In autologous reconstruction we use the patients own tissue to reconstruct one or both breasts. In our plastic surgery center the DIEP flap is the golden standard for autologous breast reconstruction. It has the most consistent blood supply and can be combined with a cosmetic procedure: a tummy tuck or abdominoplasty to provide own tissue. The DIEP flap uses fat and cutaneous to reconstruct the breast and it is not necessary to sacrifice muscle or fascia. It is a micro vascular procedure done with microsurgery under the operating microscope. The tissue is reshaped to adjust to the size and shape of the breast and the abdomen is closed as in a cosmetic tummy tuck procedure.

Other flaps that we utilise should there not be sufficient abdominal tissue are gluteal flaps and flaps from the inner thigh. The flap from the inner thigh can be compared to a thigh lift procedure. We do use local and nearby fasciocutaneous flaps often based on a skin perforator if indicated. In patients with very large breasts we sometimes use a skin reduction technique with deepithelialised flaps to reconstruct the breast. Fat grafting alone in a delayed setting can be used for reconstruction, but multiple procedures are necessary.