Look & feel of breast

Looks and feels more like a natural breast.

Feels firmer than a natural breast.

Breast volume

Determined by available tissue at donor site.

Based on anotomical considerations and available implant size.

Surgery

Unilateral 4-5 hours, Bilateral 6-10 hours.

Unilateral 3-4 hours, Bilateral 4-6 hours.

Recovery

2-3 days in the hospital;
no heavy lifting for 6-12 weeks.

1-2 days in the hospital;
no heavy lifting for 4-6 weeks.

Tissue expanders needed

Not usually
(although they may be used for hybrid reconstruction).

Sometimes
(for both implant-only and hybrid reconstruction).

Scar placement

Various options on the breast, depending on tumor location and type of mastectomy; there will be scarring at the tissue donor site as well.

Various options on the breast, depending on tumor location and type of mastectomy.

Follow-up procedures

Minor revisions are typically done three months after reconstruction.

Exchange from tissue expander to the permanent implant. Implants may need to be replaced at some point.

Limiting factors

Prior surgery; not enough fat or tissue to create a flap.

Not enough healthy skin to contain the volume of the new breast.

Complications

Very minimal risk of losing flap; risk of partial flap loss; unexpected complications at the donor tissue site.

Potential for infection; hardening of implant; implant leakage.

Considerations

Sensation may be reduced at the donor tissue site; flap procedures have fewer complications than implant procedures; women must have adequate tissue at a donor site to have flap reconstruction.

Shape of breast is restored immediately; not easy to adjust breast volume post-surgery; breast implants feel less natural than breasts reconstructed with your own tissue; implants don't last forever and eventually need to be replaced.

Flap Reconstruction

Immediate or delayed

Either. Flap reconstruction can frequently be done at the same time as a mastectomy (or lumpectomy in the case of partial reconstruction), but it can also occur later.

Look & feel of breast

Looks and feels more like a natural breast.

Breast volume

Determined by available tissue at donor site.

Surgery

Unilateral 4-5 hours, Bilateral 6-10 hours.

Recovery

2-3 days in the hospital;
no heavy lifting for 6-12 weeks.

Tissue expanders needed

Not usually
(although they may be used for hybrid reconstruction).

Scar placement

Various options on the breast, depending on tumor location and type of mastectomy; there will be scarring at the tissue donor site as well.

Follow-up procedures

Minor revisions are typically done three months after reconstruction.

Limiting factors

Prior surgery; not enough fat or tissue to create a flap.

Complications

Very minimal risk of losing flap; risk of partial flap loss; unexpected complications at the donor tissue site.

Considerations

Sensation may be reduced at the donor tissue site; flap procedures have fewer complications than implant procedures; women must have adequate tissue at a donor site to have flap reconstruction.

Implant Reconstruction

Immediate or delayed

Either. If tissue expanders are needed, then reconstruction will be done in two stages.

Look & feel of breast

Feels firmer than a natural breast.

Breast volume

Based on anotomical considerations and available implant size.

Surgery

Unilateral 3-4 hours, Bilateral 4-6 hours.

Recovery

1-2 days in the hospital;
no heavy lifting for 4-6 weeks.

Tissue expanders needed

Sometimes
(for both implant-only and hybrid reconstruction).

Scar placement

Various options on the breast, depending on tumor location and type of mastectomy.

Follow-up procedures

Exchange from tissue expander to the permanent implant. Implants may need to be replaced at some point.

Limiting factors

Not enough healthy skin to contain the volume of the new breast.

Complications

Potential for infection; hardening of implant; implant leakage.

Considerations

Shape of breast is restored immediately; not easy to adjust breast volume post-surgery; breast implants feel less natural than breasts reconstructed with your own tissue; implants don't last forever and eventually need to be replaced.