Natural Tissue vs. Implant Reconstruction Comparison
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
Determined by available tissue at donor site.
Unilateral 3-4 hours, Bilateral 4-6 hours.
Recovery
1-3 days in the hospital;
no heavy lifting for 6-12 weeks.
0-2 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.
Exchange from tissue expander to the permanent implant. Implants may need to be replaced at some point.
Complications
Very minimal risk of losing flap; risk of partial flap loss; unexpected complications at the donor tissue site.
Exchange from tissue expander to the permanent implant. Implants may need to be replaced at some point.
Considerations
Very minimal risk of losing flap; risk of partial flap loss; unexpected complications at the donor tissue site.
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.
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
0-2 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
Exchange from tissue expander to the permanent implant. Implants may need to be replaced at some point.
Complications
Exchange from tissue expander to the permanent implant. Implants may need to be replaced at some point.
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.
